Report: Georgia health sector to lose $3.7B in 2026 as ACA subsidies end
Georgia’s hospitals, doctors and other health businesses stand to lose $3.7 billion in revenue next year alone, if Congress and President Donald Trump allow Affordable Care Act health insurance subsidies to expire in December, a new forecast has found.
Georgia’s expected loss of health sector revenue would be among the three largest in the nation, behind only Florida and Texas, according to the study by the Robert Wood Johnson Foundation and the left-leaning Urban Institute.
Georgia, Florida and Texas would each see their health sector’s overall revenues decline by 4.8% in 2026, according to the forecast, the worst in the nation. The national loss would be about $32 billion.
The “enhanced” subsidies, scheduled to expire Dec. 31, were first enacted during the pandemic under the Biden administration. They lowered premium prices and out-of-pocket costs for more people. They especially made plans more affordable for the lowest-income shoppers and higher-income ones.
Millions of Americans snapped up plans. Georgia’s enrollment in ACA plans more than doubled and now stands at about 1.5 million policyholders.
The ACA marketplace exchange here is called Georgia Access, or GeorgiaAccess.gov.
But extending the subsidies would come at a cost to taxpayers: $335 billion over 10 years, according to the Congressional Budget Office.
And GOP leaders in Washington have been aiming to cut health spending, not increase it. They did not include the extension of enhanced subsidies in the recent spending and tax law called the One Big, Beautiful Bill Act.
Democrats are now trying to force a vote on the subsidies in exchange for continuing to fund the government.
Advocacy groups have been lobbying hard.
Doctors groups, including the Medical Association of Georgia, told Congress that the people who would lose insurance include “many who are older, live in rural areas, or operate small businesses. For these individuals, the credits are a key means of securing comprehensive coverage.”
The expected losses are due to the domino effect of health insurance premiums spiking for ACA customers. Several hundred thousand Georgians are expected to drop their ACA insurance when they see the higher premiums, and many of them will then go uninsured.
For example, right now, a 60-year-old couple making $85,000 a year in Fulton County might pay a $602 monthly premium for a silver plan. But if the enhanced subsidies expire, that could increase to about $2,200 per month, according to KFF.
People can click this link to forecast their own increase.
Without insurance, many of those people will skip doctor visits, medications, tests and other health care that they would otherwise have received. And other patients, especially in emergencies, will seek health care but not be able to pay for it.
Hospitals are obligated by law to stabilize anyone who goes to an emergency room.
In Georgia, out of that overall $3.7 billion health sector loss, hospitals would take about $1.6 billion of the hit, the study said.
In recent months, forecasts of the coverage loss have jumped around as a slew of federal policy changes, proposals and court rulings poured out.
But the most recent estimate from the health research organization KFF is that about 460,000 Georgians will drop ACA health insurance. That’s a result of two things: new barriers passed in President Donald Trump’s One Big Beautiful Bill Act, such as shortening the enrollment window, curtailing auto-enrollment, and adding paperwork and fees; and by far the biggest part of the projected loss, the expiration of the enhanced subsidies.
A small piece of the loss will be DACA recipients, or “Dreamers” who immigrated to the U.S. illegally but gained legal status for a while under previous administrations.
About the Author
Ariel Hart is a reporter on health care issues. She works on the AJC’s health team and has reported on subjects including the Voting Rights Act and transportation.
