Background

On May 22, the U.S. House passed a sweeping budget bill, known as the “One Big Beautiful Bill” Act. The budget bill proposes significant changes to the Affordable Care Act (ACA) Health Insurance Marketplace, which is known as Georgia Access in our state. Proponents say these changes will cut costs, but they would also make it harder for many Georgians to enroll in or keep their health coverage.

The Senate is now making its changes to the bill, but what those changes will look like is unclear. As currently written, projections from the non-partisan Congressional Budget Office (CBO) show the House’s changes would reduce overall Marketplace enrollment and increase the uninsured rate nationally and in Georgia. If the budget bill passes as currently written, the combination of Marketplace (including allowing the expiration of the enhanced premium tax credits) and Medicaid changes could lead to an estimated 560,000-940,000 Georgians becoming uninsured.^[1] (Notably, some of the marketplace changes presently in the bill are also under consideration by the Centers for Medicare & Medicaid Services (CMS), meaning they could be authorized through federal regulation even without new legislation.)