Biden-era enhanced Marketplace subsidies are set to expire at the end of the year unless Congress and President Donald Trump renew them. Thomas Barwick/Getty Images
On Jan. 1, 2026, Georgia will face the largest health coverage loss in its history — unless Congress and the president act. On that date, more than 500,000 Georgians will lose coverage due to the expiration of enhanced marketplace subsidies.
Consider a couple in Rome, Georgia. He runs an auto repair shop; she does bookkeeping. They don’t qualify for Medicaid and have no employer coverage, so they’ve relied on marketplace insurance since enhanced subsidies began. Without action, their premiums will jump by more than $1,400 a month — to over $2,000. For them, and thousands like them, it’s not about politics. It’s about whether they can afford to stay insured — or risk their health, their savings, and their livelihood by going without. Their story is about to repeat across every ZIP code.
First introduced during the pandemic and extended by the Inflation Reduction Act, enhanced marketplace subsidies didn’t just lower premiums — they made health insurance attainable for hundreds of thousands who were previously ineligible or priced out.
The subsidies capped premiums at 8.5% of household income — even for those earning over 400% of the federal poverty level. They’ve helped small business owners, gig workers, early retirees, and others without employer insurance or access to Medicaid.
Nationwide, over 24 million people enrolled in marketplace coverage in 2025. In 75 congressional districts, at least 10% of residents rely on marketplace plans — including 62 in Florida, Georgia, and Texas — putting health coverage, and political control, on the line.
Beyond Georgians losing insurance, the fallout would drive up uncompensated care, destabilize state health budgets, and disrupt local economies. Hospitals already operating on thin margins, especially in rural areas, will absorb the cost of care for uninsured patients — pushing some to the brink of closure.
Most marketplace enrollees don’t know it’s coming. A recent poll found most adults had heard either “a little” (33%) or “nothing at all” (40%) about the expiring subsidies — including majorities of Democrats (64%), independents (76%), and Republicans (75%). The risk of a blindside coverage crisis is real.
Marketplace enrollees face a two-pronged increase in their premium payments come 2026. Without action, marketplace premiums will surge — first from the loss of subsidies, then from insurers anticipating a smaller, riskier pool. Peach State Health Plan and UnitedHealthcare have filed rate hikes of 20 percent and 40 percent.
Higher premiums would price many families out of coverage — especially those without major health risks — shrinking the individual market and raising the average risk level among those who remain. As the market contracts, insurers would have less incentive to compete, making the marketplaces more vulnerable if carriers exit. The result could be a damaging cycle of fewer enrollees, higher risks, reduced competition, and escalating premiums.
The Republican Study Committee’s March 2025 fiscal budget said the enhanced subsidies “only perpetuate a never-ending cycle of rising premiums and federal bailouts — with taxpayers forced to foot the bill.” But letting them expire won’t save taxpayers; it will shift the cost to families, hospitals, and state budgets.
With millions of Americans at risk — and states like Florida, Georgia, South Carolina, Tennessee, and Texas facing the biggest state-level losses — Republicans will face pressure to reconsider. These non-expansion states saw the biggest enrollment gains over the past four years that are now at risk of unraveling.
That urgency is showing up in the polling. A July 2025 poll by Republican pollsters Fabrizio and Ward of competitive 2026 congressional districts, found that extending the enhanced subsidies is both widely popular and politically critical. The poll shows a 15-point swing in competitive 2026 districts if the subsidies aren’t extended — putting the narrow Republican House majority, and perhaps control of the Senate, at risk.
Politics can be messy. The stakes are not. The clock is running out. Failing to act before the October recess won’t just trigger a coverage crisis — it will leave Congress and the president to answer for the consequences.
Do nothing, and Jan. 1 becomes Georgia’s uninsured New Year.
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This post was originally authored and published by Roland J. Behm from Georgia Recorder via RSS Feed. Join today to get your news feed on Nationwide Report®.
