State’s final exchange sign-ups surprisingly high

More than 316,000 Georgians signed up for a health plan in the insurance exchange by the end of the enrollment period – more than doubling the state’s figure at the end of February, the U.S. Department of Health and Human Services announced Thursday.

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Georgia’s 127 percent enrollment growth since March 1 was rivaled by surges in several other states, including Texas’ 149 percent and Florida’s 123 percent, federal officials said.

“The good burst of enrollees at the last minute reflects the number of uninsured in those states,’’ said Bill Custer, a health insurance expert at Georgia State University.

It’s unknown at this point how many of the 316,543 Georgia enrollees have actually paid for coverage.

The final enrollment reporting period for the Affordable Care Act exchange was from Oct. 1 to March 31, but the numbers also include enrollment activity reported through April 19. Federal officials eased the deadline for those who got “in line’’ prior to the cutoff date but reported problems completing the process.

Georgia’s enrollment at the end of February was 139,371.

Overall, about 3.8 million Americans enrolled in the sixth and final reporting period, which began March 2. Most Americans who remained uninsured past the enrollment period face a financial penalty under the ACA.

Federal officials said Thursday that the percentage of enrollees who have paid premiums is not currently available.

Last month, Georgia insurance officials said state insurers received more than 220,000 applications for health coverage in the exchange as of March 31. But Insurance Commissioner Ralph Hudgens said premiums have been received for only 107,581 of those policies, which cover 149,465 people.

Many late enrollees have until April 30 to pay the premium, though insurers have some flexibility on those payment dates.

Of the 36 states using the federal exchange under the ACA, the only ones surpassing Georgia’s final enrollment are Florida, with 983,775; Texas, with 733,757; North Carolina, with  357,584; and Pennsylvania, with 318,077. (Three of these four states are more populous overall than Georgia, and North Carolina has almost as big a population as the Peach State.)

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The Georgia surge comes despite a new study pointing out that Georgia had the least amount of any state spent on consumer enrollment assistance per uninsured person.

Get Covered America, a campaign seeking to educate Americans about their health plan options, called the 316,000 figure “a wonderful milestone.”

“Still, our work is not done,’’ Dante McKay, Get Covered America’s Georgia state director, said in a statement. “We will continue to keep pace with the demand for further education across the state of Georgia as we apply best practices learned during the first open enrollment period to connect even more Georgians to health insurance coverage.”

The HHS report Thursday shows that of the Georgians selecting a health plan whose race or ethnicity is known, 41.4 percent are white, 38.6 percent African-American, 14.8 Asian and 3.6 percent Latino.

Overall enrollment in the exchange surpassed 8 million at the end of the first enrollment period, HHS Secretary Kathleen Sebelius announced. Of those, 28 percent were young adults ages 18 to 34.

That’s an important demographic for health insurers, who say that sufficient numbers of young and healthy adults are needed to offset the financial risk of covering older, sicker individuals.

Georgia had a higher-than-average young enrollee figure, at 32 percent.

Dante McKay
Dante McKay

Female applicants constituted 57 percent of the Georgia total, higher than the national average of 54 percent. And 87 percent qualified for subsidies to help afford the premiums, compared with  85 percent nationally.

Nearly all the Georgians who went on the exchange and were eligible for subsidies signed up for a health plan, Custer said.

He said the 316,000 enrollees were a little less than he expected a year ago, but more than he would have predicted in January, after the technological problems plaguing the  federal exchange website healthcare.gov late last year.

Graham Thompson of the Georgia Association of Health Plans told GHN recently that that the insurance industry recognized that subsidies “would be a tremendous driver of behavior. That has borne true.”

HHS also announced Thursday that more than 4.8 million additional individuals enrolled in Medicaid and CHIP (known as PeachCare in Georgia) through the end of March, compared to enrollment before the exchange opened.

The federal report says 91,914 Georgians – many of them children — were determined to be eligible for Medicare or PeachCare coverage through the exchange enrollment process.

But because of technological snags, it’s not known how many of these Georgians have joined these government insurance programs.

Georgia is one of more than 30 states that used the federal insurance exchange. But unlike roughly half of those states, Georgia is not able to process applicants into Medicaid and their children’s insurance program.

A Department of Community Health spokesman told GHN last month that people have called about enrollment in Medicaid, having been referred from the exchange. But Community Health said it did not have an exact enrollment number from this group.

Separately, a study conducted by researchers from the University of Pennsylvania’s Leonard Davis Institute of Health Economics found that Georgia spent $4.24 per uninsured person for consumer enrollment assistance. All of that money spent here was federal funding — for “navigators“ and community health centers’  help in enrolling individuals. Navigators are specially trained guides for people enrolling in the exchange.

The five states with state/federal partnership exchanges spent an average of $31.53 per uninsured resident for consumer enrollment assistance. The nation’s 16 state-run marketplaces averaged $17.15 per uninsured resident, while the 29 states relying on the federal website spent an average of just $5.42 per uninsured resident.

Given the relative lack of funding in the state, Custer said, Georgia’s final enrollment figure “demonstrates the underlying demand for affordable coverage in Georgia.”

Cindy Zeldin of the consumer group Georgians for a Healthy Future added that the enrollment numbers show “the unmet demand for health insurance was real, and many previously uninsured Georgians now have the peace of mind that comes from knowing they can see a doctor when they get sick.”

The issue of premium payments, meanwhile, has been seized by Republican opponents of the Affordable Care Act, also known as Obamacare.

A report released Wednesday by House Republicans said 67 percent of people who had signed up through federal marketplaces had paid their first month’s premiums as of April 15. That’s far lower than payment rates reported by some individual insurers, which were more in the range of 85 percent or above, the Associated Press reported.

But the insurers told a House committee that people still have time to pay the premium, so committee members will ask for an update by May 20. Committee members nevertheless cited the incomplete data to criticize the law.

“These numbers stand in stark contrast to the White House’s previous assertions,” said House Majority Leader Eric Cantor (R-Va.), according to USA Today. “If President Obama disputes the information provided by the insurance companies, he should direct HHS to immediately release complete enrollment data, including how many people were previously insured.”