Georgians start reviewing health insurance plans ahead of open enrollment

Georgians looking for a new or different health insurance plan under the Affordable Care Act can start comparing plans now, before open enrollment starts on Nov. 1. It’s called “window shopping.” This marks the second year of access through the state-based marketplace, Georgia Access.

But the premiums people see now are just estimates and could go way up come January.

On Georgia Access, monthly premiums at this point still include enhanced tax credits for those who qualify, because they won’t expire until the end of the year unless Congress decides to extend them.

People must make at least 100% of the federal poverty level and no more than 400% FPL to qualify for tax credits.

Georgia insurers have, in part, cited an expected loss of federal subsidies that help make marketplace health insurance affordable as a reason for the price hikes people are likely seeing now when browsing plans.

According to filings from health insurers in Georgia, which they file every year, proposed rate increases vary from 6% to 40% depending on the insurer and plan. Those rates people see now are fixed, unless the state opens a refiling window.

An analysis by KFF of rate filings across the country estimates an average proposed increase around 20% — that can look like a plan that costs over $1,000 or $2,000 a month for a family of three.

“This is the largest requested rate change since 2018,” said Natasha Taylor with the consumer advocacy group, Georgia Watch.

Some Georgia Democrats have been raising the alarm. An analysis by the nonprofit research group Urban Institute points to a potential uninsurance rate of around 40% in Georgia if tax credits expire. However, Republicans in Congress argue the tax credits are too expensive, cover people who shouldn’t qualify and have asked that negotiations on health care spending continue upon an end to the government shutdown.

With open enrollment a month away, Taylor wants people to plan for an even higher monthly cost come January.

“I think the main thing for insurers to know as they’re shopping for plans ahead of time is just keeping in mind that the rates are going to go up,” she said.

A deeper look at expected changes

Every year, insurers file proposed rate changes to Georgia’s Office of the Commissioner of Insurance and Safety. They justify their changes in documents called actuarial memorandums.

This year, a variety of factors have insurers justifying a rise in premium costs.

“We assume healthier individuals who tend to be more price sensitive will exit the market, worsening the average morbidity of the individual risk pool,” reads the actuarial from insurance company Ambetter filed this year.

Other factors contributing to higher premiums, insurers write in the memos, include the price of certain prescription drugs and inflation.

The upcoming open enrollment period will be Roberto Gutierrez’s 12th season as a certified assister. He works with who need help picking in insurance plan through the nonprofit Boat People SOS.

A preliminary look at plans during Georgia Access window shopping shows some 2026 plans far more expensive than last year, he says.

“The plan that used to be the cheapest last year is not the cheapest this year,” Gutierez said.

Costs have changed “dramatically” so far, though he notes some plans have decreased in price, too.

Gutierez encourages everyone, especially those who tend to automatically re-enroll in a plan, to take a look at their plans comprehensively.

“Even if the plan doesn’t change names, sometimes the copays or the deductible maximum out of pocket can change,” he said.

It’s also important to look at providers that will take a health insurance plan, because that can change every year as well.

Even though window shopping prices aren’t completely accurate during the ongoing debate over ACA tax credits, Gutierez said the extra time to compare plans can be valuable.

“In the hurry of open enrollment, we don’t have chance to review in depth or maybe as much as the client might like because time is too short,” he said.

The breadth of assistance people will have access to from the state by the time open enrollment starts isn’t clear yet. Georgia Access has not announced a list of grantees under its navigator program, in which community organizations are given state funds to “help reach underserved and uninsured Georgians.” The program was signed into effect by Gov. Brian Kemp in 2023.

Applications for navigator grants for the 2026 open enrollment season closed in August.