The Road Ahead for Georgia Access: Navigating the End of Enhanced Subsidies and the Impacts of Federal Policy Shifts examines how recent federal policy changes are reshaping Georgia’s health insurance marketplace in 2026. This policy brief traces Georgia Access’s rapid enrollment growth—from 462,000 enrollees in 2020 to more than 1.5 million in 2025—and analyzes how the expiration of enhanced premium tax credits and new federal marketplace rules are increasing premiums, reducing affordability, and driving projected coverage losses across the state.

The brief estimates that approximately 460,000 Georgians could lose marketplace coverage over the next decade due to subsidy expiration and new federal restrictions. It details the anticipated premium increases facing low- and middle-income households, older adults, and rural communities, as well as the projected $25 billion impact on Georgia’s health care system from rising uncompensated care.

In addition to outlining the scope of coverage and affordability challenges, The Road Ahead for Georgia Access explores state-level policy options available to Georgia leaders. These include targeted affordability programs, reinsurance adjustments, cost-sharing assistance, investments in consumer enrollment support, and strategic use of special enrollment periods. The brief evaluates the fiscal and administrative considerations of each option and assesses how proactive state action could stabilize Georgia Access and protect recent coverage gains.

This report provides policymakers, advocates, and stakeholders with data-driven analysis to inform decisions about Georgia’s health insurance marketplace in a changing federal landscape.