Georgia's healthcare industry is projected to lose $3.7 billion in revenue next year if enhanced federal health insurance subsidies under the Affordable Care Act (ACA) are allowed to expire in December. A new forecast indicates this would place Georgia among the three hardest-hit states in the nation, alongside Florida and Texas.
The study, conducted by the Robert Wood Johnson Foundation and the Urban Institute, warns that the expiration would not only impact hospitals and clinics but also lead to significant insurance premium increases for hundreds of thousands of state residents.
Key Takeaways
- Georgia's health sector could lose $3.7 billion in revenue in a single year.
- The state's health revenue is forecast to decline by 4.8% by 2026, one of the steepest drops in the U.S.
- An estimated 460,000 Georgians could lose their health insurance coverage.
- Monthly insurance premiums for some residents could more than triple without the subsidies.
A Statewide Economic Impact
The potential revenue loss for Georgia's healthcare providers is substantial. The forecast details that hospitals would bear the largest burden, facing a potential revenue drop of $1.6 billion. The remaining $2.1 billion loss would be distributed among doctors' offices, clinics, pharmacies, and other health-related businesses across the state.
This financial pressure stems directly from the potential loss of insured patients. If the subsidies expire, a significant number of the 1.5 million Georgians currently enrolled in ACA plans may no longer be able to afford their coverage.
National Perspective
The study projects a nationwide revenue loss for the health sector of approximately $32 billion if the enhanced subsidies are not extended. Georgia, Florida, and Texas are each forecast to experience a 4.8% decline in their health sector's overall revenues by 2026, the most severe impact in the country.
The Role of Enhanced Subsidies
The subsidies in question were enhanced as part of pandemic-era relief measures enacted by the Biden administration. These temporary provisions lowered out-of-pocket costs and made more people eligible for financial assistance, including those with higher incomes who previously did not qualify.
This expansion led to a surge in enrollment. In Georgia, the number of people with ACA marketplace plans more than doubled, reaching approximately 1.5 million policyholders. These subsidies are currently scheduled to expire on December 31.
The Human Cost of Policy Changes
The primary consequence for individuals would be a sharp increase in monthly insurance premiums. According to an analysis by KFF, a health research organization, the financial shock would be significant for many families.
For example, a 60-year-old couple in Fulton County with an annual income of $85,000 currently pays about $602 per month for a mid-tier (silver) ACA plan. Without the enhanced subsidies, their monthly premium for the same plan would jump to over $2,200.
The Domino Effect of Lost Coverage
Health advocacy groups warn that when people lose insurance, they often delay or skip necessary medical care. This can lead to individuals seeking treatment only in emergencies, which places a greater financial strain on hospitals. U.S. law obligates emergency rooms to stabilize any patient, regardless of their ability to pay, shifting costs to the hospital and, indirectly, to other insured patients.
The KFF estimates that if the subsidies expire, about 460,000 Georgians will drop their health insurance coverage due to the increased cost. This would reverse much of the progress made in reducing the state's uninsured rate in recent years.
Political and Legislative Landscape
The future of the subsidies rests with the U.S. Congress. Democrats have advocated for making the enhanced subsidies permanent, arguing they are essential for maintaining affordable healthcare access.
"Many who would lose these comprehensive coverage credits are older individuals, people in rural areas, and small businesses," stated one advocacy group in a letter to Congress, highlighting the broad impact of the potential expiration.
However, extending the subsidies comes with a significant price tag. The Congressional Budget Office (CBO) estimated that a 10-year extension would cost the federal government approximately $335 billion. This cost has been a point of contention in Washington, with some lawmakers expressing concern over the impact on federal spending.
Lobbying efforts from medical associations, hospitals, and patient advocacy groups have intensified as the December deadline approaches. They are urging lawmakers to find a solution to prevent what they describe as a looming healthcare crisis for many families.
Broader Implications for the Healthcare System
The potential loss of nearly half a million insured individuals in Georgia would create ripple effects throughout the state's healthcare infrastructure. Rural hospitals, which often operate on thin margins, are considered particularly vulnerable to an increase in uncompensated care.
Doctors and clinic operators also face the prospect of declining patient visits for routine check-ups and preventative care. When patients are uninsured, they are less likely to seek medical attention for chronic conditions or early symptoms, which can lead to more severe health issues and higher treatment costs later on.
The debate over the ACA subsidies highlights the ongoing tension between expanding healthcare access and managing federal expenditures. The decision made in Washington in the coming months will have direct and immediate financial consequences for Georgia's healthcare providers and the millions of residents who rely on the marketplace for their insurance coverage.
