Some ACA premiums fall, others spike; enrollment keeps surging

By Ariel Hart – The Atlanta Journal-Constitution

Tyrone Jenkins sat in his insurance agent’s office on Friday, relieved about his health insurance. After all the upheaval and news over skyrocketing Obamacare premiums, Jenkins will actually see his coverage costs plummet next year. He’ll pay less than half in 2018 what he did in 2017 for similar coverage. How can this be?

Jenkins doesn’t like the answer. Thanks to decisions made in Washington in recent months, it’s possible because a new and costly inequality has opened up between some policyholders. The cancellation of one subsidy brought in another that benefits people in Jenkins’ position — while leaving other policyholders to take a bigger hit, some to the point they can no longer afford coverage.

And Jenkins the taxpayer will be subsidizing this situation even more, along with other Americans. “In some stuff it’s kind of frustration,” Jenkins, a forklift driver who lives in Lee County, said of Washington’s management of health care. Jenkins said he “really” likes his plan, but he really doesn’t like that other people’s premiums are skyrocketing at the same time. And if it adds to government debt, he thinks policymakers should consider the burden on future taxpayers: “It’s the younger generation that’s coming up.”

Open enrollment for the Affordable Care Act, also known as Obamacare, is now three weeks underway. Enrollment is continuing at a ferocious clip, and situations such as Jenkins’ may be one reason why. It partly gets back to a controversial decision by President Donald Trump. For months Trump threatened to cancel “cost-sharing reduction” subsidies, and just before enrollment opened he did.

The nonpartisan Congressional Budget Office (CBO) predicted that canceling those subsidies — which went to insurers so they in turn could lower costs for lower-income customers — would on average add 20 percent to premiums; that many people would drop coverage; and that companies would pull out of some markets. That did happen and has gotten much publicity.

TIPS FOR ENROLLING: AJC FAQ on Obamacare Open Enrollment

But the CBO did not predict that everyone would suffer. The CBO also predicted that other people would get such great deals that they’d opt for new coverage. People who couldn’t afford the best plans before now could afford them. That appears to be happening, too.

For basic health coverage in 2017, Jenkins’ plan cost him $102 a month (after cost-sharing reductions made it affordable). In 2018, those subsidies are gone. Now, different subsidies come into play, and because of how the law works, after Trump’s executive order, they’re bigger. So this year, that same type of coverage will cost Jenkins just $38. It’s such a dramatic discount that he’s opting to add dental and vision, for a total of $99.

None of that would be a surprise to the CBO’s analysts. They predicted that overall, the decision to cancel the cost-sharing reduction subsidies — allowing the other, bigger subsidies to kick in —would add $194 billion to the deficit over 10 years.

Dan McBrayer, an agent several counties away from Jenkins, doesn’t think much of these developments. “The people that’s getting a tax credit are getting a bigger tax credit,” he said. “The people that aren’t are getting a bigger bill.” McBrayer concluded, “Quite frankly, this thing is such a train wreck.” McBrayer has a lot of clients who fall above the subsidy threshold of making about $48,000 for a single person’s household, and they are getting clobbered with the full force of massive premium hikes. Many of them feel they have to drop insurance, he said.

On the other end of the spectrum, Kirk Lyman-Barner, Jenkins’ agent, has a lot of clients who make less money and qualify for strong subsidies. Even as the insurance companies raised rates this year, the subsidies came in even stronger to make the consumer’s cost low. Some are even getting premiums of zero this year, mostly older people. “Every single one of them is better off except for the folks that don’t get the benefit,” Lyman Barner said. “For those folks it really breaks my heart. Because it was unnecessary.” Jenkins’ cheaper plan is not a fluke.

An analysis calculated for The Atlanta Journal-Constitution by researchers for the nonprofit Kaiser Family Foundation showed the phenomenon holds. According to those figures, a 40-year-old ACA policyholder in Atlanta making $24,000 a year would see a dramatic price drop for the lowest-cost “gold” plan. In 2017, that policyholder would be paying about $235 per month. But in 2018, that plan would cost that person just $175.

The plan wouldn’t cost less to provide. The insurance company on average hiked the overall price from $380 a month to $465. But the policyholder wouldn’t see that increase because taxpayers would take the hit. The formulas are all spelled out in the law.

There is wide agreement that the subsidy set-up is a problem, and some centrist U.S. senators briefly attempted to fix it. That fell apart in the GOP’s renewed attempt to repeal the law at the last minute in September.

Trump has said his decision on the subsidies would force Congress’ hand. In the meantime, critics of the law say blame it, not the president, for  trying to undo what pieces he can.

Bill Custer, a health care finance researcher at Georgia State University, wouldn’t say the decision to cancel the cost-sharing reduction subsidies was good or bad. But he did note the results were predicted. “By canceling these CSRs, the Trump administration has increased taxpayer costs for this coverage, increased the deficit and decreased coverage in general,” he said.

It’s impossible to know whether enrollment this year will surpass last year’s. New figures released by the Trump administration for the second week of enrollment show that in the first 11 days, nearly 1.5 million people signed up for plans, compared with just 1 million people in the first 12 days last year. But the enrollment period will be half as long. This year it ends Dec. 15.

Jenkins is one of those as he buys his plan. He wishes other people could do that too, though, because health is unpredictable and he thinks the need for health insurance is something that ties everyone.

“I’d prefer everybody to be equal,” he said.

Ga. customers scramble after Trump order

Premiums likely to soar without subsidies; divided Congress stalls.

By Tamar Hallerman and Ariel Hart

WASHINGTON — Kirk Lyman-Barner’s phone began buzzing at 7:30 a.m. Friday and didn’t stop for hours.

An Americus insurance broker who specializes in Obamacare policies, Lyman-Barner is used to being a familiar face around town. But even his morning coffee run at Cafe Campesino was interrupted repeatedly by clients, all of whom were worried about how much their monthly health care premiums would increase due to the latest headlines coming out of Washington.

“When you live in a small town, you know people’s stories. You know their illnesses and backgrounds and such, and it’s just tragic to think that they may not have access to care,” he said. “It is very confusing. People are scared.”

Lyman-Barner is one of countless insurers, regulators and customers in Georgia scrambling for answers after the White House announced it would halt the so-called cost-share reduction payments.

About 380,000 Georgians benefit from the subsidies, which are designed to make Obamacare insurance affordable.

Insurance Commissioner candidate Cindy Zeldin discussing health insurance with Tripp Pomeroy at a recent visit to Cafe Campesino.

The news wasn’t exactly a surprise. President Donald Trump for months mused publicly about cutting off the subsidies, which he described as an insurance company “bailout” that was propping up a “failing” health care law.

So the four insurance companies operating on Georgia’s Obamacare exchanges hedged.

All four — Alliant, Ambetter, Blue Cross Blue Shield and Kaiser Permanente — filed two sets of proposed 2018 rate increases last month with the state Department of Insurance. One set assumed the Trump administration would renew the subsidies and, hence, proposed lower increases.

The other accounted for more Washington uncertainty, baking the policy ambiguity in the price. Each of the four companies proposed raising monthly premiums more than 50 percent above this year’s levels under that scenario. And in the end, when the companies had to choose between the two for their final number, most chose that higher one.

For them to choose a different rate now would require an amendment from the U.S. Department of Health and Human Services, according to the state.

Kaiser Permanente was the only one of the four companies to name the lower number as its final increase, however, going with 2018 rates that would be 30.6 percent higher. Although Kaiser did prepare the second business plan accounting for subsidy threats with a higher increase, it was not clear Friday that the higher one would go into effect. The increase in that case was to be 56.7 percent.

Jim Driscoll, a spokesman for Kaiser, which covers metro Atlanta, said the company intended to stay in the exchange market but was evaluating the situation.

In any case, there is no dispute among insurers that the events in Washington have pushed customers’ costs higher.

“These are trying times to be in the fortuneteller business, but to the best of our abilities our plans have accounted for this,” said Graham Thompson, a lobbyist for Georgia insurers. “To offer that robust coverage, people are going to see higher rates for 2018 as they’re shopping on the exchange.”

‘Piece by piece’

Trump was able to unilaterally cut off the subsidy payments because of a lawsuit congressional Republicans filed against then-President Barack Obama in 2014. A federal court had ruled in favor of the GOP’s argument that Congress had not given the executive branch permission to pay the subsidies, and Obama had pursued a legal challenge to the initial ruling. Trump ended the payments by dropping his predecessor’s appeal.

“The bailout of insurance companies through these unlawful payments is yet another example of how the previous administration abused taxpayer dollars and skirted the law to prop up a broken system,” White House Press Secretary Sarah Huckabee Sanders said. “Congress needs to repeal and replace the disastrous Obamacare law and provide real relief to the American people.”

After Republicans in Congress failed to agree on a strategy for repealing and replacing Obamacare,Trump said he wanted to let the health care law collapse under its own weight. Earlier on Thursday, he indicated he would help dismantle it by signing an executive order to bolster through incentives the use of short-term health plans, which are cheaper and subject to fewer Obamacare rules, and so-called associated health plans that can be sold across state lines. Hours later came the subsidy decision.

“ObamaCare is a broken mess,” Trump tweeted on Friday morning. “Piece by piece we will now begin the process of giving America the great HealthCare it deserves!”

Lyman-Barner said consumers won’t know exactly how much rates on the Obamacare exchanges will increase until open enrollment for 2018 begins on Nov. 1.

Trump’s decision does not outright kill the help for lower-income customers, since the 2010 health care law requires insurance companies to provide affordable coverage to people with low incomes. What his Thursday move did was end the money the federal government paid to reimburse those insurers.

In other words, insurers will still need to subsidize things such as deductibles and co-pays for low-income people. They just won’t get paid back by the feds.

In return, insurance companies are expected to raise premiums on their other customers on the exchanges in order to recapture their financial losses.

In addition, federal tax credits tied to lower-income customers’ premiums will rise as the premiums rise, so that will also help those customers. Unfortunately, it will also increase the federal deficit. So the change is estimated to leave U.S. taxpayers with a $194 billion increase in the deficit over the first 10 years, according to the nonpartisan Congressional Budget Office.

And those who have individual plans but have incomes too high to qualify for help will see the wallop to their bank accounts.

Patient advocates in Georgia are deeply concerned for middle-income customers — single people making more than $48,000 or a family of four earning more than $99,000. They would have to pay in full.
“The result of this effort will be to create mistrust with the carriers, force many folks who don’t get subsidies to drop (Affordable Care Act) qualified plans and let Congress answer to its constituents who are priced out of health insurance,” Lyman-Barner wrote.

Further, more premium increases could be in line for 2019 as Georgia insurers prepare for the next round of insurance adjustments.

Division in Congress

At least 18 states’ attorneys general announced they would sue to keep the subsidies going.

In the meantime, more pressure now shifts to Congress to act on health care. Republicans are still internally divided over what should replace the 2010 health law, and Democrats refuse to make any major changes to Obamacare. Bipartisan negotiations to stabilize Obamacare’s markets have been left on the back burner.

It’s possible those talks, which aimed to trade continued insurance subsidies for more state flexibility on insurance requirements, could be revived, but it’s unclear whether Trump would sign such a compromise to keep Obamacare afloat.

The two parties on Friday appeared as divided as ever.

Democratic U.S. Rep. John Lewis of Atlanta called Trump’s move to end the subsidies “mean-spirited.”

He said the two parties should come together to work out a solution, but he also said conditions might not improve until Democrats retake control of Congress.

“People are going to suffer, are going to feel the pain of what is happening,” he said in an interview. “We’re going to assure them that if we take back the majority, we will fix it.”

Democrats are not the only ones to try to address the subsidy problem. Republican U.S. Sen. Lamar Alexander of Tennessee convened bipartisan hearings on the issue in September. But too many of his fellow Republicans ditched his effort to focus one last time on trying to repeal Obamacare.

Trump was optimistic, however, when he addressed his action on the subsidies in an early-morning tweet Friday. He suggested it would lure Democrats to his side and build the necessary votes from them and enough Republicans to form a majority for a solution.

“The Democrats ObamaCare is imploding,” the president tweeted. “Massive subsidy payments to their pet insurance companies has stopped. Dems should call me to fix!”

Blue Cross pulls back on Georgia coverage

Citing federal uncertainty, Blue Cross Blue Shield will not offer individual health insurance coverage in metro Atlanta in 2018, the company said Monday. And it came perilously close to withdrawing entirely from Georgia’s individual market, documents show, but decided to stay in the state after intense negotiations.

In 96 of the state’s 159 counties, Blue Cross is currently the only company keeping the Obamacare health insurance exchange market alive. It currently covers the entire state but is about to pull back, leaving the Georgia exchange with a patchwork of companies that blankets the state.

That doesn’t help Marc Morton, a Cobb County resident whose wife and daughter have pre-existing conditions and get their insurance from Blue Cross on the exchange. “My wife was in panic,” he said. “I looked at it and I thought, well this is just something that has to be overcome somehow.”

Blue Cross was clear about its reasons.

“Unfortunately, continued regulatory uncertainty at the Federal level and the current state of instability in the individual market have necessitated that we consider discontinuance of certain of our current offerings,” Jeff Fusile, the president of Blue Cross and Blue Shield of Georgia, wrote in a letter to the state explaining the move. He wrote the letter in June, but Blue Cross made the announcement to customers Monday.

The move applies to the individual market and doesn’t affect people who get insurance through their company group plans. Blue Cross, whose parent company is Anthem, reserved the right to make further changes by the end of September.

Health care policy in Washington has careened in recent months from one proposal to another, and the uncertainty continued even up to this past weekend. On the sidelines of the Obamacare repeal drama, the White House has threatened to withhold subsidy payments that help exchange markets function under the health care law. Just last week, Kellyanne Conway, an adviser to President Donald Trump, said the president would make a decision one way or another on the payments last week; but the weekend arrived and he had not.

Asked by The Atlanta Journal-Constitution whether the president had actually intended to make such an announcement, a White House representative said Trump was working with his staff and his Cabinet to consider the issues raised by the payments.

At present, Blue Cross’ plans are still to fill the rural gaps in Georgia’s Obamacare exchange left by other insurers who withdrew. But in a turnabout, Blue Cross is withdrawing from areas that are already covered by other insurers and typically seen as easier to cover — such as metro Atlanta. Such a move would mark the first time in decades that Blue Cross did not provide individual coverage in the Atlanta area, the company said.

Blue Cross is remaining only in counties where it has no competition. In 85 Georgia counties Blue Cross will be the only company insuring customers on the Obamacare health insurance exchange in 2018. A different company, Ambetter, is stepping in as the only insurer in 11 counties Blue Cross is leaving.

Ambetter also intends to offer individual plans in metro Atlanta.

The news sent a convulsion through Blue Cross’ world of customers and agents Monday.

“I’m scared,” said Kirk Lyman-Barner, who sells exchange plans in southwest Georgia. “I have the same size book of business to service no matter who fills in. We have to adjust. I’ve hired a partner to help sell. Is that going to impact those hiring decisions? Are commissions going to be there for that?”

Lyman-Barner had been particularly jolted by Trump’s tweet that the subsidy payments are “BAILOUTS” and Conway’s statement that the president would make a decision.

It’s also personal. His wife is covered by a Blue Cross exchange plan. She went in for a pair of routine operations and was advised by her surgeon that she should space them out and not have the second one so soon.

“She said, ‘But I don’t know what the GOP’s going to do to my health insurance,’ ” Lyman-Barner said. “The surgeon looked at her and said, ‘You’re probably right.’ ”

GOP leaders, however, have said uncertainty is the failure of the Obamacare law itself. Georgia’s GOP senators voted for its repeal several times. After repeal failed, Georgia U.S. Sen. David Perdue said in a statement that “throughout this entire process, we have witnessed everything that’s wrong with Washington.”

On Monday, a spokeswoman responded to the Blue Cross news with a similar message. “All along, Senator Perdue has warned Obamacare is collapsing under its own weight and he is working to fix our health care system,” said Caroline Vanvick, Perdue’s spokeswoman.

Morton called himself politically an independent. When he got the Blue Cross email Monday, he thought, “We’ll figure out a way.”

However, he added: “If you’d been watching the debates over the summer, it was exactly what my fear was. They were not going to do anything and allow the marketplace to just crumble. I know there’s a bipartisan effort now in Congress to shore up the market. … I don’t know how long that will take, but obviously the insurers are saying it’s not good enough.”

Morton said the system just needs to be fixed, and officials in Washington need to stop playing politics with it: “I think they’re not fully embracing the human cost.”

See what Integrity does for insurance

Client First Insurance Solutions has partnered with the Integrity Insurance Group, LC, headquartered in Harrisonburg, Virginia, nestled in the beautiful Shenandoah Valley. 


This new contract is built on a long history of friendship and respect that Kirk enjoyed for many years in Virginia. The roots are deep and the trust is well-seasoned between the agencies. It began when Kirk befriended Twila and Larry Showalter and Curtis Steele, the founders of TLC Insurance. Larry and Twila were immersed in the Aflac Insurance employer programs and Curtis picked up the home, auto and business carriers. When the founder of Habitat for Humanity International, Millard Fuller, asked Kirk to move to Georgia in 2007 to help him launch a new international affordable housing ministry, the TLC Insurance team was the only choice to take over Kirk’s successful insurance business. Last year, TLC contracted with Integrity to become the go-to company for farm insurance.  


The tumultuous world of health insurance required Kirk to explore new opportunities with his property and casualty business. So it was a no-brainer to visit with TLC and Integrity to ramp up the Client First Insurance offerings. Kirk liked – no, loved – what he heard about Integrity Insurance’s programs, professionalism and goal to do well by doing good. 


So some of Client First’s documents will carry the Integrity brand and marketing information. It is a symbol of strength-through-numbers with a team that really cares about the wellbeing of each of their clients. Client First grows by the referrals of satisfied clients and therefore no matter what brand or logo is on the contracts, is working hard as a team to put its clients’ needs first. 


The team at Client First Insurance Solutions wants to earn your trust as the go-to place for all your insurance needs. To do this, more and more insurance carriers will be added to the already long list of options and you can be assured that the team is staying on top of all the financial, tax and legal risk management issues.




Integrity [in-teg-ri-tee] noun


  1. adherence to moral and ethical principles; soundness of moral character; honesty.


  1. the state of being whole, entire, or undiminished: to preserve the integrity of the empire.


  1. a sound, unimpaired, or perfect condition: the integrity of a ship’s hull.


Another way of thinking about the ethics of integrity is “to do the right thing when no one is watching.”

Blue Cross in Georgia to limit emergency room coverage

The Obamacare exchange may survive next year in rural Georgia. But patients who depend on its last remaining insurer are now learning there’s a catch.

Over the past week letters have arrived at homes throughout the state giving patients a jolt. Blue Cross Blue Shield of Georgia, the only insurer on the exchange for 96 of the state’s 159 counties, is telling patients with individual policies that if they go to the emergency room and it’s not an emergency, they’ll be stuck with the bill.

“I am very concerned,” said Dr. Matthew Keadey, who leads an organization of ER doctors. He fears patients who need the ER but aren’t sure they do will avoid it now. “If this is fully implemented, I think we’re going to have deaths out there because of it.”Read more

Obamacare exchange hangs on in Georgia; Blue Cross may stay next year

Obamacare in Georgia has survived another day.

The last insurance company to still serve patients on the Affordable Care Act exchange in all regions of the state says it won’t back out, at least not yet.

Blue Cross Blue Shield of Georgia, the only remaining company to serve all 159 counties in the state, has filed its annual plans for next year’s insurance market. In its initial filing, it submitted plans for the entire state, said spokeswoman Debbie Diamond. Big questions remain, however, including how much the company will charge. Read more

Trump voters in South Georgia come to terms with GOP health plan

By Craig Schneider and Misty Williams – The Atlanta Journal-Constitution

Kenneth Peek had a rough year. The South Georgia farm where he and his wife grow corn, wheat and soybeans faced a drought and lost money in 2016. So he’s working construction jobs to make ends meet.

The 64-year-old hoped to catch a break on his health care costs. He has insurance through the Affordable Care Act, better known as Obamacare, but the premiums and bills keep going up and up. That’s one reason he voted for Donald Trump, hoping “he gets this old country straightened out.” Read More

Local Producer Signs With Foremost Insurance Group



June 1, 2017

CONTACT: Kirk Lyman-Barner

(229) 942-9025

Kirk Lyman-Barner of Client First Insurance Solutions is now offering superior insurance products from the Foremost Insurance Group of Companies, headquartered in Caledonia, Michigan. As a Foremost producer, Kirk Lyman-Barenr will offer customers a wide range of insurance products. Foremost has been a leading insurer since 1952. Foremost offers auto, home, umbrella, manufactured home, motor home, travel trailer, dwelling fire, specialty homeowners, motorcycle, snowmobile, off-road vehicle, boat, personal watercraft and collectible auto insurance programs that can be customized based on what coverage individual customers want. “With Foremost, Client First Insurance Solutions is even more capable of providing customers the insurance products and the coverage they want, for the things that are important to them” Kirk Lyman-Barner said. “I urge all my friends and customers to call me if they’re in the market for insurance for any of these products.”



How are life insurance premiums calculated?

IEurekaMoment-revisedf you’re thinking about life insurance, you’re probably wondering how much your premiums will cost. Your premium is the regular payment you make to the life insurance provider. While everyone’s situation is different, most life insurers follow a similar process to calculate your premium. The following outline will help you understand the steps involved.

Assessing your risk

When you apply for life insurance, the provider will review your personal situation in order to calculate the risks associated with offering coverage to you. To do this, they begin by considering the following:

  1. Your age – While it’s never too late to get life insurance, for lower rates, the earlier you start, the better. As you get older, the same coverage costs more, regardless of what type of insurance you select.
  2. Your health history – If you have health problems when you apply for life insurance, you could pay higher premiums. Insurers may also look at your complete medical history and could inquire about family health history.
  3. Your lifestyle – If you smoke or are seriously overweight, you will likely be classified in a certain risk group and will likely have higher premiums. Likewise, if you regularly engage in high-risk activities such as sky-diving or have a dangerous occupation like a firefighter, this could also affect your premium.

Reviewing the big picture

In addition to reviewing your personal information, a life insurance provider may also look at the costs associated with providing life insurance when determining how much premium they need to charge. These include:

  1. Statistical information – mortality (death) and morbidity (sickness) tables that estimate the average life expectancy for different age groups and enable the provider to spread the risk across large groups of people
  2. Economic climate – the expected interest that will accrue from investing premiums before the death benefit would need to be paid
  3. Cost of doing business – a life insurer’s operational costs (e.g. rent, salaries, legal fees, etc.)

Life insurance can seem overwhelming but it’s one of the most important decisions you can make. It’s also probably cheaper than you think. A recent survey showed that Millennials overestimate the cost of life insurance by 213%!1

However, everyone’s situation is unique and a life insurance agent can take the time to understand your personal circumstances and help you choose the coverage that best meets your needs. Foresters™ is an international financial services provider organization which offers quality life insurance and investment products.

Foresters™ is the trade name and a trademark of The Independent Order of Foresters, a fraternal benefit society, 789 Don Mills Road, Toronto, Canada M3C 1T9; its subsidiaries are licensed to use this mark.

1 Source: 2015 Insurance Barometer Study, LIMRA and Life Happens.

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