The health insurance that 694,000 Georgians bought this year won’t exist at the same price in two weeks when open enrollment begins.
🎯 Why It Matters: More than half the people in Georgia who get subsidized health insurance through the Affordable Care Act marketplace will lose their coverage because they can’t afford it anymore. That’s 372,000 Georgians expected to go uninsured while Congress remains deadlocked in a government shutdown over whether to extend the subsidies.
⏰ What’s Happening: Enhanced premium tax credits expire at the end of this year. Democrats are refusing to vote for a continuing resolution to reopen the government unless Republicans agree to extend the subsidies. Republicans left them out of the One Big Beautiful Bill Act they passed in July.
Open enrollment for 2026 coverage starts in two weeks. Families will see their premiums when they log in to shop for plans.
💰 The Numbers: According to the Urban Institute, a single person in Georgia earning $30,000 a year pays about $169 annually for health insurance right now. In two weeks, that same plan will cost $919. A family of four earning $70,000 will see their premium jump from $169 to $919. Middle-income families earning between $39,125 and $62,600 for a single person will watch premiums more than double from $1,171 to $2,455. Anyone earning above $62,600 for a single person loses federal help entirely. Their premiums nearly double from $4,436 to $8,471.
🔑 Key Terms: When talking about this issue it can sometimes be difficult to keep track of all the terms used. Here is a quick breakdown.
- Affordable Care Act: This is the law that regulates the level of insurance health insurance companies must provide, tells them they can’t charge you more for preexisting conditions, and forces them to set out of pocket maximums. It also makes health insurance available to individuals through a healthcare marketplace. The Affordable Care Act was dubbed “Obamacare” by republicans, but they are the same thing.
- Health Insurance Marketplace: This is how the individuals who are not covered by employer-based insurance buy health insurance.
- Georgia Access: Georgia’s version of the health insurance marketplace.
- Medicaid: Medicaid is not the same thing as the Affordable Care Act. It is a government program that allows low income residents to have health care.
📊 Between the Lines: Georgia will see the third-steepest drop in marketplace enrollment in the country. Only Louisiana and Mississippi face worse losses. The state’s subsidized marketplace enrollment falls by 53 percent under the standard subsidy structure. The uninsured population would jump by 39 percent.
Eight states total will lose more than half their subsidized marketplace enrollment. All of them are in the South or have not expanded Medicaid.
🔍 Catch Up Quick: The enhanced subsidies started in April 2021 under the American Rescue Plan Act. They lowered what people had to pay for health insurance and made subsidies available to higher earners for the first time. The Inflation Reduction Act extended them through 2025.
Marketplace enrollment nationwide more than doubled from 12 million in 2021 to 24.3 million people signing up for coverage in 2025.
The subsidies work by capping how much of your income you have to spend on premiums. Under the enhanced version, people earning less than $23,475 for a single person pay nothing. Under the standard version returning in 2026, they could pay up to 4.19 percent of their income.
👥 Who Loses Coverage: Black residents nationwide will see uninsurance rates climb by 30 percent, the steepest increase among racial groups. White residents face a 25 percent increase. Young adults ages 19 to 34 will see their uninsured numbers jump by 25 percent.
The self-employed and small business owners make up nearly half of current marketplace enrollees. Many will have nowhere to turn for affordable coverage.
🗺️ The Georgia Factor: Georgia is one of 10 states that has not expanded Medicaid under the Affordable Care Act. Adults earning below the poverty level have no safety net when marketplace coverage becomes unaffordable.
The state also faces additional pressures from new federal rules that eliminate premium tax credit eligibility for some lawfully present immigrants and remove special enrollment periods that helped low-income people sign up for coverage mid-year.
⚠️ The Cascade Effect: When insurers set their 2026 premiums, they did so amid uncertainty about whether the subsidies would continue. If healthier people drop coverage because of higher costs, the remaining pool of insured people will be sicker on average. That drives premiums even higher, and it drives them up for everyone. That means if you are on health insurance through your employer, you can expect higher premiums to hit you in 2027.
The kind of enrollment collapse Georgia faces raises questions about whether insurers will continue offering plans in the state at all. A larger marketplace with more enrollees encourages insurer competition and keeps premiums lower. A smaller marketplace is more vulnerable to insurer exits and premium spikes. Aetna has already dropped out of the insurance marketplace in Georgia.
📅 The Timeline: Open enrollment begins in two weeks. Coverage starts January 1, 2026. The government shutdown continues with no clear end date. The enhanced subsidies expire December 31, 2025.
🩺 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.
📚 The Sources:
- Urban Institute Health Insurance Policy Simulation Model, 2025
- Centers for Medicare and Medicaid Services Marketplace enrollment data
- American Rescue Plan Act of 2021
- Inflation Reduction Act of 2022
- One Big Beautiful Bill Act, 2025
- Marketplace Integrity and Affordability Final Rule, 2025
B.T. Clark
B.T. Clark is an award-winning journalist and the Publisher of The Georgia Sun. He has 25 years of experience in journalism and served as Managing Editor of Neighbor Newspapers in metro Atlanta for 15 years and Digital Director at Times-Journal Inc. for 8 years. His work has appeared in several newspapers throughout the state including Neighbor Newspapers, The Cherokee Tribune and The Marietta Daily Journal. He is a Georgia native and a fifth-generation Georgian.
