More than 650,000 Georgians will be eligible for subsidies in the health insurance exchange, the seventh-highest total in the nation, a new report said...

More than 650,000 Georgians will be eligible for subsidies in the health insurance exchange, the seventh-highest total in the nation, a new report said Tuesday.

A total of 17 million people who are uninsured or who buy their own coverage will be eligible for the discounts, according to the Kaiser Family Foundation analysis.

The biggest number of those people come from Texas, with 2 million; California, with 1.9 million; and Florida, with 1.6 million. Those states have the highest numbers of uninsured residents.

New York has the fourth-highest number eligible for subsidies, with 779,000. Pennsylvania has 715,000, followed by North Carolina, with 684,000 and Georgia, 654,000.

Much recent coverage of the exchange has been negative, focusing on the technical problems plaguing the website, the portal through which millions of Americans are supposed to access these discounts. The government says the problems will be mostly fixed by Nov. 30.

In addition, insurance companies are canceling million of individual policies that don’t meet the minimum standards of coverage required. That has led to charges that President Obama broke his pledge that if people liked their health care coverage, they could keep it. The White House denies deliberately deceiving people, but even some advocates of the ACA say the promise was misleading.

State Insurance Commissioner Ralph Hudgens said an estimated 400,000 Georgians have individual coverage today that doesn’t meet the ACA requirements.

He told GHN last week that some individuals don’t need all the things that the ACA requires to be in health policies. For instance, single men don’t need benefits for children or maternity coverage, he said.

“As I’ve been out in the state, the people I’ve talked to are complaining they’re going to [have to] buy these more expensive, ACA-compliant policies.’’

To qualify for credits in the exchange, consumers must earn between 100 and 400 percent of the poverty level. That’s between about $11,490 and $45,960 for an individual, and between $23,550 and $94,200 annually for a family of four.

Amanda Ptashkin of the consumer advocacy group Georgians for a Healthy Future said Tuesday that many people are looking at the premium price in the exchange without realizing they may be eligible for the discounts.

Ptashkin, a navigator who will help enroll people in the exchange, emphasized that consumers should check out all their options. “Now is not the time to panic. It’s really easy to get scared and confused,’’ she said.

She said many consumers whose coverage is being canceled have “junk policies’’ that lack important benefits.

Some people who face higher premiums through the insurance cancellations currently have policies with “little value,’’ said Bill Custer, a health insurance expert at Georgia State University. That’s because those policies didn’t really protect people from a catastrophic illness, he said.

Consumers paying more will get much better coverage, he said, and won’t face the danger of having their policy dropped due to a health condition. “It’s not [comparing] apples to oranges; it’s comparing apples to earthworms.”

There will be a tradeoff with better benefits, including lower out-of-pocket annual spending limits, Custer said.

“Insurance has always been a complicated issue,’’ Custer said. “Consumers will really have to sift through these changes.”


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Andy Miller

Andy Miller is editor and CEO of Georgia Health News

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