ACA enrollment tops 587,000 in Ga., but insurers nervous over signup rules

More than 580,000 Georgians signed up for coverage in the insurance exchange during the third open enrollment for the Affordable Care Act, federal health officials said Thursday.

The total of 587,845 during the signup period, which ended Jan. 31, was a 9 percent increase over last year’s Georgia total of 536,929 at the end of open enrollment.

Nationally, more than 12 million Americans selected plans, federal health officials said adding that  4 million new consumers enrolled in the 38 states – including Georgia — that used the federally run exchange.

Sylvia Burwell
Sylvia Burwell

“Open Enrollment for 2016 is over, and we are happy to report it was a success,” U.S. Department of Health and Human Services Secretary Sylvia Burwell said in a statement. “The [exchange] is growing and getting stronger, and the ACA has become a crucial part of health care in America.”

The large majority of  Georgia enrollees came in the Atlanta metro media market, with 443,720 signed up. That was followed by the Savannah media market, with 48,549; Augusta, 33,718; Macon, 24,095; Columbus, 20,961; and Albany, 17,339.

(Note: Media market numbers sometimes go across state lines.)

Cindy Zeldin of Georgians for a Healthy Future said the enrollment numbers “show that the health insurance options available to Georgia consumers are meeting an important need.”

“Having meaningful coverage choices, access to financial help, and enrollment assisters available who could help consumers make sense of their options all led to robust enrollment,’’ Zeldin added.

Georgia’s enrollment total trailed that of Florida, Texas and North Carolina among states using the federally run exchange.


The highest rates of growth from last year’s open enrollment were in Oregon (31 percent), Utah (25 percent), Iowa (22 percent), South Dakota (22 percent) and Nevada (20 percent).

The news of the enrollment increases, though, follows recent criticism of the exchanges by national health insurers.

Aetna said Monday that it has been struggling with customers who sign up for coverage outside the ACA’s annual enrollment window and then use a lot of medical care, the Associated Press reported. This dumps claims on the insurer without providing enough premium revenue to counter those costs, the AP article noted.

The law established that window to prevent people from waiting until they become sick to buy insurance. But insurers say it has become too easy for customers to sign up outside of this window, AP reported.

Consumers are allowed to buy coverage outside that time frame if they lose a job, get divorced or have a child, among other reasons. Insurers want the federal government to take a closer look at whether people actually qualify for these special enrollment periods when they apply for coverage, the article said.

The Centers for Medicare and Medicaid Services recently outlined several changes it said it was making to help shore up exchange enrollment windows.

Anthem, parent company of Blue Cross and Blue Shield of Georgia, also is paying close attention to how the government deals with special enrollment periods as it judges how sustainable the exchange business will be in the future, CEO Joseph Swedish said recently.

UnitedHealth Group has already said it will decide this year whether to participate in the exchanges next year.

And Kaiser Health News reported that in recent days, major insurers including Anthem, stung by financial losses, told brokers they will stop paying them sales commissions to sign up most customers who qualify for new coverage outside the normal enrollment period, according to the companies and broker documents.

That has occurred in Georgia as well, documents obtained by GHN indicate.

Some health insurers have told Georgia agents that they will not pay commissions on new individual health insurance policies, on or off the exchange, from a period that starts soon and lasts for the end of the year, the documents say.