Nearly a million Georgians insured through the Affordable Care Act (ACA) health program could face premium price hikes of 20% or more for their 2027 coverage. This increase is projected to take effect when open enrollment begins this fall, according to state data obtained for Georgia Access, the state-run ACA exchange.
These potential increases come on the heels of what were described as "massive price increases" for 2026 coverage, which occurred after Congress and President Donald Trump allowed pandemic-era extra ACA subsidies to expire. While insurance companies have proposed these increases for the Georgia marketplace, the numbers are not final. Bryce Rawson, a spokesman for the Georgia Office of the Commissioner of Insurance, confirmed that these figures are from a mid-summer negotiation point and will be finalized before open enrollment starts on November 1. The premium price changes that consumers will ultimately see will also be influenced by the calculation of federal and state subsidies.
The news signals a significant financial blow to customers and raises concerns for hospitals across the state. Hospital administrators worry that more people will be forced to go without insurance next year, leading to an increase in uninsured patients seeking free care. Monty Veazey, a lobbyist for hospitals in Georgia, stated that based on his calculations of the average value per insured person, Georgia hospitals lost $441 million after the previous price increases took effect for 2026 coverage.
For individuals like Carry Smith, an ACA customer in coastal Georgia, the prospect of further increases is daunting. Smith, who juggles multiple part-time jobs, relies on her ACA plan to manage a life-threatening infection. She saw her premium insurance skyrocket seven-fold earlier this year, a cost she managed only because she had recently paid off her car. When informed about the possible new increases, Smith was terse, simply stating, “Wow,” and was unsure how she would manage another jump in cost. Nora Pullen, a self-employed life and wellness coach and tutor in Fayette County, already dropped her ACA coverage this year after prices became unaffordable. Pullen expressed little hope that prices would become accessible again, saying, “I honestly don’t think this is sustainable for people.”
Experts note that healthier individuals, like Pullen, are more likely to drop coverage when prices increase, creating a "corporate Catch-22." This situation makes it even more expensive for insurance companies to continue providing coverage, prompting them to raise prices further. Cynthia Cox, senior vice president and director of the Program on the ACA at the health research nonprofit KFF, noted that two consecutive years of steep increases are "not a good indication of where the market’s going." She indicated that insurers are anticipating the market to continue shrinking, primarily as healthier individuals leave, which in turn drives up premiums for those who remain.
Georgia experienced one of the nation's largest drops in ACA insurance enrollment after the last round of price increases, with about 350,000 people discontinuing their coverage from spring 2025 to spring 2026. This significant decline is partly attributed to Georgia's decision not to expand Medicaid to all its poor residents, leaving large numbers of Georgians just above the poverty level reliant on Georgia Access for their insurance. Current enrollment in Georgia Access stands at approximately 900,000, according to the state.
Some advocates, including Monty Veazey, also attribute the rising costs to insurance companies, suggesting they are capitalizing on the current situation to increase profits. For example, Ambetter, part of Centene Corporation, is proposing a 10% price increase this year for its Georgia ACA plans, which is lower than many other insurers. However, Ambetter had previously implemented a 38% price increase for Georgia ACA plans. Forbes reported that Centene has touted such moves as contributing to its financial comeback this year, resulting in a $1 billion profit in the last quarter. Centene did not respond to criticisms on Friday afternoon.
Ultimately, Veazey, who is president of the Georgia Alliance of Community Hospitals, predicts that more people will drop their insurance. He warned that this will lead to individuals delaying necessary medical care until their conditions worsen, at which point they will often seek treatment in emergency rooms. Federal law mandates that emergency rooms stabilize patients regardless of their ability to pay, meaning hospitals bear the cost. Veazey summarized the situation by stating it is "not good for us, nor is it good for the patient."
