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Most people don't think about health policy until it affects them personally. That moment might come when a larger-than-expected medical bill arrives, a doctor is suddenly no longer in-network, a prescription becomes too expensive to fill, or hours are spent trying to renew a child's Medicaid coverage.

Those experiences often begin long before someone walks into a doctor's office or pharmacy. They are shaped by decisions made by elected leaders about how health care is funded, regulated, and delivered.

As Georgia prepares for the 2026 elections, voters will choose leaders who will make important decisions affecting Medicaid, Georgia Access (the state's Health Insurance Marketplace), public health programs, hospitals and providers, and much more. Many of these responsibilities have always belonged to the state government, but this year's elections carry additional significance because major federal health policy changes enacted in 2025 will require states to make important implementation decisions over the next several years.

The choices that Georgia's elected leaders make will influence how easily people can obtain health coverage, what consumers pay for insurance, how health care providers are supported, how people in communities across the state access care, and whether people are put ahead of profits in health care.

And voters are watching. A new statewide poll commissioned by the Georgia Health Initiative found that most Georgians think the health care system is broken and want leaders to fix it:

• 84% say the health care system is more about money than people
• 62% say health care is not affordable
• 77% say a candidate's views on health care will factor into how they vote this November

Read the Georgia Health Initiative's full Issue Brief for more on what Georgia voters are saying about health care.

Why Federal Policy Makes State Leadership More Important

In 2025, Congress and President Trump enacted H.R. 1, commonly known as the One Big Beautiful Bill Act, which made significant changes to Medicaid and the Health Insurance Marketplace. While Congress established the new federal requirements, many of the decisions that determine how those changes affect Georgians will be made here at home, as parts of the law continue to phase in over the next several years.

For Medicaid, the law creates new work reporting requirements for many adults enrolled through the Medicaid expansion population. Georgia already has experience with a similar concept through its Pathways to Coverage program, which requires many participants to document at least 80 hours each month of qualifying work, education, job training, or volunteer activities to keep their health coverage.

Supporters argue these requirements encourage employment and self-sufficiency. Critics, including us here at GHF, note that Georgia's experience with Pathways has shown how complex reporting requirements can create barriers to enrollment for people who are otherwise eligible for coverage. Missing paperwork, technical problems, or confusion about reporting rules can result in people losing coverage even when they meet the requirement. H.R. 1 expands similar work requirements nationally, meaning Georgia will face important decisions about how they are implemented and how people receive assistance navigating the process.

The law also changes how people enroll in and renew coverage through Georgia Access. Many consumers will face additional paperwork requirements to verify their eligibility for financial assistance, shorter timelines for responding to requests for information, and new documentation requirements throughout the year. Taken together, each new form, deadline, or verification requirement increases the paperwork burden and creates new opportunities for eligible people to lose coverage, what health policy experts call administrative barriers.

Ahead of H.R. 1's passage, Georgians for a Healthy Future joined health care providers, patient advocates, and policy experts in warning that these provisions could make coverage less affordable, increase administrative barriers, and place additional strain on Georgia's health care system. Early evidence suggests those concerns may already be emerging: preliminary data show substantially fewer Georgians enrolled in Marketplace coverage for 2026 than the previous year, and GHF's outreach and consumer assistance work reflects similar trends, with clients increasingly reporting that plans they once could afford are now out of reach.

These changes extend beyond insurance paperwork. They can determine whether someone delays preventive care, can afford to fill a prescription, skips a follow-up appointment after a hospital stay, or waits until a medical condition becomes an emergency before seeking treatment. They can also affect the hospitals and clinics that care for all of us.

Why Georgia's Elections Matter

Federal law establishes broad health policy, but states determine much of how those policies work in practice. No single elected official controls Georgia's health care system. Instead, responsibility is shared across several offices that make decisions about implementation, funding, oversight, enforcement, and administration.

The people elected in 2026 will help determine how Georgia responds to changing federal requirements, how state resources are invested, and how health programs operate for years to come. The guide at the bottom of this post breaks down what each of these offices does and why the race matters this year: the Governor, Insurance Commissioner, Georgia General Assembly, Lieutenant Governor, Secretary of State, Attorney General, and Georgia's members of Congress.

How Does This Affect Me?

Health policy can sometimes feel removed from everyday life, but the decisions made by our elected leaders directly shape the experiences families have when seeking, paying for, and keeping health coverage and care.

Over the next several years, Georgians could see changes to the cost of health insurance, the amount of financial assistance available through Georgia Access, the paperwork required to enroll in or renew coverage, and funding for Medicaid, mental health and substance use recovery services, public health programs, and rural hospitals. In fact, 86% of Georgia voters say increasing access to behavioral health services, including mental health counseling and addiction treatment, should be a priority for the next governor.

These decisions can affect whether people are able to afford preventive care, keep seeing the doctors they trust, fill prescriptions, or receive care close to home. They can also influence the financial stability of hospitals and clinics that serve communities across Georgia.

Not every Georgian will experience these changes in the same way. Some may notice them when shopping for health insurance. Others may experience them while caring for an aging parent, managing a chronic illness, or seeking care during an emergency.

Understanding who makes these decisions and how those offices influence Georgia's health care system can help voters make informed choices at the ballot box.

Your Voice Matters

Health care policy does not begin in the exam room. It begins at the ballot box. The leaders elected by voters make decisions that influence how we access and pay for care, and how healthy our communities are or will be in the future.

The leaders elected in 2026 will help determine how Georgia responds to major federal health policy changes, how public dollars are invested in health care, and how people access coverage and care in the years ahead.

Yet only 40% of Georgia voters feel that elected officials listen to what their constituents have to say about health care policy. That gap is exactly why an informed, engaged electorate matters so much this November.

Whether you are buying health insurance for your family, managing a chronic condition, caring for a loved one, or simply planning for the future, these decisions will have lasting consequences.

An informed vote is one of the most powerful ways Georgians can help shape the future of health care in their communities. Before heading to the polls, take time to learn about the offices on your ballot, understand what responsibilities they have, and research where candidates stand on the issues that matter most to you.

Start with these actions:

• Explore the office-by-office guide below for a deeper look at the responsibilities and health care impacts of each elected office.
• Look up your current elected officials using our Find your Elected Officials tool, and preview your November ballot at Georgia's My Voter Page.
• Share this blog or our 2026 Voter Guide so your friends and family can go to the polls prepared too!