Georgia’s average premium for insurance through the Affordable Care Act exchange is the second-lowest among the 36 states using the federally run marketplace, according to a report released Wednesday. Georgians who qualified for subsidies or discounts for coverage are paying an average of $54 per month, the report said. Their average premium is $341, but they also get the immediate subsidy or tax credit of $287. Only Mississippi, with an average premium of $23 a month, is lower. Nationally, the consumers who selected silver plans, the most popular plan type in the federal exchange, are paying an average premium of $69 per month, counting the tax credits. Georgians picking silver plans pay an average of $39 a month.
The low premiums in Georgia may be largely due to a high number of purchasers having low incomes – and thus are getting substantial subsidies to afford coverage, said Bill Custer, a health insurance expert at Georgia State University. He pointed to the fact that the average premium in Georgia of $341 is just $5 a month lower than the U.S. average. The average subsidy in Georgia for a person qualifying for a subsidy is higher than the national average of $264. That credit in Georgia is subsidizing 84 percent of the original premium. Custer said Georgia may have many people in the exchange who are making just over the federal poverty level, which is about $11,500 for an individual. Just higher than that amount is where the biggest subsidies are.
(Because of the way the health law is designed, there are no subsidies for people lower than the federal poverty level, which is roughly $23,500 for a family of four. The intent of the ACA was that these people, instead of using the exchange, would become eligible for Medicaid as the states expanded their Medicaid programs. But the U.S. Supreme Court has ruled that states don’t have to expand Medicaid. Georgia is one that has not done so, citing the costs.)
Choice of insurers
The federal report, released by the U.S. Department of Health and Human Services, said that overall, 82 percent of people eligible to purchase a qualified health plan could choose from three or more health insurance issuers, and 96 percent could choose from two or more health insurers in the exchange.
“Consumers have more choices, and they’re paying less for their premiums,” said new Health and Human Services Secretary Sylvia Burwell in a statement. “Nearly 7 in 10 consumers who signed up for marketplace coverage are paying $100 or less for that coverage. When there is choice and competition, everybody benefits.”
In Georgia, five insurers are offering coverage in the exchange this year, and that competition is heaviest in metro Atlanta. But in two regions of southwest Georgia, there’s only one insurer offering coverage –- Blue Cross and Blue Shield of Georgia. And the premiums in that corner of the state are much higher than in the rest of Georgia. GHN reported last week, though, that UnitedHealthcare is considering entering the Georgia exchange for the 2015 plan year.
“Competition matters,” Custer said. “Premiums are much lower where there’s much competition.”
Georgia has large regional disparities in premiums, he added.
Cindy Zeldin of Georgians for a Healthy Future, a proponent of the ACA, said, “It’s exciting that many Georgians who were uninsured in the past now have coverage.”
“It will be important to get educational information out in communities so that consumers who haven’t had health insurance in the past have solid information about how their plans work, what is covered and what is not, and what their rights are as a consumer,” Zeldin said.
“It will also be important to monitor the adequacy of the provider networks that insurers have put together to ensure that consumers have reasonable access to all of the covered services in their plan,” she added.
The federal report did not include data on the premiums paid in the 14 states running their own exchanges, nor on each insurer’s enrollment numbers. It also did not include what percentage of the 8 million people who signed up for coverage are actually paying their premiums – an area on which Republican critics of the health law have focused attention.