Alice Jaye has not had health insurance for years.
Though the Colquitt resident has a restaurant job, it does not pay that much and does not offer coverage.
Jaye has high blood pressure, and recently went to a hospital emergency room to get care. Now she’s stuck with a big ER bill that she’s paying off at the rate of $10 a month.
What about the insurance offered on the Affordable Care Act exchange?
“I didn’t know anything about it,” said Jaye, explaining why she didn’t sign up to get coverage this year.
But with the help of a navigator, or insurance counselor, Jaye, 52, has signed up for coverage in the ACA exchange’s second year, with a Jan. 1 start date.
“I’m glad there’s something for people of low income,’’ said Jaye. “I really needed health insurance.”
Jaye lives in the southwest corner of the state – a region that had extremely high premiums for exchange coverage in the first year of enrollment.
Southwest Georgia gained national prominence for those insurance rates, which were reported to be the second-highest in the country, behind only ski resort areas of Colorado.
Monday at midnight was the deadline for people to sign up for an ACA health plan that will begin Jan. 1, 2015. (Open enrollment will continue till Feb. 15 for plans that would take effect later.)
With the hours ticking away till the Monday deadline, insurance counselors said ACA coverage appears to be picking up more interest from southwest Georgia residents like Jaye, who would be joining the exchange for the first time.
Others who currently have ACA coverage are generally re-enrolling in the same health plan, insurance experts said.
Lower premiums for the region
This time around, though, the region is seeing significantly lower premiums.
The Albany area of southwest Georgia will have a 23 percent drop for the second-lowest silver plan, according to Bill Custer, a health insurance expert at Georgia State University.
During the last enrollment period, only one health insurer offered coverage in the southwest Georgia ACA marketplace. This time, three other insurers have joined Blue Cross and Blue Shield of Georgia in offering exchange plans statewide: UnitedHealthcare, Time Insurance Co. and Coventry.
Lack of insurance competition was one factor in the 2014 high premiums in southwest Georgia, Custer said. He also cited the lack of health care competition – the Albany area is dominated by Phoebe Putney Health System – and the fact that the population in the area tends to be less healthy than in other regions.
A map of exchange enrollment in Georgia in 2014 shows generally low participation rates in rural Southwest Georgia, even though these counties have high percentages of uninsured residents.
Custer also predicted that the region should see an overall increase in people getting coverage even outside of the insurance exchange. That’s because the exchange premiums help set the non-exchange rates, he said.
State and regional ACA enrollment numbers are not yet available for the open enrollment period, which began Nov. 15.
People who assist consumers in signing up for exchange coverage – including navigators, certified application counselors and others – say that the people they’ve helped are roughly split 50/50 between re-enrollers and new candidates.
Sheila Freeman of Spring Creek Health Cooperative in Colquitt, which works with the Seedco navigator organization, says, “We’re staying very, very busy.”
The majority of re-enrollers are staying with the same plan,’’ said Freeman, although she added, “People like the idea they have more choices.’’
In addition, the website healthcare.gov is working much more smoothly this time around.
Dante McKay of Enroll America said Monday that during the first year of coverage, many residents of southwest Georgia found that they were in the “coverage gap.” That means they were not eligible for Medicaid, and did not make enough income to qualify for subsidies in the exchange.
That’s true across Georgia, which has not expanded Medicaid under the ACA.
Still, McKay said he hoped Year 2 of open enrollment would increase the state’s total of 316,000 ACA signups during the first year.
‘We’re booked solid’
Monica Posey, a navigator with Spring Creek, noted that for many re-enrollers, premiums have gone down, but so have their tax credits, or subsidies.
There’s consumer interest in the higher tax penalty for those who don’t obtain insurance, Posey said. That penalty will rise to $325 per adult or 2 percent of income, whichever is greater, if a consumer remains uninsured in 2015.
Demand for getting signup assistance is high, she said. “We’re booked solid,’’ Posey said late last week. “They want coverage Jan. 1.”
Russ Childers, a longtime insurance agent in Americus, said, “Last year there were a lot of folks that were nervous, uninformed, worried about the coverage, etc. This year those folks are enrolling.”
April Bush, an application counselor in Blakely, also said many uninsured people are showing more interest this time. “A lot of it is word of mouth, people talking to people who had coverage last year. People realize they need to sign up.”
There are still people who have heard bad things about the ACA, also known as Obamacare, Bush said.
“I just say, ‘It helps everyone have access to coverage.’ ”
Open enrollment is a confusing time for many consumers, whether they’re signing up for employer coverage, Medicare or the ACA exchanges.
Monday’s deadline for the ACA is for people who want coverage Jan. 1. People still have till Feb. 15 to sign up for a health plan and avoid the tax penalty.
Don’t hesitate to seek help if you need it.
You can consult a local insurance broker or agent. Go to http://www.nahu.org/consumer/
Another place to go is healthcare.gov, which has a list of navigators or insurance counselors who can offer free help, as well as health clinics that can assist you. This help is free.
Seedco is supplying navigators for Georgia, and consumers and small business owners can call 1-855-899-6092 for assistance. Community Health Works is also providing navigators.
Or you can call the federal consumer assistance center at 800-318-2596.