WSJ What’s News - How a Health Insurance Shortfall in Georgia Could Play Out in the Midterms

Episode Date: June 14, 2026

Thousands of residents in the Peach State have dropped out of health insurance coverage since the start of 2025, prompted in part by this year’s expiration of enhanced federal subsidies that helped ...them pay their monthly premiums. For our special What’s News series The Cost-of-Living Election, WSJ national politics reporter Sabrina Siddiqui speaks to Republican pollster Adam Geller and Democratic pollster John Anzalone. They discuss voters’ expectations of Congress when it comes to healthcare costs, Democrats’ trust advantage on healthcare, and whether that could swing the election to their party—including incumbent Georgia Sen. Jon Ossoff—in November. Learn more about your ad choices. Visit megaphone.fm/adchoices

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Starting point is 00:00:30 So I'm using Georgia Access's state-based exchange website as a starting point, but you can actually do this at health care.gov. John Chikowsky is at his computer, scrolling through the options for health insurance in Georgia. I'm plugging in. I live in Fulton County, so I'm in downtown Atlanta. Here's my day to birth, and then my income. Chikowsky is an independent insurance broker, and he's giving us a closer look at what he calls a double whammy. premiums for insurance that complies with the Affordable Care Act, also known as Obamacare, have gone up, and federal tax credits that would have helped people pay for them expired on January 1st. Chikowsky saw the effects of this on prices and on the people he helps find insurance. Seeing the rates increase year over year, that's kind of par for the course.
Starting point is 00:01:21 seeing the rates jump overnight from one year to the next, that significant, you know, 30 to 40 percent, that was a shock to the system. Most people were not expecting the shift to be that dramatic. And this last open enrollment, like, eyes were wide open. And people interiors saying, I can't pay for this. I'm going to have to go uninsured. Some subsidies are still in place. But Congress allowed enhanced Obamacare subsidies doled out to. during the COVID-19 pandemic to lapse,
Starting point is 00:01:59 a fight so bitter, it led to a government shutdown over whether or not to extend them. Providing those subsidies obviously comes at a cost for the U.S. government. A Congressional Budget Office analysis from September found that a three-year extension for them would have cost the federal government roughly $90 billion.
Starting point is 00:02:17 But losing those subsidies has been tough for a lot of the people Chikowsky works with. He calls the latest period of health insurance signups the hardest one he's seen in his 17 years on the job. The health research nonprofit KFF estimates that on average, the expired subsidies mean that annual premium payments for ACA marketplace enrollees will more than double, from an average of $888 in 2025 to roughly $1,900 this year.
Starting point is 00:02:48 Chikowski says that in a few cases, he saw families' premiums triple. A lot of people were flat out upset. devastated in some cases. I'm Sabrina Siddiqui, and this is What's News Sunday. Over the last few weeks, I've been reporting on how the rising cost of living could determine who controls Congress next year. In this episode, we talked to some of the Georgians navigating higher health care costs and to the pollsters who work with the Wall Street Journal
Starting point is 00:03:16 to tell us what those costs might mean ahead of statewide primary runoff elections coming up this Tuesday. This is The Cost of Living Elections. Part 3. According to the Georgia recorder, the Pete State has seen a 37% drop in Affordable Care Act enrollment since the start of last year. That represents more than half a million Georgians in a state of roughly 11.5 million. And data from the U.S. Census shows that a few years ago, Georgia had one of the highest rates of residents under 65 without insurance at 13.6%.
Starting point is 00:03:55 Joey Bernard is one of them. He would have gotten insurance through Georgia Access this year, but it was too expensive. The prices we were seeing on the Georgia Access website was going to be about a third to a little under half of our monthly budget and everything, and that's, I couldn't justify it. Bernard is 40, and he lives with his wife and daughter in the city of Ball Ground. It's in Cherokee County, which isn't far from Atlanta, though far enough from that urban center so as to be solidly Republican. At the presidential level, the county hasn't voted for a Democratic president since Georgia's own Jimmy Carter. For Bernard, the premium costs on marketplace insurance just weren't sustainable. Basically seeing $800 one night and then the following day or the next day or so in seeing $1,600 and $2,400.
Starting point is 00:04:46 I was like, are you kidding me? I shook my head and I was like, there's no way. Like, this can't continue. This is outrageous. Last year, Bernard was laid off from the IT job he'd worked for 15 years. He's found work again, but his new job doesn't provide health insurance like his old one did. Now he and his wife are setting money aside to pay out of pocket for any medical attention they might need. We've taken the money that otherwise would have been spent for insurance and just using it for straight up cash and just, you know, kind of hoping and praying that, you know, nothing catastrophic happens for right now until we can find something more reasonable for our family.
Starting point is 00:05:24 For some other Georgians, the higher cost of health care is already leading to tough choices. We haven't been going out. We've been doing meatless Mondays, to be frank, other expenses have gone up as well on top of insurance. Elizabeth Barnett lives with her husband, daughter, and grandfather in Stone Mountain, Georgia, also near Atlanta. For a while, she was uninsured. We spent several years where we were not in the financial position to take care of our health. and even have insurance at all. That changed when her husband started a job as a paramedic, which provided her with health insurance.
Starting point is 00:06:03 During the pandemic, she took advantage of the more affordable marketplace insurance to tap into a broader network of doctors. Those costs have gone up, so she's back on her husband's insurance. Barnett has to see a cardiologist because heart issues run in her family. Her coverage to see that kind of specialist isn't great,
Starting point is 00:06:22 so she doesn't visit him as much as she'd like. The price went up. And the coverage went down. We're having to plan and micromanage our budget to be like, okay, well, can we afford to see the cardiologist? Or are we going to have to, you know, push it out and just hope for the best? Because to be frank, I cannot afford a $500 doctor visit to see a cardiologist. Joey Bernard and Elizabeth Barnett are both paying attention to the elections coming up in Georgia. The state holds runoff elections this Tuesday.
Starting point is 00:06:58 One race will decide which Republican challenger will take on Democratic Senator John Ossoff for his seat in November. Ossoff will have to motivate people like Barnett. We'll be voting Democrat. Pretty much have only ever voted Democrat, actually. While also pulling over people like Bernard. He's leaning toward the Democrats this time around, even though he's voted Republican in the past. We've had a rash of a lot of Republicans.
Starting point is 00:07:22 recently the last number of years here where I live and in Georgia in general. And things just do not seem to have gotten significantly better for me or my family and a lot of my friends and coworkers. So that's why I just feel like, okay, you know, maybe it's time to swing to the other side for this round. Coming up, I talked to a pollster from each party to ask what they've seen and how voters in Georgia and across the country are responding to increase health insurance costs. We, in a way, are giving voice to people and their opinions and attitudes. And that's really important. That's after the break. Visit BetMGM Casino and check out the newest exclusive.
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Starting point is 00:08:31 BetMGM operates pursuant to an operating agreement with Eye Gaming, Ontario. Here at the Wall Street Journal, we don't just report on the results of polls. We also work with pollsters to conduct some of our own. As a national politics reporter at the paper, I always appreciate a conversation with those pollsters. I'm joined now by Adam Geller and John Anzolone, our Republican and Democratic pollsters, respectively. Adam, hello. Great to be here. Thanks for having me.
Starting point is 00:09:05 John, hello. Hey, Sabrina. John, I want to ask you first, a lot of the voters we talked to didn't have much faith in politicians' ability to offer real solutions to the growing costs of health care. But is one party more trusted than the other on that issue? Yeah, you know, it's one of the rare issues where Democrats actually have a trust advantage over Republicans. We've seen that consistently on health care. But I think that there's actually a broader problem in terms of how people feel that the political and financial systems in this country are stacked against you. Right. And our poll from May, it was basically three quarters of respondents who said they felt the economic and political systems in the U.S. are stacked against people like that.
Starting point is 00:09:50 Right. And so the trust level, there's an impediment there. But we can talk about what people think politicians can actually fix. And that's where it gets really kind of interesting. And our January Wall Street Journal poll, healthcare was right up there with groceries. But when we asked a separate question about what do you want the president and Congress to make a priority, healthcare beat out groceries by 20 points, which kind of tells you that they think that there's something that they can do about health care, but maybe not so much about groceries. Adam, John was just talking about that Wall Street Journal poll in January. A vast majority of voters also expected their premiums to rise, 70%. more people said they would blame Trump administration policies, 44%, compared to health insurance companies. That was just 27% for their premiums going up.
Starting point is 00:10:39 So how much of a liability is this issue for Republicans? And has anything changed since January? Has it gotten better or worse for Republicans? Wow. I mean, there's a lot there's a lot there. And the reality is, John is right. You know, let's start with the basics. in terms of which party voters trust more, Democrats absolutely have the advantage on health care.
Starting point is 00:11:06 President Trump is a easy target for partisan Democrats, most of whom are united in blaming him. Republicans don't have an easy target such as Trump. And so what happens is independents and Republicans split blame a little bit more evenly, insurance companies get some of the blame. Previous administrations get some, and yes, the current administration also gets some. Within premiums going up, one of the things that really stopped with me was the woman who said she couldn't afford the $500 that the cardiologist was going to cost. Well, in our most recent May poll, we asked this very question about whether you could actually
Starting point is 00:11:51 afford a $500 surprise bill. That could be health care. It could be tires. is it could be a water heater. And 34% of Americans say they could not come up with $500. That kind of tells you the financial anxiety that people are dealing with right now. And Sabrina, can I just add that, you know, Democrats have an advantage, but only if they talk about health care the right way. You know, we heard a lot about ACA subsidies, Medicaid cuts, $35 insulin, prescription drugs. Democrats tend to focus on those things instead of the 70% of people who have private health insurance. And in some of our
Starting point is 00:12:30 internal polling, this isn't necessarily Wall Street Journal polling, those things that tested with incredible intensity because they met people where they were had to do with things that they deal with every day. We find that one is health insurance costs. And two, the other big thing is I don't feel like they're getting what they pay for. They want to require health insurance companies to cover the treatments and procedures that doctors prescribe. And they always are getting denied. And those two things, health insurance costs ranked at like 43 percent, requiring health insurance companies to cover treatments their doctors ask for is at 38 percent. Lowering prescription drugs and co-pays was actually down at 7 percent. And it seems like that's all Democrats and Republicans
Starting point is 00:13:17 want to talk about, right? And so a lot of times they're not talking about the right thing. That's a really interesting point because Republicans have long talked about replacing the Affordable Care Act with something else, though it's not always clear what. Meanwhile, for the Democrats, in recent years, the idea of Medicare for All really gained traction among progressives, but it's not something that the party is touting so much anymore. Adam, how do the party's visions differ on health care? Well, it's dollars and cents. the way in which the parties split on this has to do with the cost, the deficit when it comes to public funding and taxpayer costs. There's an element of potential fraud or perhaps even known fraud when it comes to who's eligible for some of these subsidies or who might even
Starting point is 00:14:12 be eligible for other kinds of health care issues. It's not just illegal migrants, which I know sometimes it's easy to break it down in terms of that's the Republican argument, but it's also people whose income far exceeds what it really should be in order to be eligible for such things. So I think the real concern with fraud and potential for fraud is something that Republicans are looking at, but it's really easy then to message against them to say, well, in the meantime, this is what you're cutting for working people who can use it. And it's a compelling message in a strong one. John, the subsidies were such a source of contentious. and I covered it very closely.
Starting point is 00:14:49 Democrats shut down the government in a bid to try and extend the subsidies. And some might argue that they caved in that fight because ultimately in order to reopen the government, they secured a vote on the subsidy issue, but it was very clear that there was no deal in place to extend the enhanced subsidies. And so do you feel like voters,
Starting point is 00:15:13 especially Democratic voters, believe that the party has done enough on health care that they really did everything they could to try and protect these subsidies since they impact such a large share of voters. Yeah, I do think that this is kind of like an opinion elite versus real voter. You know, I mean, I think, you know, your segment was in Georgia. I think John Ossoff, Senator Ossoff, is going to benefit by the fact that he's fighting to restore those cuts to ACA or restore cuts to Medicaid. When you take in Georgia, for example, I think 10% of the populace is on ACA, 20% on Medicaid.
Starting point is 00:15:53 That's 30%. And they're going to believe John Ossoff on those issues a hell of a lot more than Republicans because they know that Republicans are the ones who cut both of those. So I think we're on firm ground. And I think that whether we went far enough or what was the pain threshold before you gave in and things like that is more of an insider argument. Adam, what are the kids? candidates saying on the subsidy issue, especially a Republican candidates, this election cycle? It just feels like there's been a little bit of light messaging when it comes to that as the Republicans have really focused on each other and getting through the runoff.
Starting point is 00:16:35 And that, I think, really does back up John's point that Senator Ossoff in the meantime is the beneficiary because he has a really, easy message to put out there in terms of what he's fighting for. And I would say that from a Democratic consultant, there's two groups to really focus on. Women are the health care deciders. They deal with their own individual health care problems. They deal with their kids. They often deal with either their parents or their in-laws. And number two, seniors are very health care sensitive.
Starting point is 00:17:12 They just have a little bit more time. They're just in a little different stage of their life. And seniors have become much more of a persuadable or swing universe starting in 2020. President Biden in that year moved the gap down from Trump's previous election in 2016. And these are really astute voters, women voters, especially suburban women voters and older voters will pay a lot of attention to the health care issue. John, Adam, thank you so much for being here. Thank you for having us. Thanks, Sabrina.
Starting point is 00:17:49 The Cost of Living Election is part of the Wall Street Journal's What's News. This episode was produced and mixed by Pierre B'Aname. Michael LaValle wrote our music. Editorial oversight from Joshua Jamerson, Chris Zinsley, and Tali Arbell. I'm Sabrina Siddiqui, and I'll be back soon with the last installment of the Cost of Living Election. Thanks for listening. Are you one of those media strategy people clicking through slides, scrolling spreadsheets? Yes?
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