Week 6: Senate advances its version of the Amended FY26 budget, setting up negotiations with the House
On Friday, the Georgia Senate passed its version of the Amended Fiscal Year 2026 (AY26) state budget by a vote of 49-1. The Senate version takes a different approach to several major health-related investments than the House. Most notably, the Senate goes significantly further than the House in funding mental health infrastructure.
Here is what the Senate version means for health care, human services, and the programs Georgians rely on:
The Big Picture
The Senate budget’s largest, and arguably most significant, investment is the $409 million added for a new 300-bed state mental health hospital, the first built in Georgia since the 1960s. The Senate also increases Medicaid funding above House levels, reverses a proposed $25 million reduction to the state’s reinsurance program, and includes $20 million for graduate medical education at three facilities. At the same time, it scales back the House’s largest foster care investment and reduces the Housing Trust Fund. Statewide, the Senate reduces the one-time salary supplement for state employees from $2,000 (House) to $1,250.
Medicaid and PeachCare
The Senate budget funds Medicaid at slightly higher levels than the House. For the Aged, Blind, and Disabled population, the Senate includes a $241 million adjustment to reflect higher-than-expected enrollment and utilization, appropriating approximately $3.1 billion in state funds, roughly $14 million more than the House. For Low-Income Medicaid, the Senate reduces funding by nearly $150 million due to lower-than-projected enrollment but still allocates approximately $2.1 billion in state funds, about $8.6 million more than the House. PeachCare for Kids funding remains steady at approximately $115.5 million in state funds.
Georgia Gateway and Eligibility Systems
The Senate maintains $35 million for Integrated Eligibility System (IES) modernization through the Georgia Technology Authority, as well as $6.2 million in state funds for Gateway system modifications to reduce SNAP payment errors. These investments are unchanged from the House version.
Rural Health and Workforce
The Senate includes its own $20 million graduate medical education investment, larger than the House’s $17.8 million but structured differently. Rather than the House’s broader South Georgia expansion (103+ residency slots), the Senate targets three facilities: Thomasville, St. Joseph’s Candler in Savannah, and Southeast Georgia Medical Center in Brunswick. The Senate investment specifically includes psychiatry residency programs. The conference committee will need to reconcile these two approaches.
Behavioral Health and Mental Health Infrastructure
The Senate makes its most significant investment in mental health infrastructure:
$409 million for a new state mental health hospital: This is the Senate’s single largest health investment. The investment responds to a real and urgent crisis: county jails have become de facto mental health facilities across Georgia, with some individuals waiting two years or more for competency hearings (legal proceedings to determine if someone can stand trial). But the scale of this investment also raises questions for advocates familiar with Georgia’s deeply troubled history of mental health institutionalization.
Central State Hospital in Milledgeville was once the largest mental institution in the world, housing nearly 12,000 patients at its peak in the 1960s with grossly inadequate staffing and widespread reports of abuse and neglect. The national deinstitutionalization movement, combined with decades of advocacy, ultimately resulted in more community-based mental health care. However, Georgia only adopted the model when it was forced to in 2010, when the US Department of Justice and the State of Georgia entered into the Olmstead settlement agreement. That agreement resolved allegations that people with mental illness and developmental disabilities were being unnecessarily institutionalized in state hospitals in violation of the Americans with Disabilities Act, and it required the state to invest in community-based alternatives such as housing vouchers, crisis stabilization centers, and assertive community treatment teams rather than congregate facilities. In the years since, Georgia invested over $256 million into expanding its community-based crisis system.
In January of this year, the DOJ released Georgia from the behavioral health provisions of the Olmstead settlement, and a federal judge approved the release just days after the House passed its version of the AY26 budget. With the constraints of the settlement lifted, the Senate immediately moved to fund a new large-scale mental health hospital. While the jail crisis is real and forensic bed capacity is critically short, it’s essential that state leaders can explain how this facility fits within the broader continuum of community-based care that Georgia has spent 16 years building. A $409 million investment in a single congregate facility is a significant policy choice, and GHF will be watching to ensure that community-based services are not deprioritized in the process.
Not included: The $500,000 behavioral health provider rate study focused on the abandonment of patients with intellectual and developmental disabilities in community hospitals. This House-only addition could have produced important data about whether reimbursement rates are adequate for people with IDD.
Child Welfare and Foster Care
The Senate invests over $89 million in the Department of Human Services to address a structural budget shortfall at DHS and DFACS, though the approach differs from the House:
Out-of-Home Care: The Senate funds a $41.5 million increase in state funds, matching the Governor’s recommendation but roughly half the House’s $82.7 million.
Insurance and the Marketplace
The Senate does not include the $25 million reduction to the 1332 waiver reinsurance program (a federal-state partnership that helps stabilize insurance costs) that appeared in both the Governor’s and House versions. The Senate maintains the full $145.9 million in state funds for reinsurance, potentially providing greater stability for Georgia’s individual insurance market heading into the next open enrollment period. The reinsurance program helps keep marketplace insurance premiums affordable by paying insurers for very high-cost care and services needed by Georgia consumers.
Other Health-Related Investments
$10 million for the State Housing Trust Fund to address homelessness, reduced from $50 million in the Governor’s and House versions. The Senate directs all of the funding toward veterans experiencing homelessness, despite data showing that only 6% of unhoused Georgians are veterans.
$5 million for school-based mental health support, including funding for social workers and out-of-school care.
What Comes Next
A conference committee of House and Senate members will negotiate the final version of the AY26 budget, which will then head to the Governor for his signature.
Crossover Day Is Around the Corner
Next Friday, March 6 is Crossover Day, the deadline for bills to pass out of their chamber of origin to remain alive for the rest of the session. We will be monitoring activity closely and will have a full update on what made it through.
Stay Informed
GHF is tracking every stage of the budget process and we advocate for investments that improve health coverage, access, and affordability for all Georgians. We will also continue to push for the funding that is currently absent from the budget, including:
Affordability of health insurance premiums for Georgia Access consumers
Medicaid provider rate increases
Public health workforce
Rural hospital sustainability
Understanding Georgia’s Budget Timeline
Georgia’s budget process can be confusing. Here’s what you need to know:
Two Budgets, Two Years:
Amended FY 2026 = Updates to the current year’s budget (July 2025 – June 2026)
FY 2027 = Brand new budget for next year (July 2026 – June 2027)
The Process:
Amended FY 2026
FY 2027
January
Governor proposes a plan → Agencies present their needs
Governor proposes a plan → Agencies present their needs
February–March
Lawmakers debate → House passes its version → Senate passes its version (we are here) → Joint negotiations → Final vote
Usually still in debate at this point in the session
Late March (Sine Die)
Usually already signed at this point in the session
Usually passes on last day of session
April–May
Usually already in effect at this point in the session
Governor signs into law
Why This Matters: The amended budget (AY 2026) shows how Georgia is spending state resources right now. The FY 2027 budget shows whether the state is preparing for emerging or new challenges, or just short-term needs.
Advocate With Us At The Capitol!
Join These Advocacy Events During the Legislative Session
Each week during the legislative session, we’ll highlight legislative advocacy days hosted by our partner organizations. These events offer excellent opportunities to engage in lawmaking by meeting your legislators and advocating for critical health issues.
Please contact Anthony Hill at ahill@healthyfuturega.org if you have an advocacy event you’d like included in GHF’s legislative update.
We hope to see you at one or more of these impactful events!
GHF Has You Covered!
Stay up-to-date with the legislative session.
GHF monitors legislative activity on many critical consumer health care topics. Along with our weekly legislative updates and timely analysis of bills, here are tools to help you stay in touch with health policy under the Gold Dome.
State lawmakers talk budget priorities: What’s on the table for Georgia’s health care
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