Proposal would redirect more than $7 billion a year into a state-designed credit, new personal health accounts, and reinsurance; older adults and lower-income families would face the largest cost increases; public comments due November 13, 2026
ATLANTA — Georgia is seeking federal approval for the most far-reaching change to its individual health insurance market since the Affordable Care Act took effect. For the nearly 900,000 Georgians who buy coverage through Georgia Access, more than nine in ten of whom rely on federal premium tax credits, the proposal would replace those credits with a state credit that grows more slowly than premiums. If approved, the changes would take effect for 2028 coverage, with open enrollment starting November 1, 2027.
How the proposal would work
- A state credit would replace the federal tax credit. Today, the federal credit rises automatically as premiums rise, capping what a consumer pays for a benchmark plan as a share of their income. The state credit would be a fixed dollar amount, set before each open enrollment based on age, income, and location. It would grow with medical inflation, not with premiums.
- The credit would go into a personal health account. Instead of going directly to the insurer, the credit would be deposited into an account run by a private vendor. Consumers would use the account to pay premiums and could spend any remaining balance on medical costs.
- Cost-sharing help would change for some enrollees. Silver plan enrollees with incomes below 200% of the poverty level would keep their reduced deductibles and copays. Enrollees between 201% and 250% of poverty, and lower-income enrollees who choose Bronze plans, would instead receive a flat deposit into their personal health account.
- The Navigator program would end. Community organizations would handle outreach and education. Insurance agents and the Georgia Access call center would handle enrollment.
- Part of the funding would support reinsurance. The proposal would direct federal funding into the state credit, the new accounts, and reinsurance.
See the full release for consumer impacts.