Millions of Georgians Could Face Big Increases in Health Insurance Costs—Here’s What You Need to Know
Updated April 2026: The Enhanced Premium Tax Credits Have Expired
Congress did not act to extend the enhanced premium tax credits (ePTCs) before they expired on December 31, 2025. The impact on Georgia families is already taking shape:
Enrollment is down. Initial 2026 plan year data shows Georgia Access enrollment dropped by roughly 200,000 people compared to 2025, a 14% decrease.
Premiums have surged. For Georgians who kept their coverage, out-of-pocket premium costs rose by an average of 114%, with the average net monthly premium roughly doubling from $69 to $148.
More coverage losses are projected. An estimated 460,000 Georgians are expected to lose Georgia Access coverage and become uninsured between 2025 and 2034 because of the ePTC expiration combined with new restrictions in the federal “One Big Beautiful Bill Act” (H.R. 1).
Georgia’s health care system will feel it. Health care providers are projected to lose $25 billion in revenue over that same period, deepening strain on rural hospitals and communities already facing provider shortages.
Georgia is not without options. State leaders can act to soften these impacts through targeted premium assistance, reinsurance program adjustments, cost-sharing support, stronger consumer assistance, and special enrollment flexibilities.
Note: The blog content below was written before the enhanced premium tax credits expired. For the most current information and analysis, please refer to the policy brief linked above.
August 2025: Enhanced Affordable Care Act premium tax credits (ePTCs) still expire on December 31, 2025, unless Congress acts. In 2025, Georgia Access enrolled over 1.5 million Georgians, 93% of whom depend on these subsidies to make health coverage affordable. Without an extension, premiums in Georgia are projected to jump over 75% on average, and most 2026 insurer filings already assume the credits will lapse. A typical example: a 60-year-old couple earning about $85,000 would pay roughly $18,000 more per year if the ePTCs disappear. The premium increases resulting from the expiration of the ePTCs could cause about 340,000 more Georgians to become uninsured. In short: swift Congressional action to extend the ePTCs—ideally before rate finalization—would prevent sharp premium spikes for Georgia families and avert significant coverage losses.
If you or someone you know gets health insurance through the Health Insurance Marketplace, you’ve probably noticed it’s been more affordable in recent years. This increase in affordability is thanks to extra financial help from the federal government. These enhanced premium tax credits (ePTCs) make health coverage affordable for working families, self-employed individuals, and people who would otherwise struggle to pay for insurance. But this critical financial help is set to expire at the end of 2025—unless Congress steps in.
If Congress doesn’t extend these tax credits, over 1.2 million Georgians will see huge price increases, and many may be forced to drop their coverage altogether.
Why These Tax Credits Matter to Georgians
Right now, 95% of Georgians buying health insurance through Georgia Access receive financial help to lower the cost of their monthly premium. In 2021 and again in 2022, Congress established additional financial support through the ePTCs to further reduce costs. This extra support has made a big difference:
Lower monthly premiums – The tax credits reduce the amount people pay for their health insurance each month.
Lower deductibles – Many Georgians have seen their deductibles cut in half, meaning they pay less before their insurance kicks in.
Protection from medical debt – More affordable coverage makes Georgians less likely to face overwhelming medical bills.
What Happens if Congress Doesn’t Act?
If these tax credits disappear, health insurance will become unaffordable for many Georgians. Here’s what that could look like:
Higher costs for families – A single person making $30,000 a year could see their premiums jump by $1,350 per year. A retired couple in their 60s making $80,000 could see an increase of $16,800 annually.
Fewer people with coverage – With such large price hikes, many Georgians may be forced to drop their insurance altogether, putting their health and finances at risk.
Higher costs for everyone – When more people lose coverage, hospitals and doctors are left with unpaid bills. This can lead to higher costs for everyone, as hospitals pass those costs along to insured patients and taxpayers.
What Can Georgia Leaders Do?
While the decision to extend these tax credits is up to Congress, Georgia lawmakers (and you!) can take action to help protect Georgians:
Push Georgia’s Congressional Representatives to act – Our state’s leaders should urge Congress to extend these tax credits and protect Georgia families from skyrocketing costs.
You can also urge your Congressperson to act! See the “Take Action” section below!
Explore state-level solutions – Some states are creating their own tax credits to keep coverage affordable. Georgia could do the same, especially for middle-income families and those in high-cost areas.
Help Georgians navigate their options – If tax credits expire, many people will need help understanding their choices. Georgia could expand outreach efforts and local support so that more residents can find coverage they can afford.
Real Impact: Cassie’s Story
For many Georgians, the ePTCs are life changing. Cassie Cox, a Georgia resident, was able to sign up for Marketplace coverage with no monthly premium because of these subsidies. When she needed emergency medical care, her insurance helped cover the cost. Without it, she could have faced a massive medical bill.
Her story is just one example of why these tax credits are so important. If Congress doesn’t act, thousands of Georgians like Cassie could lose their coverage or face financial hardship.
Take Action
Georgians for a Healthy Future will continue to monitor changes to Georgia Access and other health coverage programs. We urge all Georgians to stay informed and speak out — contact your members of Congress and urge them to extend the enhanced premium tax credits before the end of the year to prevent devastating premium hikes and coverage losses.
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