'Isn't Obamacare dead?'
ACA supporters are concerned that residents in the rural portions of Georgia -- which make up about 17 percent of the population -- could be most at risk. In recent decades, those rural areas have fallen behind other parts of the state in income, educational achievement and in access to health care.
With enrollment assistance resources so strapped, it will be hard to reach out to rural consumers.
"We had a booth at the PRIDE festival in Atlanta last Sunday, and someone said, 'Why are y'all even here? Isn't Obamacare dead?' " Ammons said. "And if they think that in Atlanta, you can only imagine what they think in south Georgia."
Health economist William Custer, who teaches at Georgia State University in Atlanta, echoed those fears about increases in the number of uninsured in rural Georgia.
The effects of less insurance will be felt hard in those areas, he explained. Nearly half of the state's counties, most of them in rural areas, do not have an OB-GYN. Seven hospitals in rural Georgia have closed within the past four years. Several have closed their labor and delivery units. If people in rural Georgia lose insurance rather than gain it, efforts made in recent years by state leaders to stanch financial bleeding at rural hospitals could be jeopardized, Custer said.
"This is really the big worry. The problem in Georgia is that we have very different geographics, very different demographics and very different health care. These changes this year really seem to be pushing us even more to two Georgias," Custer said.
'Let Obamacare fail'
Much of the cutbacks and confusion, health care advocates said, follows President Donald Trump's disparagement of the law. He campaigned on a promise to "repeal and replace the disaster that is Obamacare" and announced in July that he would "let Obamacare fail." Even though Congress could not pass a replacement bill, the Trump administration's changes in timing and funding for enrollment will have an effect, the advocates charge.
"The most damaging has been the rhetoric and confusion," said Laura Colbert, executive director of Georgians for a Healthy Future, an advocacy group. "Overall, this could be a bellwether for future years."