Georgia Access Shrinks Toward 900,000 After Credits Expire

Enhanced Affordable Care Act premium tax credits expired on December 31, 2025, and Georgia’s net marketplace premiums rose 114% in 2026. Paid enrollment on Georgia Access was down to about 900,000 by August 2026, from 1,519,153 plan selections a year earlier.

Insurers have already locked in another 20.7% average increase for 2027. Open enrollment starts November 1, 2026, and the state cancelled the usual preview week.

Georgia Premiums Doubled After the Credits Lapsed

The extra credits, first added in 2021 and later extended through 2025, cut what people paid each month and opened help to households above 400 percent of poverty. In Georgia, 95 percent of Georgia Access enrollees received them in 2025. Georgians for a Healthy Future, an Atlanta consumer group, found they cut the average monthly premium from $616 to $69 that year.

When the extra help ended, the sliding scale went back to the older Affordable Care Act formula. Help stops at 400 percent of poverty, about $62,600 for a single person in the 2026 plan year on KFF’s subsidy tables. Households above that line pay the full sticker price.

The original premium tax credit still exists. It did not vanish with the 2025 sunset. It is smaller, and it no longer reaches middle-income buyers who had used the extra credits to stay on the exchange.

THE 2026 PREMIUM SHOCK

• Net monthly average: Rose from $69 in 2025 to $148 in 2026, a 114% increase, according to Georgians for a Healthy Future.
• Extra cash each year: That $79 monthly gap is $948 a year for a typical subsidized enrollee.
• Gross rates: Insurers’ approved 2026 prices rose 34.6% before tax credits, based on final Georgia filings.
• Who still got help: The share of enrollees with premium subsidies fell from 95% in 2025 to 89% in 2026.

A February 2026 policy brief from the same group found net monthly premiums roughly doubled for people who kept coverage. A 45-year-old in Liberty County earning $40,000 went from $130 a month to $275, up $145. A family of four in Macon County earning $88,000 went from $369 to $672, up $303.

KFF, a health policy research group, estimated that subsidized shoppers nationwide would see net payments more than double if the extra credits lapsed, from an average $888 a year in 2025 to $1,904 in 2026. Among people who actually signed up for 2026 coverage, KFF later found net payments rose 58 percent, a smaller jump because many high-cost households left.

Paid Enrollment Kept Falling After Sign-Up Day

Plan selections are a head count of people who picked a policy. Paid enrollment is the smaller group that sent in the first premium. In 2026 those two numbers pulled apart.

KFF’s tally of federal open-enrollment files shows Georgia plan selections fell from 1,519,153 for 2025 to 1,301,254 for 2026, a drop of 217,899 people, or 14 percent. CMS paid-enrollment figures for February, compiled by the Center on Budget and Policy Priorities, show a milder early cut: 1,298,071 in February 2025 to 1,188,140 in February 2026, down 109,931, or 8 percent.

Then the grace periods ran out. The Georgia Office of the Commissioner of Insurance and Safety Fire counted 950,000 active policies on April 17, 2026. State figures cited with 2027 rate filings put paid enrollment at about 900,000 in August 2026.

GEORGIA ACCESS ENROLLMENT, 2025 TO 2026

Emma Wager, a senior policy analyst at KFF, said there is no public file showing how many of those dropouts became uninsured and how many moved to a job plan or other coverage. A KFF follow-up survey of 2025 marketplace enrollees found that 9 percent said they were uninsured for 2026, and eight in 10 people who changed plans or dropped coverage named cost as a reason.

Michelle Au, a physician and Democratic member of the Georgia House, put the marketplace loss in blunter terms after the credits expired. “More than half a million Georgians have lost access to their marketplace health insurance,” she wrote in September 2026.

Another 20.7% Hike Is Locked In for 2027

The 34.6 percent gross increase for 2026 was the first wave of 2026 rate hikes after Congress left the extra credits on a sunset clock. Final 2027 filings in Georgia’s SERFF database, posted September 25, 2026, approve a weighted average increase of 20.7 percent on top of that.

Unsubsidized buyers would pay about $1,925 more per person per year if they kept the same plan, based on those filings. People who still qualify for the older tax credit will see some of the sticker increase absorbed, because the credit tracks the second-lowest-cost silver plan. People over the 400 percent cutoff will not.

Two national carriers are leaving the Georgia individual market for 2027. Cigna is exiting the ACA individual market nationwide; it had about 35,000 Georgia members in spring 2025. UnitedHealthcare is also leaving Georgia’s individual market. Antidote Health Plan of Georgia is entering. Shoppers whose 2026 carrier is gone will have to pick a new plan or be moved.

KFF’s national scan of 2027 filings found a median proposed increase of 15 percent, the second straight year of double-digit hikes after several flat years. Georgia’s 20.7 percent approved average sits above that national midpoint.

What Open Enrollment Looks Like This Fall

Georgia Access will not offer the early “window-shopping” period it ran a year ago. Garrison Bennett, press secretary for Insurance Commissioner John King, said the agency could not put one up. “This year, due to some changes, we are unable to put forward a window-shopping period before open enrollment,” Bennett said. He did not give a public reason.

The state site says open enrollment begins November 1, 2026. Coverage for 2027 starts January 1 only if a person enrolls by December 15, 2026. The window closes January 15, 2027, with later sign-ups generally starting February 1.

THE 2027 SIGN-UP WINDOW

• November 1, 2026: Open enrollment starts on Georgia Access, with no preview week.
• December 15, 2026: Last day to enroll for coverage that begins January 1, 2027.
• January 15, 2027: Last day to enroll at all for 2027 plans.
• Carrier exits: Anyone whose 2026 insurer left the market has to choose a new plan.

Georgia Access still auto-renews people who do not make a new choice, and it sends a notice first. If the 2026 company is not selling in that county in 2027, the enrollee has to pick again. After January 15, a special enrollment period is available only after a qualifying life event such as a job loss, a move, a marriage, or a birth.

Georgia’s House Split, and the Senate Did Not Pass It

The extra credits did not die in silence. Democrats refused to fund the government in the fall of 2025 unless Congress renewed them, producing a long shutdown that ended in mid-November 2025 with a promise of later Senate votes. On December 11, 2025, the Senate rejected both a three-year extension and a Republican health-savings-account substitute. Each vote was 51-48. Both needed 60 votes to advance.

The House passed a three-year extension on January 8, 2026, on a 230-196 vote, with 17 Republicans joining Democrats. None of those 17 was from Georgia. Every Democrat in the Georgia House delegation voted to extend the tax credits. All eight Georgia Republicans voted no.

Today I voted YES to extend the Affordable Care Act’s enhanced premium tax credits because no Georgian should have to choose between paying their health insurance bill and putting food on the table.

Rep. David Scott, D-Ga., January 8, 2026 statement

Rep. Austin Scott, R-Tifton, said he voted no because he believes the Affordable Care Act itself pushed premiums up and the extra credits only hid that cost. Sen. Jon Ossoff, D-Ga., warned the same week that without an extension, “it’s projected that half-a-million Georgians will lose their health insurance altogether.”

The House bill did not become law. As of early October 2026, the Senate had not passed an extension, and 2027 prices were already approved. A later Senate vote on September 29, 2026, rejected a bid to undo a separate Trump administration marketplace rule, 48-51. That fight was about plan design and verification, not a revival of the 2021 credits.

The One State That Replaced the Federal Credits

KFF’s 2026 paid-enrollment study found enrollment fell in every state except New Mexico. New Mexico put state money in to replace the expired federal extra credits. Its February paid enrollment rose 14 percent, from 69,915 to 80,047.

Nationally, CMS counted 19,169,148 paid marketplace enrollees in February 2026, down 2,607,478, or 12 percent, from 21,776,626 in February 2025. States that use HealthCare.gov and offered no state subsidy saw about a 15 percent drop. State-run exchanges as a group fell about 6 percent. Georgia is a state-run exchange, and its February CMS drop of 8 percent sat near that state-run average. The later Georgia counts, 950,000 in April and about 900,000 in August, show how many people who selected a plan did not keep paying.

Georgia already had a tool that lowers sticker prices. Its Section 1332 reinsurance program, live since January 1, 2022, pays a share of high claims and uses a three-tier map that sends more relief to rural counties. The state reported premium reductions of 16.7 percent in 2022 and 19.2 percent in 2023, with cuts of 25 to 34 percent in the highest-cost rural counties. Federal pass-through funding tied to that waiver rose from about $306 million in 2022 to more than $1 billion in 2025. Reinsurance did not replace the extra tax credits, and Georgia did not add a state credit on top of it.

Other 2025 federal changes stacked onto the sunset. The July 2025 reconciliation law ends automatic re-enrollment in 2028, tightens income checks, and has already closed the year-round special enrollment period that low-income buyers used through August 2025. About 930,000 Georgia Access customers, 61 percent of the 2025 book, had been auto-renewed.

Hospitals Are Already Counting the Unpaid Bills

When people leave the exchange, unpaid hospital bills do not leave with them. Monty Veazey, a lobbyist for Georgia hospitals, put the 2026 hit at $441 million, using an average value per insured person after the first-year drop. Georgians for a Healthy Future has projected a $25 billion hit to the state’s health system over a longer window if coverage keeps falling.

Those figures are estimates, not audited losses. They point at the same pressure: emergency rooms still treat people who drop coverage, and the remaining insured book is older and sicker if healthier buyers leave first. That is one reason 2027 filings came in with another double-digit increase even after 2026 already moved tens of thousands of people off the rolls.

Georgia never expanded full Medicaid, so the marketplace is the main private-coverage door for adults who do not get insurance at work and who earn too much for the state’s narrow Pathways program. The extra credits had been the patch over that gap. They are gone. The older tax credit is what is left, 2027 prices are already approved at plus 20.7 percent, and the shop window opens November 1, 2026, with no preview.

Disclaimer: This article is news reporting on federal tax-credit rules, Georgia marketplace enrollment, and insurer rate filings. It is for information only and is not personal insurance, tax, or medical advice. It does not tell any reader which plan to buy, whether to drop coverage, or how to file taxes. Anyone making a coverage choice should talk with a licensed insurance agent, a certified Georgia Access assister, or a tax professional about that household’s income and options. Enrollment counts, premiums, and approved rates reflect the filings and agency figures cited here and can change as insurers, Congress, or the state update them.