Georgia ACA health insurance enrollment surges again, to 1.5 million

“Enrollment has nearly doubled since I took office,” President Joe Biden said in a written statement. “That’s no coincidence,” he said, noting the emphasis his administration has put on making enrollment easier and more affordable. That includes a longer enrollment period, more funding for outreach and assistance, and enhanced subsidies to lower premium prices.

The news also marks a success for Georgia’s new computer system for ACA shoppers, which launched Nov. 1. Georgians are now blocked from shopping on the federal ACA website, healthcare.gov, and must buy ACA plans on GeorgiaAccess.gov.

A spokesman for Georgia Commissioner of Insurance John King, a Republican, declined to comment.

White House officials said there is cause for alarm going forward, however. The surging popularity of ACA plans, which use federal subsidies to make premiums cheaper for consumers, is due in large part to extra federal subsidies enacted during the pandemic. Those “enhanced” subsidies are set to expire unless Congress decides to extend them.

Sabrina Corlette, co-director of the Center on Health Insurance Reforms at Georgetown University’s McCourt School of Public Policy, responded “wow” when told of Georgia’s increase.

Quite often when states launch a state-based marketplace, as Georgia Access is called, they see a dip in enrollment, she said.

“It’s actually pretty impressive that in spite of the fact that there’s just the hassle factor (for customers) of switching to the new state-based platform, Georgia still saw an increase in enrollment,” she said. “It is no small lift to design, build and launch a state-based exchange.”

The state-based website had problems at the beginning, but most were quickly addressed, a spokesman said at the time. Whether Georgia shoppers buy their plan directly on the website or through a private broker, in the end, the state website holds their information and plays a role in the purchase.

Corlette said that Georgia’s increase in investment in advertising for Georgia Access and funding navigators for support probably also helped spur shoppers to join.

But like other researchers, she said the primary factor boosting popularity was the temporary premium subsidies enacted under Biden, which are set to expire.

The ACA has always subsidized shoppers’ premiums based on their income level. But the “enhanced” subsidies were added to the existing system to do more of that. They lowered premium prices for both the lower-income ACA shoppers and middle-income shoppers.

For example, under the original ACA, subsidies faded out completely for people who make more than 400% of the federal poverty level, or about $60,000 a year. Under the enhanced subsidies, however, those people got subsidies too if the premium exceeded 8.5% of their income. At the lower income levels, plans that were essentially free were game changers.

“Congress faces a choice this year; if they do not extend the enhanced premium tax credits that were passed through the Inflation Reduction Act (... then), costs will essentially skyrocket for millions of Americans,” Neera Tanden, a White House adviser , told reporters. “The results would be catastrophic. A single parent could see their premiums be increased by $1,500 per year. A retired couple could see their premiums increased by $18,000 per year.”

Extending the enhanced subsidies would cost approximately $335 billion total over 10 years, according to the Congressional Budget Office.

King, whose office runs Georgia Access, and Gov. Brian Kemp, whose idea it was, have argued that Georgia Access deserves the credit for the large increases in Georgians signing up for ACA plans in recent years.