ACA navigator Ted Hall guides Lizella's Donna Hughes as she renews her insurance under the Affordable Care Act. This happened during a one-day event at the Macon Centerplex.

ACA navigator Ted Hall guides Lizella's Donna Hughes as she renews her insurance under the Affordable Care Act. This happened during a one-day event at the Macon Centerplex.

It was all business at a conference room in the Macon Centerplex. Six staffers from the Insure Georgia program sat behind laptop computers. They are Affordable Care Act navigators, working to sign up people for insurance under the federal exchange during this one-day event.

Georgians apply for insurance under the ACA.

Among those who made the trip is Donna Hughes of Lizella.

"I am one in the number of many people who are lower income and can't afford regular health insurance," said Hughes, who works a seasonal job as an office manager for a tax preparer. The rest of time she cares for her aging mother.

She sat with navigator Ted Hall and they began by reviewing her insurance through the federal exchange. What became quickly apparent was that she'll have to change coverage plans. Her current provider has pulled out of what is commonly known as Obamacare. Large insurers like Aetna and United Healthcare have left the federal exchanges.

Hall told Hughes: “The only options you have in this part of the state are Blue Cross-Blue Shield. Now they offer different types of plans. But Blue Cross-Blue Shield is the only actual provider you can choose from."

The Atlanta area does have some limited provider choices. But Blue Cross is the only company offering health care across the state.

Hughes grudgingly accepted a Blue Cross plan. But she's going to have to find a new primary care doctor that's part of the Blue Cross network.

It's a strange time for Georgians choosing insurance through the Affordable Care Act. While open enrollment for plans under the ACA continues, those seeking coverage are wondering about the future of the controversial health law. And, as Hughes found out, insurance plan choices have been greatly reduced.

Steve Allen runs a small business in Macon. He's signing up for insurance on the federal exchange because it’s the most affordable option for someone who is self-employed. He, too, must switch insurers.

"We're having to go back to Blue Cross, which we hated in the past but that is really the only option open to us,” said Allen from his living room.

Fred Ammons, CEO of Community Health Works, runs the Insure Georgia program, which supplies navigators across much of the state. Ammons said reduced choice has been one of the biggest hurdles his navigators have had to address with consumers.

"In some cities and counties where we had competition, that is a barrier," said Ammons. "There are absolutely no easy answers when it comes to the problem of insurers pulling out."

The other barrier is confusion over the future of the ACA. Donald Trump's presidential victory came with a promise.

“There's this big question mark hanging over the entire framework of health insurance for many consumers all across the country with the conversations in Washington about potentially repealing the Affordable Care Act without really communicating what a replacement would be,” said Cindy Zeldin,  executive director of the Atlanta-based Georgians for a Healthy Future, a consumer advocacy group.

But despite all the change and uncertainty, Zeldin said people are signing up for coverage under the federal exchange at a brisk pace since open enrollment started on November 1. The latest figures from the federal Health and Human Service Department show slightly more Georgians have signed up than this time a year ago.

“It’s clearly meeting a need even if there may be some aspects of it that could be improved,” Zeldin said.  

Open enrollment continues until the end of January, just as Congress begins meeting to debate the future of the Affordable Care Act.

Support for health, education and poverty reporting on GPB Macon comes from the Peyton Anderson Foundation.