Expiration of ACA Tax Credits May Double Premiums for Georgians in 2026

The impending expiration of federal premium tax credits, initially enacted under the 2021 Covid relief legislation, is forecasted to significantly increase Affordable Care Act (ACA) insurance premiums in Georgia in 2026. An analysis by the Georgia Health Initiative indicates that, without congressional action to extend these subsidies, average monthly premiums could more than double from $69 to $148. This increase is expected to impact approximately 1.5 million Georgians currently enrolled in ACA plans, with a potential uninsured surge of about 340,000 individuals due to affordability challenges. The loss of these subsidies carries particular financial pressure for individuals earning above 400% of the federal poverty level, who will face full-price premiums. However, those below this income threshold are also anticipated to experience premium hikes. Market responses may include shifts to lower-coverage plans offering reduced premiums but higher out-of-pocket expenses, potentially increasing financial risk for enrollees. The failure of two Senate proposals on December 7 to extend or supplement these subsidies leaves the legislation unresolved as the congressional recess approaches, creating uncertainty for consumers and providers. The Georgia state government has established the GeorgiaAccess portal for plan comparison and enrollment, replacing the federal marketplace for ACA sign-ups, with enrollment deadlines set for January 15 but with January 1 coverage start dates for earlier enrollment. Industry experts warn that rising uninsured rates could amplify health care costs across the system, as uninsured individuals may delay care or rely on emergency services, shifting financial burdens onto hospitals and insured patients. Hospitals in Georgia express concern over resource constraints linked to increased uncompensated care, which could contribute to further premium increases. Policy implications include significant considerations for state health officials and insurers regarding coverage stability and affordability. The withdrawal of Aetna from the Georgia ACA market in 2026 is expected to necessitate customer reassignment to alternative providers. Ongoing monitoring of congressional developments and stakeholder engagement will be critical to navigating the evolving insurance landscape in Georgia.