For the second straight year, fewer people enrolled in Affordable Care Act insurance plans, both in Georgia and nationwide, according to preliminary numbers released Wednesday by the Trump administration.
The decline in Georgia, where 460,139 people chose an ACA plan by Saturday’s deadline, was bigger than the national decline, with a slide of 4.7 percent compared with just over 4 percent nationwide.
There is a kink in the numbers for Georgia, though: A large swath of the state appears to be eligible for an extension past Saturday, giving them an extra week to sign up. The federal agency that runs the Affordable Care Act, also known as Obamacare, would not say so outright.
But general guidance documents and announcements from the agency, the Centers for Medicare and Medicaid Services, or the CMS, and from the Federal Emergency Management Agency appear to indicate that people who reside or resided during the storm in the counties affected by Hurricane Michael, seen on the map linked here, have through Dec. 22 to continue enrolling. An extension would also apply to some counties affected by Michael in Alabama and Florida.
The Atlanta Journal-Constitution has been asking CMS officials in three different offices for several days to clarify the extension question. A CMS official said Wednesday that the agency would not comment beyond general guidance documents from the CMS and FEMA. They seem to piece together an extension.
At least one agent said he has been able to get an Obamacare client through the first computer step of enrollment this week, when she received an insurance company bill over the weekend and realized the enrollment website, healthcare.gov, did not have her current information. She was able to register with her correct information Monday, said the agent, Kirk Lyman-Barner. He works in one of the affected counties, Sumter County.
Several factors could be contributing to the decline in enrollment. Supporters of the ACA have decried the administration's actions to steeply reduce funding for advertising and navigator assistance in signing up, and to cut the enrollment period in half last year. Enrollment also declined last year. Detractors of the health care law point to higher employment levels, which might have led to some people obtaining health insurance through a new job instead.
CMS Administrator Seema Verma opted for that explanation.
“This Administration has taken strong steps to promote a more competitive, stable health insurance market and these steady enrollment numbers are yet another sign that the Administration’s efforts are working,” Verma said in a statement. “With the lowest unemployment rate in 50 years, it’s possible that more Americans have employer based coverage, and don’t need exchange plans.”
Census figures will help answer that question, but they don’t come out for a while. The most recent numbers available show that Georgia’s uninsured rate declined steeply following the implementation of the ACA under the Obama administration, then rose slightly for the first time last year.
Georgia has the nation’s fourth-highest rate of uninsured non-elderly people.
The CMS said in its statement that the agency had endeavored to make the experience of enrolling “seamless.”
In Georgia, the agency switched its statewide funding for navigator assistance to Georgia Refugee Health and Mental Health, an organization that had not previously worked statewide but had experience working with the immigrant population in metro Atlanta. That agency focused in part on increasing enrollment for the Hispanic population, and it was able to make partnerships with some Spanish-language radio stations that aired public service announcements for the program.
The navigator whose funding was zeroed out, Insure Georgia, got some of its navigators licenses to work as insurance agents and attempted to continue signing up people for coverage in the ACA market that way.
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