Sticker shock strikes as Georgia small business owners navigate 2026's pricey health care options

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Kendra Fuentes, co-owner of ISI Elite Training in Sandy Springs, is keeping her health care plan the same in 2026.

Credit: Orlando Montoya / GPB News

At a fitness center in Sandy Springs, north of Atlanta, about a half-dozen people lift kettle bells and squat at a high-energy morning training session.

This was Kendra Fuentes’ dream — to open a business that brings people together on a shared path to self-improvement.

“Everyone’s at different points in their fitness journey,” she said. “But here, they’re all in a room doing the same workout together, cheering, coaching.”

The politics of health care stays out of the workout space.

But in Congress, it’s dividing Democrats and Republicans.

A Democrat-sponsored bill to extend expiring Affordable Care Act tax credits is expected to fail in the U.S. Senate this week.

The partisan deadlock comes as small business owners navigate open enrollment season for 2026.

Fuentes said she doesn’t have any plans to change her coverage.

“I have health care through Georgia Pathways,” she said, referring to the state’s Medicaid alternative for low-income workers. “I didn’t pay myself the first year we opened the business, so I qualified for that.”

She and her mother have run this fitness center, an ISI Elite Training location, since 2024. And she says that, while her business is growing, she still qualifies for Georgia Pathways. 

Generally, the lower your income, the more your health insurance is going to be covered by federal subsidies.

“I’m always going to do the lowest plan because I don’t ever — thank gosh, I’m pretty healthy,” she said. “I don’t have any prescriptions, any medications.”

The problems start when you earn a little bit more.

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Molly Dickinson and Damon Sgrignoli are adjacent to the health care industry but still shocked by premium increases.

Credit: Orlando Montoya / GPB News

At a home in Atlanta’s Kirkwood neighborhood, consultants Molly Dickinson and her husband Damon Sgrignoli work from their computers in cozy rooms, one of which is a guest bedroom.

On any given Zoom call, their backgrounds could include antique furniture, a framed American flag or the couple’s dog, Bocce.

“And the bed can sort of look like a couch,” Dickenson said.

She works in brand strategy and he’s in health care leadership coaching.

Despite Sgrignoli’s proximity to the health care industry, he says they both still were taken aback by the premium increases as they searched for 2026 health care coverage.

“I recently had a medical event and we had some sticker shock from the bills on our current plan,” he said. “So I thought, ‘Well, let's be prudent and go out to the market and really look at what we can do for next year.'”

But under Georgia Access, the state’s year-old alternative to the federal marketplace, he said the best that they could find was a plan that would almost double their annual cost.

“I came back to the kitchen table here with Molly and said, ‘Honey, you’re not going to believe this; the cheapest plan I found was just south of $15,000 for the premium alone,’” he said. “That’s before the actual maximums. Some of the plans that were actually equivalent to what we actually wanted and needed were north of $20,000 and $30,000 just for the premium alone.”

He said they currently pay about $700 per month or $8,400 per year, without children on their plan.

Dickinson sees skyrocketing health insurance premiums as part of a larger problems.

“Which is that the economy is becoming harder for all of us to work and to succeed within,” she said. “And so, we’re having to pass the costs along."

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Hair stylist and owner of She Salon, Gina Palmer, was still searching for a health care option in 2026 when GPB spoke to her, but she knows it's going to be a steep increase from what she's paying now.

Credit: Gina Palmer / She Salon / Instagram

At a hair salon in Atlanta, called She Salon, just south of downtown, women wait for their shampoos, trims, color and styling in a bright space with large windows looking out onto a busy street.

Business owner Gina Palmer has been cutting hair for 30 years.

“Okay, Miss Sheila, how are we cutting it?” Palmer asks her first customer on a busy weekday.

“Oh, you know how you do it,” the client responded.

She seems to know everyone in the room like old friends and doesn’t want to pass along her higher costs to them —and it’s not just about health care premiums.

The cost of everything is going up, she said, and, of course, she still has to respond to the unexpected, such as a door that recently needed repair.

“I have to have reserves for that, right?” she said. “Now I’m concerned about my reserves.”

She knows that her premium under Georgia Access will cost more next year.

But after weeks of trying to figure out her best plan of action — even briefly contemplating going without coverage — she was still trying to figure out exactly what plan to choose and how much it’ll cost.

Her previous insurer, Aetna, pulled out of the Affordable Care Act marketplace this year, and she was looking at plans that would almost double her current monthly premium.

So how will she budget for that?

“I’m not trying to work more,” she said. “But I have to do what I have to do. So that looks like working more. That may look like cutting my marketing budget.”

She says she might consider scaling back on a weekly cleaning service, a social marketing guru or a business coach.

“Those are the first things that are going to go if it’s my health care ‘or,’ you know?” she said.

So if Palmer doesn’t cut, she’ll have to cut.   

The deadline to apply for 2026 ACA coverage beginning on Jan. 1 is Monday, Dec. 15.