Georgia and the ACA

In 2014 Georgia had the dubious honor of being the only state with 2 of the 10 most expensive health insurance markets in the country.  Southwest Georgia ranks as the second most expensive market in the country after an affluent area of western Colorado (#1).  Centered around Albany, GA, this area has a number of factors likely playing into the expensive premiums there.  Neighboring southern GA has many of the same issues:

*These two markets are fairly rural.

*Georgia's legislature chose not to expand Medicaid to residents making 101-138% of the Federal Poverty Limit even though the Federal government pays 100% of the expansion costs for the first couple of years and 90% of the costs after that.  Rural hospitals in GA thus continue to have to treat uninsured poor patients and pass along the costs in higher costs to their insured patients and these insured residents' insurance companies.  Compounding this scenario is the fact that southwestern Georgia is served by a single hospital system.  In terms of seeking medical care, there is no other game in town.

*Southwestern and southern Georgia are fairly poor, rural areas with relatively high levels of chronic disease.  In other words, the populations of these areas are sicker and poorer than other parts of the state.  

The differences in average premiums between relatively affluent north Georgia/Atlanta and southern, rural Georgia earned Georgia the distinction of having the greatest disparities of any state in terms of insurance premiums.