If you’ve been scrolling through your neighborhood Facebook group or NextDoor app lately, you’ve probably seen the posts. A family of four in metro Atlanta paying $2,300 a month for a Kaiser plan — and that’s the higher deductible option. Another family paying $2,800 a month. Parents of kids with Type 1 diabetes doing the math and realizing they could hit $21,000 in out-of-pocket costs before their insurance pays a single dollar toward anything significant.
These are not outliers. And this did not happen by accident. It also wasn’t sudden, though many Georgia families are starting to feel it.
Here is what is actually going on — and why Georgia families are feeling it harder than almost anywhere else in the country.
What Changed at the Start of This Year
For four years, millions of Georgians were buying health insurance with the help of enhanced federal tax credits — subsidies that kept monthly premiums manageable for working families, self-employed people, Realtors, and small business owners who don’t get coverage through an employer.
Those subsidies expired on December 31, 2025. Congress did not renew them.
The result was immediate. According to health research organization the Kaiser Family Foundation, the average monthly premium for a 60-year-old Georgian earning $62,800 a year on a benchmark plan jumped by $862 — to a total of $1,307 a month. For families, the numbers are even more jarring.
Middle-income families earning between $39,000 and $62,000 saw premiums more than double. Anyone earning above $62,600 lost federal help entirely, and their premiums nearly doubled — from $4,436 a year to $8,471.
The families posting in community groups are not exaggerating. The math checks out.
What Is the ACA, and Why Does It Matter?
The Affordable Care Act — dubbed “Obamacare” by Republicans, though they are the same law — regulates what health insurance companies must cover, prevents them from charging more because of pre-existing conditions, and sets limits on out-of-pocket costs. It also created health insurance marketplaces where individuals who don’t get coverage through an employer can shop for plans.
Georgia runs its own version of that marketplace, called Georgia Access.
The enhanced subsidies that just expired were first created in 2021 under the American Rescue Plan Act as a pandemic-era measure. They were extended through 2025 by the Inflation Reduction Act. During that time, they helped push national marketplace enrollment from 11.4 million people in 2020 to 24.3 million people last year. In Georgia alone, more than 1.5 million people were enrolled.
When the subsidies expired, enrollment in Georgia’s health exchange dropped by more than 190,000 people, according to the Georgia Office of the Commissioner of Insurance. Many of those people didn’t choose to leave. They simply couldn’t afford to stay.
Why Georgia Is Getting Hit Harder Than Other States
Here is where Georgia’s own policy choices come into the picture.
Ten states — California, Colorado, Connecticut, Maryland, Massachusetts, New Jersey, New Mexico, New York, Vermont, and Washington — are using their own money to help residents buy health insurance plans, at least partially replacing the expired federal subsidies. Some of those states are saving residents hundreds of dollars a month.
Georgia is not one of them.
A bill introduced during the 2025 session of the Georgia General Assembly, Senate Bill 192, would have provided state subsidies to Georgians at 400 percent of the poverty level and eliminated premium costs entirely for those at 200 percent of the poverty level. The bill never received a hearing.
Senate Minority Leader Harold Jones II, D-Augusta, said the bill could be revived, but acknowledged he needs Republican support to pass it.
“The question is, are they going to be willing to actually come to the table and say we’re going to do right for Georgia’s families or we’re going to continue to just play politics,” Jones said.
Georgia also has not expanded Medicaid — the government program that provides health coverage to low-income residents. Georgia is one of only 10 states that has not done so. That means adults who earn below the poverty level have no safety net when marketplace coverage becomes unaffordable. In states that expanded Medicaid, those residents would qualify for coverage. In Georgia, they fall through the cracks, or into the massive canyon of health care inequality entirely.
Georgia House Minority Whip Sam Park, D-Lawrenceville, put it plainly at a press conference at the state Democratic Party headquarters.
“Republicans like Buddy Carter and Mike Collins voted to end the tax credits that made health care coverage affordable, and every single day they fail to restore those credits, more Georgians are losing access to life saving health care because they can’t afford it,” Park said.
Georgia Republican Party Chairman Josh McKoon pushed back, arguing the subsidies were never sustainable to begin with.
“The subsidies are financially unsustainable and point to how broken Obamacare has been from the beginning,” McKoon said. “President Trump and Republicans have offered sustainable solutions to increase access and affordability for all Americans, but Democrats would rather play politics.”
The Cascade Effect
There are consequences when healthy people drop their coverage because they can’t afford it.
When healthier people, who are a lower-cost to insurance companies leave the insurance marketplace, the pool of people who remain tends to be sicker and more expensive to cover. Insurance companies respond by raising premiums for everyone still enrolled. That drives more people out. Premiums go up again. The cycle repeats.
Georgia is already seeing the early signs of this. Aetna has already dropped out of the Georgia insurance marketplace entirely.
But this doesn’t just hurt those using the insurance marketplace. Georgians with employer-sponsored insurance will also be impacted. When hospitals treat uninsured patients — which they are required to do in emergencies — they don’t get paid. They make up that lost revenue by charging more to insurance companies. Insurance companies pass those costs on through higher premiums. Analysts warn that employer-sponsored plan premiums could feel the impact as soon as 2027.
What Other States Are Doing
New Mexico has gone the furthest. Democratic Gov. Michelle Lujan Grisham and state lawmakers tapped a state health care fund to entirely replace the expired federal subsidies for all enrollees, regardless of income. Enrollment in New Mexico is actually up 18 percent this year — while Georgia’s is collapsing.
Colorado approved up to $110 million to partially replace the federal subsidies. Massachusetts set aside $250 million to stabilize premiums for around 270,000 enrollees. Maryland fully replaced the federal aid for residents earning below 200 percent of the federal poverty level.
These states can do this, in part, because they operate their own state-based insurance marketplaces — which gives them tools Georgia also has, through Georgia Access. The difference is political will.
What Happens Next?
If you are one of the parents in those community groups staring at a $2,300 or $2,800 monthly premium — or doing the math on a $21,000 out-of-pocket exposure before your plan pays for much of anything — here is what the numbers and the policy actually tell you.
This is not one thing. It is several things hitting at once: the expiration of federal subsidies that Congress chose not to renew, a state government that has not moved to fill the gap, a Medicaid program that has not been expanded to cover low-income adults, and an insurance market that responds to enrollment drops by raising prices on everyone who stays.
🩺 Take Action: Georgia’s healthcare system won’t improve unless residents demand it. As a “business-friendly” state, Georgia often prioritizes the needs of businesses, including insurance companies, over patients — and that leaves many families behind. If you want better, tell your state lawmakers to invest in rural hospitals, expand access to care, and support programs that help mothers and children thrive.
