The topic at the center of the budget dispute that could lead to a federal government shutdown at midnight Tuesday is health care — specifically, should Congress extend enhanced federal subsidies for the so-called Obamacare health insurance plans beyond the end of the year?
For consumers and hospitals in Georgia, the stakes are high as Republicans — most of whom are ready to end the subsidies— and Democrats — who want to continue them — try to find common ground.
Ending the subsidies will mean $1.6 billion in lost revenue for hospitals in Georgia next year — and lead to $2 billion in higher costs for Georgians who rely on these plans for health insurance, according to a report by the Robert Wood Johnson Foundation and the Urban Institute, which study health care policy and the consequences of federal social safety net programs.
This projected hit to Georgia businesses and families is the third largest among all 50 states, behind Florida and Texas, according to the study.
The new research adds to data that has worried many Georgia state lawmakers about how state budgets will handle the vacuum of funding set to begin in 2027 due to the cuts to federal programs like Medicaid and food assistance signed into law by President Donald Trump in July.
During the summer, neither Trump nor Congressional Republicans discussed funding for the so-called Obamacare marketplace insurance plans — known in the state as Georgia Access — during budget negotiations. As a result, health insurance plan prices for 1.5 million Georgians currently signed up for marketplace plans, as well as more than 20 million other Americans, are set to rise at the start of 2026.
The Affordable Care Act, passed more than a decade ago, was designed to provide affordable health insurance for all Americans. The federal government added more subsidies to make insurance even cheaper during the Covid-19 pandemic, a situation that allowed low-income adults to receive insurance for little to no premium payments.
In Georgia, with one of the highest rates of uninsured adults in America, residents signed up for these insurance plans in record numbers. In 2025 enrollment stands at about 1.5 million people, a level that Gov. Brian Kemp has hailed as a success for his administration.
If these enhanced subsidies are not renewed beyond their Dec. 31, 2025, expiration, costs for Georgia Access marketplace insurance plans will rise to such an extent that 450,000 Georgians won’t be able to afford them, the health policy research organization KFF says.
The research by Robert Wood Johnson and the Urban Institute suggest that the fiscal consequences will be severe. Georgia hospitals could be facing an estimated $139 million in unreimbursed medical costs as a result, the research shows.
That’s because without insurance, many of those people will skip doctor visits, medications, tests and other health care, but other patients would seek care at the emergency room when issues become too acute to ignore — a situation that costs hospitals, counties and states more money.
For Georgia rural hospitals that are already struggling to stay in the black, these numbers look grim.
Hospital leaders in most of the state’s 71 rural hospitals have already ripped up their strategic plans as they try to predict the changes to their revenue due looming federal budget cuts, Bill Wylie, the vice president of the Georgia Hospital Association said at the Rural Health Association’s annual conference earlier this month. Some hospitals are debating cuts to patient services, like Evans Memorial Hospital in Claxton, and others are considering delays in expansion plans, like Effingham Health System.
Georgians with Obamacare insurance plans can check on the projected increased costs of their policies without enhanced subsidies here.
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Type of Story: News Based on facts, either observed and verified firsthand by the reporter, or reported and verified from knowledgeable sources.