Atlanta | Georgia didn’t shine in a recent analysis of its health insurance exchange.
The report, released Tuesday by the National Health Council, an advocacy organization representing Americans with chronic conditions, provided a state-by-state analysis of the improvements each state has made to its online health insurance marketplace. The report prioritized specific characteristics of a “truly patient-focused insurance market,” which included non-discriminating, transparent and uniform online marketplaces.
The federal government operates Georgia’s exchange through HealthCare.gov. In 2014, through the website, 316,500 Georgians selected exchange plans. About 29 percent of Georgia residents who are eligible for exchange coverage enrolled in an exchange plan.
According to the report, Georgia has taken no action to limit discrimination or to make plan information uniform.
Georgia also allows for passive purchasing, meaning the state does not actively negotiate with plans to participate in the exchange.
Even worse, Georgia received the bottom score, or “low-performing,” for transparency, as well as for its work to develop continuity-of-care requirements to help patients maintain access to care.
“At the end of the day, the exchanges are for the people, and they have to be about the people,” said Marc Boutin, CEO of the National Health Council. “We need to have marketplaces where people can find the information to find the plan that best fits their needs.”
According to the report, Georgia’s HealthCare.gov site lacks a drug and provider search tools, as well as calculators to help estimate tax credit and out-of-pocket expense amounts.
“It’s critical that there’s continuity of care, so patients are not left without access to the doctors that know them and the medications they need,” Boutin said.
A major flaw in Georgia’s program, according to the report, is the state has not yet expanded Medicaid, which would provide health insurance for nearly 600,000 Georgians. State leaders say expansion would cost state taxpayers too much.
The Affordable Care Act, passed in 2010 and upheld in June by the U.S. Supreme Court, established sweeping insurance reforms including the introduction of health insurance exchanges, where individuals and families can shop for coverage from private companies.
The report matches state exchanges and highlights areas the council recommends for change.
“Give everybody a level playing field from which to compare their states with other states around the country,” said Kelly Brantley, director of Avalere Health, which provided data and assessments for the report.
President Barack Obama said using these exchanges should be similar to shopping for a plane ticket online, with clear instructions, comparable prices and uniform insurance plan information.
“Uniformity is key, because if you’re going to make an informed decision about what plan works for you and your family, you need to be aware of what you’re purchasing,” Boutin said.
Date: July 16, 2015