Georgia has one of the largest ACA marketplace enrollments in the country, with over 1.3 million residents signed up for 2026 coverage. But 2026 is a different year than recent ones. The enhanced premium tax credits that lowered costs for millions of Georgians expired at the end of 2025, and that changes how you should approach plan shopping this year.
Quick Answer: Georgia residents can enroll in ACA marketplace plans through Georgia Access (georgiaaccess.gov). For 2026, subsidies are available to households earning 100% to 400% of the federal poverty level. Enhanced credits expired December 31, 2025, so premiums are higher than they were in 2024 or 2025 for many people. Open enrollment runs November 1 through January 15 each year.
This guide covers what plans cost, who qualifies for help, and exactly how to enroll.
What Changed in 2026
Two things matter most for Georgians shopping for coverage in 2026.
First, the enhanced premium tax credits from the American Rescue Plan and Inflation Reduction Act expired on December 31, 2025. Those credits had expanded subsidy eligibility above 400% of the federal poverty level and made premiums significantly lower for nearly everyone. Without them, the old income cap is back: if your household earns more than 400% of the federal poverty level, you get no subsidy at all. This is called the "subsidy cliff."
Second, Georgia insurers filed weighted average rate increases of 34.6% for 2026 before subsidies. That means unsubsidized premiums are substantially higher. If you received subsidies in prior years, your net cost may still be manageable. If you were just above the 400% FPL threshold, you could be looking at a significant jump.
Georgia does operate a Section 1332 reinsurance program that partially offsets rate increases by reimbursing insurers for high-cost claims. It provides some relief, but it does not replace the expired enhanced credits for most enrollees.
Who Qualifies for Subsidies in 2026
As of 2026, premium tax credits (subsidies) are available to households earning between 100% and 400% of the federal poverty level (FPL). Cost-sharing reductions, which lower deductibles and out-of-pocket costs, apply to households at 100% to 250% of FPL, but only if you enroll in a Silver plan.
Georgia has not expanded Medicaid, which means adults without dependents generally do not qualify for Medicaid regardless of income. The 100% FPL floor for marketplace subsidies is therefore meaningful: if your income falls below that threshold and you do not qualify for Medicaid, you may fall into the "coverage gap" with no affordable options.
2026 ACA Subsidy Income Limits by Household Size
The table below uses 2025 federal poverty guidelines, which is the benchmark used for 2026 coverage year subsidy calculations.
| Household Size | 100% FPL (minimum for subsidy) | 250% FPL (max for cost-sharing reductions) | 400% FPL (maximum for any subsidy) |
|---|
| 1 | $15,650 | $39,125 | $62,600 |
| 2 | $21,150 | $52,875 | $84,600 |
| 3 | $26,650 | $66,625 | $106,600 |
| 4 | $32,150 | $80,375 | $128,600 |
| 5 | $37,650 | $94,125 | $150,600 |
| 6 | $43,150 | $107,875 | $172,600 |
| 7 | $48,650 | $121,625 | $194,600 |
| 8 | $54,150 | $135,375 | $216,600 |
| Each additional | +$5,500 | +$13,750 | +$22,000 |
If your income is between 100% and 400% FPL, you qualify for premium tax credits. If it is between 100% and 250% FPL, you also qualify for cost-sharing reductions on a Silver plan.
Georgia Access: How Georgia's Marketplace Works
Georgia uses a state-based exchange called Georgia Access (georgiaaccess.gov), operating under a Section 1332 waiver. This means you do not go to HealthCare.gov to enroll. You use the Georgia Access platform instead.
One advantage of Georgia's setup: licensed brokers can complete your full ACA enrollment outside of HealthCare.gov. This includes subsidy calculations, plan selection, and finalizing coverage. This pathway is not available in most other states, which means Georgians who work with brokers often have more flexibility.
Georgia Access offers plans from eight insurers for 2026 coverage (down from nine, as Aetna exited at the end of 2025). Available carriers include Ambetter by Peach State Health Management, Blue Cross Blue Shield of Georgia, Cigna, Oscar Health, and Kaiser Permanente in the Atlanta metro area, among others. Availability varies by county.
Plan Tiers and What They Cover
Georgia Access offers four metal tiers. Each tier reflects a different split between what you pay in monthly premiums versus what you pay when you use care.
| Metal Tier | Average Monthly Premium | Typical Deductible | Best For |
|---|
| Bronze | Lowest | $7,500 to $8,700 | Healthy people who want catastrophic protection |
| Silver | Moderate | $3,500 to $5,000 (before CSR) | People qualifying for cost-sharing reductions |
| Gold | Higher | $1,000 to $2,500 | People who use care frequently |
| Platinum | Highest | Near $0 | People with predictable high healthcare needs |
Silver plans are the only tier eligible for cost-sharing reductions. If your income is between 100% and 250% FPL, enrolling in a Silver plan effectively gives you a much richer plan than the premium alone suggests. Your deductible could drop from $4,000 to under $500 depending on your income level. This is one of the most underused features of the ACA.
Bronze plans make sense primarily if you are healthy and mainly want coverage for emergencies or catastrophic costs. The low premium saves money monthly, but you will pay more out of pocket if you actually need care.
Gold plans work well if you use healthcare regularly, such as managing a chronic condition or expecting surgery. The higher premium is often offset by lower cost-sharing throughout the year.
Plan network types available in Georgia include HMO, EPO, PPO, and POS. HMO and EPO plans generally require you to stay within a network of providers, while PPO plans offer more flexibility to see out-of-network providers.
How Premiums Break Down With Subsidies
Subsidies are calculated to cap your premium contribution at a percentage of your income. In 2026, under the standard (non-enhanced) rules, here is roughly what you can expect to pay for a benchmark Silver plan:
| Income as % of FPL | Max % of Income You Pay for Benchmark Plan |
|---|
| 100% to 133% | 0% to 2% |
| 133% to 150% | 3% to 4% |
| 150% to 200% | 4% to 6% |
| 200% to 250% | 6% to 8.5% |
| 250% to 300% | 8.5% |
| 300% to 400% | 8.5% |
| Above 400% | No subsidy; full premium |
If you qualify for a subsidy and the cheapest Silver plan in your area costs less than your maximum contribution, the difference goes toward any plan you choose. If you pick a lower-cost Bronze plan, your out-of-pocket premium can drop to near zero.
Step-by-Step: How to Enroll in Georgia Access
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Go to georgiaaccess.gov. Georgia operates its own marketplace, so do not go to HealthCare.gov.
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Create an account or log in. You will need your name, date of birth, Social Security number, and address.
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Answer eligibility questions. The system will ask about your household size, income, current coverage, immigration status, and whether anyone in your household is eligible for other coverage like Medicare or employer insurance.
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Review your subsidy estimate. Georgia Access will calculate your estimated premium tax credit and show you your net monthly cost for each plan.
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Compare plans. Filter by metal tier, insurer, and whether your current doctors are in-network. Pay attention to both the premium and the total deductible plus out-of-pocket maximum.
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Enroll. Select a plan and complete enrollment. Your coverage start date depends on when you enroll during open enrollment.
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Pay your first premium. Coverage does not begin until you make your first payment directly to the insurance company.
Open enrollment typically runs November 1 through January 15 for the following coverage year. Outside that window, you can only enroll if you have a qualifying life event (losing other coverage, getting married, having a child, moving to a new state, and others).
Special Enrollment Periods
If you missed open enrollment, you may still qualify for a Special Enrollment Period (SEP) if you experienced one of these life events:
- Lost job-based health insurance
- Got married or divorced
- Had or adopted a child
- Moved to a new state or zip code with different plans available
- Became a U.S. citizen or gained lawful immigration status
- Left incarceration
- Income changed enough to affect your subsidy eligibility
You generally have 60 days from the qualifying event to enroll.
Georgia's Medicaid Gap
Georgia has not expanded Medicaid under the ACA. Adults without dependent children generally cannot qualify for Medicaid in Georgia regardless of income. Adults with dependent children can qualify at very low income thresholds.
Georgia launched a limited Medicaid expansion program called Georgia Pathways in 2023, which requires work or community engagement hours for eligibility. Enrollment has been slow and the program reaches far fewer people than full expansion would.
If your income falls below 100% FPL and you do not qualify for Georgia Medicaid, you are in the coverage gap. You cannot get marketplace subsidies (those start at 100% FPL) and you do not qualify for full Medicaid. This affects a meaningful share of low-income Georgia adults.
If you are close to 100% FPL, accurately reporting your income matters. If your projected income will cross 100% FPL this year, you qualify for marketplace coverage with potentially free or near-free premiums.
What to Do Now
The most important step is checking your actual subsidy amount based on your household income and size. Subsidy amounts vary significantly by county because they are tied to local benchmark plan costs, not just income.
Use the screener at CoveredUSA to find out what you qualify for. The tool takes about two minutes and checks your eligibility for ACA marketplace plans, Medicaid, CHIP, and other programs. Check your eligibility now at CoveredUSA, it takes 2 minutes.
For ACA-specific income reference data, see the ACA income limits guide on CoveredUSA.
Frequently Asked Questions
Does Georgia use HealthCare.gov or a different marketplace?
Georgia uses its own state-based marketplace called Georgia Access at georgiaaccess.gov. You do not enroll through HealthCare.gov. Georgia Access operates under a Section 1332 waiver and allows licensed brokers to complete enrollments outside the federal platform.
Did ACA subsidies get cut in 2026?
The enhanced premium tax credits from the American Rescue Plan and Inflation Reduction Act expired December 31, 2025. Starting in 2026, subsidies are only available to households earning 100% to 400% of the federal poverty level. The 400% FPL subsidy cliff has returned, meaning higher-income households no longer get any subsidy help. Average premium costs increased substantially for people who were above 400% FPL.
What is the income limit to get help paying for health insurance in Georgia in 2026?
For a single adult, the income limit is roughly $62,600 per year (400% of the 2025 federal poverty level). For a family of four, the limit is approximately $128,600. Below these thresholds and above 100% FPL, you qualify for premium tax credits to reduce your monthly cost.
What is a Silver plan and why does it matter for cost-sharing reductions?
A Silver plan is one of four metal tiers available on the marketplace. Silver plans cost more per month than Bronze but less than Gold or Platinum. More importantly, Silver is the only tier eligible for cost-sharing reductions (CSRs). CSRs significantly reduce your deductibles, copayments, and out-of-pocket maximums if your income is between 100% and 250% FPL. At lower incomes, a Silver plan with CSRs can provide richer coverage than a Gold plan at a fraction of the cost.
What if I miss open enrollment in Georgia?
If you miss the November 1 to January 15 open enrollment window, you can only enroll during a Special Enrollment Period triggered by a qualifying life event. Common qualifying events include losing job-based coverage, moving, getting married, or having a child. You have 60 days from the event to enroll. If you do not have a qualifying event, you must wait until the next open enrollment period.
How many health insurance companies offer plans in Georgia's marketplace?
Eight insurers offer plans through Georgia Access for 2026, down from nine in 2025 after Aetna exited. Ambetter by Peach State Health Management is the largest carrier by market share and offers plans statewide. Other carriers include Blue Cross Blue Shield of Georgia, Cigna, Oscar Health, and Kaiser Permanente (Atlanta metro only). Not all carriers operate in every county.
Can I get a $0 premium plan in Georgia?
Depending on your income and household size, yes. If your income qualifies you for a large enough subsidy, the cost of a Bronze plan (and sometimes a Silver plan) can be reduced to $0 per month. This is most common at lower income levels close to 100% FPL. Use the Georgia Access platform or the CoveredUSA screener to see your estimated net premium based on your specific income and location.
What is Georgia Pathways and does it affect my ACA eligibility?
Georgia Pathways is a limited Medicaid program that requires work or community engagement to qualify. It launched in 2023. It is separate from full Medicaid expansion, which Georgia has not adopted. Pathways does not affect your ACA marketplace eligibility. If you qualify for Pathways Medicaid, you would generally get coverage through that program rather than the marketplace.
