Georgia Health Insurance Guide

Health Insurance Overview in Georgia

Georgia has not expanded Medicaid under the ACA, leaving a significant coverage gap. The state implemented a limited Medicaid waiver program (Georgia Pathways) in 2023 that requires work requirements for certain adults, but this program covers a much smaller population than full Medicaid expansion. Since the 2025 plan year Georgia has run its own state-based marketplace, Georgia Access, instead of HealthCare.gov.

Average Health Insurance Costs in Georgia

Marketplace Enrollment in Georgia

Georgia residents can enroll in individual and family health insurance plans through Georgia Access (State-Based). Open enrollment runs November 1 – January 15 (Georgia Access).

Average Premiums by City in Georgia

Medicaid in Georgia

Georgia has implemented a limited Medicaid waiver (Pathways) with work requirements covering some adults, but has not implemented full Medicaid expansion. Many low-income adults remain without affordable coverage options.

Children's Health Insurance (CHIP) in Georgia

PeachCare for Kids covers children under 19 in families with incomes up to 247% of the federal poverty level.

What Makes Georgia Unique

Georgia's Pathways to Coverage program represents a partial Medicaid expansion with work requirements — a controversial approach that has covered far fewer people than full expansion would. The program requires 80 hours per month of qualifying activities and covers adults earning up to 100% of the federal poverty level, but administrative barriers have limited enrollment.

ACA Subsidies: What Georgia Residents Should Know

The enhanced subsidies first enacted in the American Rescue Plan expired at the end of 2025. For 2026, premium tax credits follow the original ACA rules: there is no credit above 400% (the “subsidy cliff”), and enrollees are expected to pay up to 9.96% of income toward the benchmark Silver plan. House in January 2026 but has not become law, so 2027 plans are being priced and subsidized under the same rules unless Congress acts.

Georgia Access Replaced HealthCare.gov

Starting with 2025 coverage, Georgia left HealthCare.gov and runs its own marketplace, Georgia Access. Georgia is unusual among state-based exchanges because it also lets people enroll through approved private web brokers and insurers (“enhanced direct enrollment”) — so you may see the same plans on several sites. Financial help is the same wherever you enroll, but make sure the site is connected to Georgia Access so your tax credit is applied.

Open enrollment for 2027 runs November 1, 2026 through January 15, 2027.

Cigna and UnitedHealthcare Leave Georgia for 2027

Georgia had 10 insurers for 2026. Cigna and UnitedHealthcare exit at the end of 2026, and Antidote Health Plan enters, leaving eight. Proposed 2027 increases average about 20.7% (weighted) before subsidies, from 12.2% for Anthem Blue Cross Blue Shield to 27.4% for CareSource. That follows a 34.6% average full-price increase for 2026, even with Georgia’s reinsurance program, in place since 2022, holding premiums down.

About 1.32 million Georgians enrolled for 2026; 89% received credits averaging about $688 a month, for an average net premium of about $164.

Georgia Pathways: Medicaid With a Work Requirement

Georgia Pathways to Coverage is a partial Medicaid expansion for adults up to 100% FPL who document 80 hours a month of work, school, job training, or volunteering. Because of the reporting burden, enrollment remained under 18,000 as of May 2026 — a small fraction of the adults who would qualify under full expansion. Adults below 100% FPL who can’t meet the requirement have no marketplace credit to fall back on.

Tips for Choosing Health Insurance in Georgia

Georgia residents should check marketplace subsidy eligibility carefully through Georgia Access. PeachCare provides coverage for children. Adults below the poverty level face limited options due to Georgia's partial Medicaid expansion. ACA subsidies are available for incomes 100-400% of the federal poverty level.

• Enroll during open enrollment (November 1 – January 15 (Georgia Access)) — missing the deadline means waiting until the next open enrollment unless you have a qualifying life event.
• Georgia has not expanded Medicaid, so if your income falls below the federal poverty level you may fall into the coverage gap — a community health center or sliding-scale clinic can serve as a bridge until your income qualifies for marketplace subsidies.

Frequently Asked Questions

Does Georgia use HealthCare.gov?

No. Since the 2025 plan year Georgia has run its own state-based marketplace, Georgia Access. Georgia also allows enrollment through approved private web brokers and insurers connected to Georgia Access.

Which insurers are leaving Georgia’s marketplace for 2027?

Cigna and UnitedHealthcare exit at the end of 2026, and Antidote Health Plan joins, leaving eight insurers. Proposed 2027 increases average about 20.7% before subsidies.

What is Georgia Pathways?

A partial Medicaid expansion for adults with income up to 100% of the poverty level who document 80 hours a month of work, school, training, or volunteering. Enrollment was under 18,000 as of May 2026.

The information on this page is provided for general informational purposes only and reflects estimated industry averages and program eligibility rules as of 2026. Health insurance premiums, Medicaid eligibility thresholds, marketplace options, and program rules change annually. Always verify current eligibility and enrollment options at the official Georgia Access marketplace (Federal) or by contacting a certified navigator or broker. Premium figures shown are approximations before subsidies — actual net premiums depend on individual income, household size, and plan selection.