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Georgia's 'Coverage Gap' Leaves Many Uninsured


The first week of open enrollment for ObamaCare has gone smoothly so far. The website is working, and that means outreach workers can focus on outreach. Jim Burress of member station WABE in Atlanta reports on the groups workers are focusing on this time around.

JIM BURRESS, BYLINE: A year ago, Michael Lappin and husband John West were among the first to sign up for coverage through Georgia's federally-run insurance marketplace. And they're pretty have.

MICHAEL LAPPIN: We've both been to the doctor. We've both used our dental. We both used prescription coverage. We've had absolutely no issues with it at all.

BURRESS: But Lappin says they're again shopping on the website after premiums for their platinum level Humana plan went up by about 19 percent. Lappin says, even with the increase, they'll still save hundreds of dollars a month compared to their previous open-market policy.

LAPPIN: We will most likely stay with the Humana plan because it has been working for us.

BURRESS: Aside from encouraging consumers like Lappin to shop again, health insurance experts will try to reach the uninsured who fell through the cracks last year. In Georgia that includes Asians, Hispanics, African-Americans and residents in rural parts of the state.

CINDY ZELDEN: It's a big undertaking, for sure.

BURRESS: Cindy Zelden is executive director of the nonprofit Georgians for a Healthy Future. But she worries a good portion of those groups fall into what's known as the coverage gap. They earn too little to qualify for a subsidy, but too much to meet Medicaid guidelines. That gap happens when states like Georgia don't expand Medicaid.

ZELDEN: Until Georgia closes the coverage gap by expanding Medicaid, we are going to continue to have a very large number of people without health insurance.

BURRESS: An estimated 282,000 Georgians fall into the gap. Still, there are many times that number here who are eligible. To reach them, outreach efforts will focus on affordability and available subsidies. And that's important. An analysis by Georgia Health News finds insurance premiums were the biggest predictor whether or not someone purchased a policy. For NPR News, I'm Jim Burress in Atlanta.

SIEGEL: And that story is part of a partnership of NPR, WABE and Kaiser Health News. Transcript provided by NPR, Copyright NPR.