Federal changes are raising the stakes
Over the past year, federal policy changes have created serious new risks for Georgia’s health care system. H.R.1 (aka. “One Big Beautiful Bill” or “The Working Families and Tax Cuts Act”) and the expiration of the enhanced premium tax credits (ePTCs) reshape how Georgia Access and the state’s Medicaid program are financed and administered. Together, these changes mean higher premiums for families, stricter eligibility and reporting rules, and less federal funding flowing to Georgia’s health care system unless the state steps in.
What the latest data shows
A new report commissioned by the Georgia Health Initiative, Impact of Federal Policy Changes to Georgia’s Health Care Landscape, lays out what these changes could mean for our state. The analysis projects that nearly 500,000 Georgians could lose coverage and become uninsured by 2034, if the changes move forward as written. Most of those losses would come from Georgia Access, with 460,000 enrollees expected to become uninsured. Especially steep coverage losses are expected among rural residents, older adults, and families with low incomes.
How much Georgia stands to lose
The report also estimates that Georgia providers would lose $51.1 billion in health care revenue over 10 years, including $10.5 billion in uncompensated care losses, and that the state could see tens of thousands of jobs lost and hundreds of millions in foregone tax revenue as coverage declines.
What Georgia can do now
The good news is that Georgia still has options. Because the state operates Georgia Access as a state-based marketplace and controls key decisions about Medicaid, state leaders have tools to blunt federal cuts and protect families and hard-working Georgians from losing coverage. This legislative session, policymakers can act by adopting proven solutions, such as:
- Creating a state affordability program to lower premiums and out-of-pocket costs for Georgia Access enrollees.
- Strengthening Georgia’s reinsurance program so it continues to bring down premiums, especially in rural regions where prices are highest, and coverage losses are expected to be most severe.
- Fully expanding Medicaid to more low-income adults to reduce the uninsured rate, stabilize rural hospitals, and offset some of the damage from the federal Medicaid financing cuts.
- Investing in outreach and enrollment assistance so eligible Georgians stay covered, and families understand their options as rules and premiums change.
- Modernizing Medicaid and Marketplace eligibility enrollment systems to reduce paperwork barriers, speed up processing, and prevent avoidable, paperwork-driven coverage losses.
A path forward
As we head into the legislative session, GHF is urging state leaders to treat this report as a roadmap, and not a preordained outcome. With timely, state-level action, Georgia can shield families from rising premiums and shrinking coverage to keep our state on a stronger footing for the years ahead. Read our latest press release to learn more about the report and Georgia’s path forward.
