How Are Health Insurance Price Hikes Impacting Real Georgians?

Congress is moving ahead with measures to reopen the federal government after a temporary spending bill was passed by the Republican majority and some Democrats in the Senate. The House was expected to vote on the bill Wednesday, Nov. 12.  

But the break in the shutdown stalemate comes without the one thing most Democrats in Congress had been insisting on: protecting tax subsidies for health insurance under the Affordable Care Act. Instead, the Republican Senate majority has promised a vote on an extension to the ACA tax credits in mid-December.  

Meanwhile, the more than 1.5 million Georgians with a marketplace plan via the Affordable Care Act (also referred to as Obamacare) are in the middle of open enrollment, which started Nov. 1. That means consumers can see how much the cost of their coverage is changing, particularly without the Enhanced Premium Tax Credits (EPTCs) passed during the COVID-19 pandemic in 2021.  

The enhanced tax credits, extended through the end of this year in 2022, created additional eligibility for the monthly tax credits offered on Affordable Care Act plans. People are eligible for the enhanced tax credits if they receive at least 100%, but no more than 400%, of the federal poverty level annually.  

Varying levels of sticker shock 

Georgia operates its own website for ACA plans, a state-based exchange called Georgia Access. And this year’s open enrollment marks the second year Georgians are shopping for a new marketplace plan or making changes to their plan selection on that site. 

Brandi McGee Polatty, who lives in Jackson County near Athens, said after speaking with her insurance agency she learned her premium will rise three times higher than it was before.  

“The new premium is $345.23, [up] from $124 a month,” she told GPB soon after reviewing her plan. 

Nationwide premium costs have been estimated to more than double next year without the enhanced tax credits. That’s on top of premium increases set by insurance companies that estimate they’ll have to make up for a loss of customers, especially among healthy people who may drop their coverage all together.  

Polatty is still eligible for a type of ACA subsidy that’s different from the recent Enhanced Premium Tax Credits, which helped nearly 20 million people afford health care and are set to expire if Congress doesn’t renew them.  

• RELATED: ACA health insurance will cost the average person 75% more next year, research shows 

Polatty said she really likes her plan, even if her family will have to save more money to keep it. It’s got a low out-of-pocket expense, no annual deductible and it’s helped her get care from doctors she trusts for an immunodeficiency disorder, and a variety of expensive conditions that affect her brain. Not having health insurance isn’t an option for her family.  

“I definitely am someone that is causing insurance rates to rise for other people,” Polatty said. “How does that make me feel? It angers me.”  

Polatty worries proposals to cut the COVID-era subsidies suggest lawmakers might not protect her husband’s monthly disability, or her child’s Social Security check. 

“And what would we do if they did that?” Polatty wonders.  

Polatty is not alone in having to navigate the fragility of all these social safety nets.  

In the Atlanta suburb of Dunwoody, Teresa Acosta is coming to terms with closing her catering business, which she started during the coronavirus pandemic. 

“People were afraid to go out to eat or grocery shopping, and so I started cooking family meals out of my house and selling them to my neighbors,” she said.  

Overtime, it became her source of income.  

“And it worked really well for my family, and I was able to sustain us,” she said. “And I really was able to do that because I could afford insurance.” 

While growing her catering business, Acosta was eligible for an Affordable Care Act plan with a COVID-era tax credit, too. Her plan covers her and her three kids.  

But then, President Donald Trump signed the budget reconciliation bill into law, and it did not include an extension to the subsidies she’d come to rely on. Acosta said she knew she would have to close her business if federal lawmakers didn’t intervene. Already many ingredients on her catering menu had been getting more expensive because of tariffs.  

Acosta decided to speak out about how cuts to health care will affect her family.  

On Nov. 1, she got a look at her new premium: over $500 a month next year, a third of her current income. That’s on top of a higher annual deductible.  

“I don’t see a world in which I can afford that, especially working part-time,” she said. “I’ll likely have to look at Medicaid, see if I qualify — or if at least my kids qualify.” 

One of her children has Type 1 diabetes and requires daily medication. She’s hoping to get employer-sponsored health coverage soon.  

Georgia ranks near the top among states that could see their job economies squeezed by the expiration of ACA tax credits, according to a report out of the Georgia Washington University Milken Institute School of Public Health and funded by The Commonwealth Fund.  

In early November, Acosta still had the menu from her last event pasted near her refrigerator. 

“I don’t want to take it down,” she said. “I put a lot into that business — a lot of my heart — and it’s sad to close the door.” 

Other changes to look out for

As in previous years, everyone who uses the marketplace should check to see if their premiums and or eligibility has changed.   
But unlike previous years, it’s been difficult even for insurance agents to nail down how much exactly a health insurance plan will cost next year. For example, if the ACA tax credits are extended, the plans people sign up for now would likely change. 

When asked how that would affect what people see on Georgia Access, a spokesperson for Georgia’s Office of Insurance and Safety Fire Commission said, without additional detail, that the agency is “prepared to mobilize and respond” to changes at the federal level, and that insurance companies were required to file alternative rates for different scenarios, such as the extension of the tax credits.  

A higher monthly premium is just one change people have to wrestle with, said Deanna Williams, a certified counselor of health insurance applications with the nonprofit advocacy group, Georgians for a Healthy Future.  

She’s been telling people to check everything during open enrollment, including what they’ll have to pay out of pocket to see the doctor, and where they can see a doctor. 

“Review your income, your estimated amount, your household size, your current plan,” Williams said.  

There are new changes to the eligibility for a Georgia Access plan, too, as of August 2025. This upcoming tax year, people whose income has changed must pay back the entirety of any extra money they received from the Advanced Premium Tax Credits. Previously, there was a cap on how much people had to pay back.  

• RELATED: With ACA open enrollment underway, some business owners worry about upcoming changes 

And some people are no longer eligible for coverage at all. That includes recipients of the Deferred Action for Childhood Arrivals and lawfully present immigrants, a classification that applies to refugees, people seeking asylum and those with a green card.  

Williams knows many people, both healthy and sick, just won’t be able to afford their new plans. She worries about her friends and family who might go without health insurance all together.  

“If you can’t pay for your premium, you certainly can’t pay for a large hospital bill,” Williams said.  

If someone’s income is low enough, or they have a qualifying condition, Williams can screen them for and enroll them in Medicaid or other state medical assistance. Everyone else just has to decide what they’re willing to pay. 

This story comes to The Georgia Sun through a reporting partnership with GPB a non-profit newsroom focused on reporting in Georgia.