You have reached your limit of free articles this month.

Enjoy unlimited access to myAJC.com

Starting at just 99¢ for 8 weeks.

GREAT REASONS TO SUBSCRIBE TODAY!

  • IN-DEPTH REPORTING
  • INTERACTIVE STORYTELLING
  • NEW TOPICS & COVERAGE
  • ePAPER
X

You have read of premium articles.

Get unlimited access to all of our breaking news, in-depth coverage and bonus content- exclusively for subscribers. Starting at just 99¢ for 8 weeks

X

Welcome to myAJC.com

This subscriber-only site gives you exclusive access to breaking news, in-depth coverage, exclusive interactives and bonus content.

You can read free articles of your choice a month that are only available on myAJC.com.

Obamacare exchange hangs on in Georgia; Blue Cross may stay next year


Obamacare in Georgia has survived another day.

The last insurance company to still serve patients on the Affordable Care Act exchange in all regions of the state says it won’t back out, at least not yet.

Blue Cross Blue Shield of Georgia, the only remaining company to serve all 159 counties in the state, has filed its annual plans for next year’s insurance market. In its initial filing, it submitted plans for the entire state, said spokeswoman Debbie Diamond. Big questions remain, however, including how much the company will charge.

» MORE COVERAGE: The latest on healthcare in Georgia

Without Blue Cross, 96 counties in Georgia would have no insurance plan on the exchange. Other private insurance would still be available, but it wouldn’t be subsidized for the lower-income patients like exchange plans are.

Companies across the nation have been wavering on their participation, and this spring some analysts roiled the markets saying Anthem, the parent company of Blue Cross Blue Shield of Georgia, was leaning toward pulling back.

“Oh wow,” a relieved Kirk Lyman-Barner said on hearing Friday’s news from a reporter. An insurance broker in Sumter County, Lyman-Barner’s clients are mostly low-income patients on the Obamacare exchange and would be unable to afford private insurance if Blue Cross withdrew from the subsidized market, he said. “That was my biggest fear.”

But this is hardly the end of uncertainty for rural patients.

Leaders in Congress and President Trump are working to repeal Obamacare altogether. It’s unclear how those efforts will proceed. The bill passed by the House has yet to be sent to the Senate and the Congressional Budget Office has yet to provide an estimate of its impact. 

In the mean time, the Trump administration has broad powers to undermine the exchange, and has used a couple of them. Trump has hinted at endangering some cost-sharing subsidies. And on Monday Trump administration lawyers are scheduled to participate in a hearing defending Obamacare subsidies against Republicans in Congress, but it’s unclear what they’ll say in its defense, if anything.

Even if Obamacare stays in place, Blue Cross’s decision can still change, as negotiations between insurers and the state continue over the coming months.

More immediately, there is the question of rates the company will charge Georgians. The state and Blue Cross will not release the company’s proposed rates until the end of June, when all companies have a deadline to file. If rate increases are too high for people to afford, then that will likely damage the market.

“Ninety-five percent of my clients all receive subsidies, so without that they could not afford it,” said Lyman-Barner.

Several states have seen double-digit rate increases this year. And that’s on top of rates for premiums and deductibles that were already increasing to distressing levels, especially for patients who have incomes of around $50,000 a year and up.

“Some of it’s Obamacare and some of it’s Trumpcare,” said Cynthia Cox, associate director of health reform and private insurance at the Kaiser Family Foundation, a research organization. “In Obamacare the premiums in the first two years came in too low. There weren’t enough healthier young people signing up. Insurance companies have had to raise their rates significantly over the last year or so…It’s a like learning to ride a bicycle, in a market that’s not completely formed.”

Then under Trump, the administration cut funding for advertisements that have been effective in reminding younger, healthier patients to sign up. And there are cost sharing subsidies that the Obama administration paid out that the Trump administration may decide not to. That makes the companies wonder whether to raise prices to prepare for such problems.

“Some are getting cold feet,” Cox said. “Some are leaving, some raising premiums and pricing for that uncertainty.” It wouldn’t be a surprise to also see increases in Georgia premiums, she said.

One way or the other, Lyman-Barner said, the whole community needs for residents to be covered with health insurance. “People will go without getting medical services and treatment that they need if they don’t get covered,” he said. And if they just go to the hospital then the hospital takes on bad debt. “The hospital can only handle so much, it would have put tremendous pressure on all the providers.”



Reader Comments ...


Next Up in Georgia Politics

New council promises results, seeks patience in helping rural Georgia
New council promises results, seeks patience in helping rural Georgia

Members of the newly minted state House Rural Development Council heard a litany of challenges facing the rural parts of Georgia on Monday, as local officials, economists and experts tallied the woes. Rural Georgia is aging rapidly. It is losing population and jobs, it lacks infrastructure and it often struggles to educate its youth. House leaders...
Georgia’s 6th District has added 5,500 voters, with more coming
Georgia’s 6th District has added 5,500 voters, with more coming

More than 5,500 voters have so far been added to the rolls in Georgia’s 6th Congressional District after a federal judge ordered local counties to reopen registration through this past Sunday. The total includes two types of voter: the newly registered, plus so-called “transfer” applications — already registered Georgia voters...
Rural council promises results, asks for patience
Rural council promises results, asks for patience

House Speaker David Ralston on Monday said rural Georgia can’t afford to wait for the next election to find progress and solutions. “Rural Georgia cannot wait on political seasons to come and go because they will always come and go,” the Blue Ridge Republican told the first meeting of the House Rural Development Council. “I...
Problems of rural Georgia easy to find, difficult to fix
Problems of rural Georgia easy to find, difficult to fix

The summer before he graduated high school in 1963, Hasan Hanks helped build what he was certain was the future of his little town on Georgia’s southwestern edge. The Walter F. George Lock and Dam was near completion and would soon form a 45,000-acre lake, with 650 miles of prime shoreline property, and generate enough electricity to power 58...
Will the ‘Ossoff effect’ propel Democrats beyond the 6th District?
Will the ‘Ossoff effect’ propel Democrats beyond the 6th District?

Katie Landsman watched her 11-year-old son embrace Jon Ossoff at his cramped Marietta campaign office. The boy was bawling. He had just learned about the horrors of the Holocaust, she explained, and wanted to meet a young politician who gave him hope. Then she offered a confession. She lives in Acworth, miles outside the 6th Congressional District...
More Stories