Obamacare in Georgia

Obamacare-enrollment is a site where you can find detailed information on the Affordable Care Act


Health Insurance Marketplace in Georgia

If you live in Georgia, you’ll use this website, HealthCare.gov, to apply for coverage, compare plans, and enroll. Spanish language speakers can contact cuidadodesalud.gov. Specific plans and prices will be available on October 1, 2013, when Marketplace open enrollment begins. Coverage can start as soon as January 1, 2014.

The Insurance Exchange/Marketplace

What has been done, not been done, or left up to the federal government to do.

Establishing the Exchange in Georgia

On November 16, 2012, Governor Nathan Deal (R) announced that the Georgia had stopped planning for an exchange.1 In the previous year Governor Deal issued an Executive Order to create the Georgia Health Exchange Advisory Committee to assess whether and how Georgia should establish a health benefit exchange.2 The 25-member Committee included state officials, insurers, brokers, business representatives, consumers, and providers.3 The Committee also formed subgroups to develop recommendations on governance, operations and finance, and insurance markets. In October 2011, the subgroups released reports that included recommendations to establish a ‘Georgia Health Insurance Marketplace Authority’ as a quasi-governmental, non-profit corporation with a single governing body that maintains two separate risk pools for businesses and individual consumers.4,5,6 In December 2011, the Committee submitted final recommendations to the Governor in support of creating a small business health insurance marketplace through a wholly private or limited quasi-governmental entity, but did not commit to building an individual exchange.7

Essential Health Benefits (EHB): The ACA requires that all non-grandfathered individual and small-group plans sold in a state, including those offered through the Exchange, cover certain defined health benefits. Since Georgia did not put forward a recommendation, the state’s benchmark EHB plan will default to the largest small-group plan in the state, Blue Cross Blue Shield of Georgia- HMO Urgent Care 60 Copay.

Exchange Funding

The Georgia State Office of Planning and Budget received a federal Exchange Planning grant of $1 million in 2010.

Expansion of Medicaid

From 2014 to 2017, the federal government will pay for 100% of the difference between a state’s current Medicaid eligibility level and the ACA minimum. Federal contributions to the expansion will drop to 95% in 2017 and remain at 90% after 2020, according to the ACA.

As the ACA was originally written, states would lose all Medicaid funding if they refused to expand their program to the ACA minimum.

However, the Supreme Court in June 2012 ruled that the federal government could not withhold Medicaid funding for states that chose not to expand their programs. The decision effectively allowed state officials to opt out of the expansion, and some have said they will do just that.

Georgia is not participating in Medicaid expansion.

Next Steps

The federal government will assume full responsibility for running a health insurance exchange in Georgia beginning in 2014.

1. Press release from Governor Nathan Deal. “Georgia Will Not Set Up Exchange.” November 16, 2012.http://gov.georgia.gov/press-releases/2012-11-16/deal-georgia-will-not-set-state-exchange
2. Executive Order issued on June 2, 2011.http://gov.georgia.gov/vgn/images/portal/cit_1210/21/41/17217485106_02_11_01.pdf
3. Georgia’s 2011 Health Insurance Exchange Advisory Committee Appointees.http://healthcarereform.georgia.gov/vgn/images/portal/cit_1210/15/45/173596255Advisory%20Committee%20Appointees%20-%20Updated%20072111.pdf
4. Georgia Health Insurance Exchange Advisory Committee Governance Subcommittee Presentation. October 27, 2011.http://healthcarereform.georgia.gov/vgn/images/portal/cit_1210/42/42/178821132Governance%20Subcommittee%20Presentation.pdf
5. Insurance Markets Subcommittee Report for the Georgia Health Insurance Exchange Advisory Committee. October 27, 2011.http://healthcarereform.georgia.gov/vgn/images/portal/cit_1210/42/41/178821134Insurance%20Markets%20Subcommittee%20Report.pdf
6. Health Insurance Exchange Advisory Committee Operations and Finance Subcommittee. October 27, 2011.http://healthcarereform.georgia.gov/vgn/images/portal/cit_1210/42/40/178821136Operations%20%20Finance%20Subcommittee%20Report.pdf
7. Report to the Governor. Georgia Health Insurance Exchange Advisory Committee. December 15, 2011.http://healthcarereform.georgia.gov/vgn/images/portal/cit_1210/28/4/179765813GHIX%20Final%20Report%20to%20the%20Governor.pdf

Also of interest

Provided by the Henry J. Kaiser Family Foundation

Who can help you (the Navigators)

Get local help

Structured Employment Economic Development Corporation

Seedco, a national organization helping low-income households and communities move toward economic prosperity since 1987, will act as lead agency for a consortium of partners in each state and oversee all aspects of the proposed program, providing technical assistance, financial oversight, compliance protocols, and partner facilitation. Seedco and its partners will support the activities of Navigators in Georgia and Tennessee, many of whom will be roving.

University of Georgia

The University of Georgia’s College of Family and Consumer Sciences and Cooperative Extension Service (UGA CES) plans to place navigators in several offices outside the Atlanta metro region. UGA CES plans to create awareness through community workshops, engage a network of existing partners to reach uninsured Georgia residents and provide direct services to consumers seeking assistance.

Who you can contact for more help

Information for:

Individuals and Families

Small businesses

If you need more detailed analysis, identification of issues, solutions, and implementation of your health insurance plan please let us know and we’ll get right back to you.


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