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Track Health Legislation
The 2025 Legislative Session began on January 13, 2025. Below please find a listing of bills that Georgians for a Healthy Future is tracking during this session. New bills will be added as they are introduced. For email updates on how to stay involved sign up for action alerts.
GHF released its 2025 policy priorities at our fifteenth annual Health Care Unscrambled event. These annual priorities outline the issues that GHF believes are most pressing for Georgia consumers and are best addressed by the state legislature.
Georgians for a Healthy Future Legislative Priorities
| Sort By: Bill Title Bill Status | Bill | Status |
|---|---|---|
| “Private option” Medicaid expansion | HB 97 | Did not cross over |
| Ban on Coverage of Gender-Affirming Care in State-Funded Health Insurance Plans | SB 39 | Did not cross over |
| Ban on Gender-Affirming Medical Care for Minors | SB 30 | Passed the Senate; assigned to the House Public and Community Health Committee |
| Community Health Worker Certification | HB 291 | Passed the House; recommitted by Senate on 01/12 |
| Community Service Board Governance Restructuring | HB 1368 | Passed the House; assigned to the Senate Health and Human Services Committee |
| Community Service Board Governance Restructuring | SB 535 | Passed the Senate; assigned to the House Public and Community Health Committee |
| Dignity and Pay Act | SB 55 | PASSED |
| Efficiency of Dept. of Insurance | HB 182 | 04/02/2025 - House agreed to Senate Substitute as House amended |
| Georgia Buy American Medicine Act | HB 1332 | Passed out of committee; never scheduled in Rules |
| Georgia Insurance Consumer and Policyholder Advocacy Act | HB 733 | Passed out of committee; never scheduled in Rules |
| Georgia Insurance Oversight | HB 1344 | Passed the House; assigned to the Senate Insurance and Labor Committee |
| Health Care Workforce Database Expansion | SB 500 | Passed the Senate; assigned to the House Public and Community Health Committee |
| High Deductible Health Plans in the State Health Benefit Plan | HB 422 | PASSED |
| Homelessness Prevention Program | HB 689 | Passed the House; assigned to the Senate Government Oversight Committee |
| Hope for Georgia Patients Act | SB 72 | PASSED |
| House Study Committee on Cancer Care Access | HR 72 | Passed the House |
| House Study Committee on Evaluating Funding for Public Health | HR 847 | Passed the House |
| House Study Committee on Improving Access to Internal Medicine in Rural Areas | HR 753 | Passed the House |
| House Study Committee on Insurance Market Reform | HR 659 | Did not cross over |
| Housing Trust Fund for the Homeless Commission Expansion | SB 96 | PASSED |
| Increasing Insurance Enforcement Penalties | HB 1262 | Passed the House; assigned to the Senate Insurance and Labor Committee |
| Insurer Credentialing Reform Act | HB 1354 | Passed out of committee; scheduled for floor debate on 3/6, but no vote taken on House floor |
| Interstate Compact for School Psychologists | HB 81 | PASSED |
| Medicaid Coverage for Children in Foster Care | HB 1002 | Passed out of committee; never scheduled in Rules |
| Medicaid Coverage for Georgians Living with HIV | HB 178 | Did not cross over |
| Medicaid Coverage for Tobacco Cessation Treatments | HB 506 | Passed the House; assigned to the Senate Health and Human Services Committee |
| Medicaid Eligibility Verification Requirements | HB 1276 | Passed out of committee; scheduled for floor debate on 03/04; withdrawn and recommitted to Rules on 03/04; amended in Rules and scheduled for floor debate on 03/06, but no vote taken on House floor |
| Medicaid Home and Community-Based Services for Mental Health | SB 428 | Passed the Senate; assigned to the House Health Committee |
| Mental Health Parity Compliance Review Panel | SB 131 | Passed the House in 2025; awaiting a vote from the Senate agreeing to the House’s changes to the bill |
| Over-the-Counter Access to Pre-Exposure Prophylaxis (PrEP) | SB 195 | Senate agreed to House’s changes; awaits Governor’s signature |
| Pathway for Internationally Trained Physicians | SB 427 | Passed the Senate; assigned to the House Health Committee |
| PBM Price Transparency in the State Health Benefit Plan | HB 196 | PASSED |
| Peach Care Plus Act of 2025 | SB 50 | Did not cross over |
| PeachCare for Adults Act | HB 258 | Did not cross over |
| Peer-to-Peer Review Requirements | HB 197 | PASSED |
| Penalties for Insurance Rate Manipulation | SB 364 | Heard in the Senate Insurance and Labor Committee, but no vote was taken |
| Preventive Services Protection Act | SB 262 | Did not cross over |
| Prior Authorization Gold Card Program | SB 5 | PASSED w/ amendment |
| Protecting Consumers from Surprise Ambulance Bills | SB 462 | Passed the Senate; assigned to the House Health Committee |
| Recovery Community Organizations and Peer Specialist Certification | HB 657 | Passed the House, referred to the Senate HHS Committee |
| Required insurance coverage of prostate cancer screenings | SB 91 | Did not cross over |
| Requires health care providers, health care facilities, and pharmacies to provide the Maternal Mortality Review Committee with psychiatric or other clinical records | HB 89 | PASSED |
| Requires health insurers to cover fertility preservation services for individuals undergoing treatment for cancer, sickle cell disease, or lupus that may impact fertility | HB 94 | PASSED |
| Respite Care for Families of Youth with Behavioral Health Needs | HB 1238 | Passed the House; assigned to the Senate Health and Human Services Committee |
| Rural Hospital Authority Antitrust Immunity | HB 1393 | Passed out of the House; assigned to Senate HHS |
| Rural Hospital Joint Venture Outpatient Facilities | HB 1299 | Passed out of committee; never scheduled in Rules |
| Small Business Health Insurance Tax Credit | HB 1110 | Passed out of committee; never scheduled in Rules |
| State Agency Financial Accountability | HB 1192 | Passed the House; assigned to the Senate Government and Oversight Committee |
| Strengthening Utilization Review for Medical Necessity | HB 1236 | Passed out of committee; never scheduled in Rules |
| Student Safety, Health, and Well-Being Act | HB 268 | PASSED |
| Surprise Billing Consumer Protection Act | HB 961 | Passed the House; assigned to the Senate Health and Human Services Committee |
| TANF Eligibility and Benefit Update | HB 500 | Did not cross over |
| Third-Party Payer Accountability for Medicaid Claims | SB 276 | PASSED |
| Transfer Medicaid Eligibility to DCH | SB 460 | First read in Senate; never scheduled for committee hearing |
| Transfer Medicaid Program to DHS | SB 461 | First read in Senate; never scheduled for committee hearing |
| Transgender Sports Ban | SB 1 | PASSED |
| Updates to the Behavioral Health Reform and Innovation Commission (BHRIC) | SB 233 | PASSED |
“Private option” Medicaid expansion
Ban on Coverage of Gender-Affirming Care in State-Funded Health Insurance Plans
SB 39 would prohibit the use of state funds to cover gender-affirming care, including hormone therapy and sex reassignment surgery, for individuals enrolled in state-funded health plans or receiving public assistance. The bill also bans state-owned health care facilities and state-employed providers from offering gender-affirming care.
You can make a difference today in the outcome of this bill!
Ban on Gender-Affirming Medical Care for Minors
SB 30 would expand Georgia’s restrictions on gender-affirming medical care for minors by banning puberty blockers, hormone therapy, and gender-affirming surgeries. It goes further than the existing SB 140 law from 2023 by removing some exceptions, increasing penalties for doctors, and allowing parents to sue medical providers. The substitute permits the use of blockers, if approved ahead of time by two psychiatrists or psychologists and under the care of a pediatrician certified in the condition or board-certified. The new language makes it very difficult for a minor currently receiving puberty blocker treatment to continue, but does not fully prohibit it.
Community Health Worker Certification
HB 291 would establish a certification process for community health workers (CHWs) in Georgia. CHWs are frontline public health workers who help connect individuals to health care and essential services, particularly in underserved communities. They go by many titles, such as Patient Navigator, Community Health Advocate, and Promotora de Salud. By setting uniform standards and training for CHWs, creating a statewide certification system would support a skilled, stable CHW workforce.
You can make a difference today in the outcome of this bill!
Community Service Board Governance Restructuring
What HB 1368 does: Restructures governance of Georgia’s community service boards (CSBs) by transferring the authority to appoint local executive directors from local governing boards to the DBHDD Commissioner. Executive directors would become DBHDD employees with expanded powers over hiring, firing, contracts, and daily operations. The Commissioner could authorize executive directors to bypass governing board decisions when a CSB does not meet performance standards. HB 1368 is the House companion to SB 535.
Consumer impact: CSBs deliver behavioral health and developmental disability services across Georgia. Centralizing executive director appointments under DBHDD could improve accountability and address underperformance, but removes a key mechanism for community input into local behavioral health priorities. Governing boards would lose meaningful authority, and the bill does not define the “performance standards” that trigger state override of local decisions. Consumers and families who participate in CSB governance through local board membership would see their influence reduced.
Community Service Board Governance Restructuring
What SB 535 does: Restructures governance of Georgia’s community service boards (CSBs) by transferring executive director appointment authority from local governing boards to the DBHDD Commissioner. Executive directors would become DBHDD employees. The Commissioner could direct executive directors to override governing board decisions when a CSB fails to meet performance standards. CSB conversions to nonprofit or other structures require Commissioner approval, and cessation of operations requires Governor approval. SB 535 is the Senate companion to HB 1368.
Consumer impact: CSBs are the primary delivery system for community-based behavioral health and developmental disability services in Georgia. Centralizing executive director appointments under DBHDD could improve statewide accountability and help address underperforming CSBs, but removes local community input from leadership decisions. The bill does not define the “performance standards” that would trigger a state override of local governing board authority, leaving significant discretion to DBHDD. Consumers and families who participate in CSB governance would see their influence reduced under the new structure.
Dignity and Pay Act
SB 55 ends the practice of paying people with disabilities less than the minimum wage in Georgia. Right now, some employers use a federal rule (called a 14(c) certificate) that allows them to pay workers with disabilities less than the federal minimum wage. This bill would phase out that rule, making sure all workers with disabilities get paid fairly. By July 1, 2026, employers must pay at least half of the federal minimum wage, and by July 1, 2027, they must pay at least the full minimum wage.
Efficiency of Dept. of Insurance
HB 182 was replaced with the language from HB 410. Now, HB 182 makes changes to how Georgia’s Department of Insurance (DOI) operates. These changes include repealing several regulations, eliminating certain fees paid by insurers, and removing the requirement for insurance agency branch offices to obtain separate licenses. The bill’s author says HB 410 will streamline the DOI’s operations, reduce costs for insurers, and modernize regulations. However, several potential drawbacks could negatively impact consumers and public insurance industry oversight. These include less transparency in insurance company operations, less financial security, reduced oversight of insurance agencies operating multiple locations, and fewer financial resources for DOI to investigate and enforce consumer protections.
You can make a difference today in the outcome of this bill!
Georgia Buy American Medicine Act
What HB 1332 does: Requires hospitals and healthcare facilities receiving state funds to prefer American-manufactured pharmaceuticals. Exceptions apply when domestic drugs are unavailable, would jeopardize patient safety, are needed during emergencies, or cost more than 20% higher. DCH enforces the law, and noncompliance can result in loss of state funding eligibility.
Consumer impact: While the bill aims to strengthen domestic drug supply chains, requiring a domestic sourcing preference could increase pharmaceutical costs for hospitals, particularly safety-net and rural hospitals that rely heavily on state funds and often use lower-cost generic medications manufactured overseas. Cost increases could be passed through to patients.
Georgia Insurance Consumer and Policyholder Advocacy Act
What HB 733 does: Creates a new insurance consumer and policyholder advocate position within the Georgia Department of Insurance and tightens rate-review rules by replacing the file-and-use system for auto insurance with a prior-approval process. Rate increase filings would be posted publicly within 10 days of submission, and any increase of 10% or more within 12 months would trigger a mandatory DOI examination.
Consumer impact: HB 733 does not explicitly apply to health insurance, which is a significant gap for Georgia consumers.
Georgia Insurance Oversight
What HB 1344 does: A wide-ranging insurance bill that strengthens DOI enforcement authority, insurance fraud penalties, and other areas specific to property and casualty insurance. The bill adds consumer protections for claims processing after disasters and increases penalties for violations by pharmacy benefit managers (PBMs). The bill’s relevance to health insurance is relatively narrow, but the PBM enforcement and rate-review expansions have direct implications for Georgia health consumers.
Health Care Workforce Database Expansion
What SB 500 does: Expands the existing Behavioral Health Care Workforce Database to cover all licensed health care professionals in Georgia and renames it the Health Care Workforce Database. The bill broadens the set of licensing boards required to participate in data collection without appropriating new funds or setting implementation deadlines.
High Deductible Health Plans in the State Health Benefit Plan
HB 422 would require the State Health Benefit Plan (SHBP) to offer at least two high-deductible health plans (HDHPs) by October 1, 2025. These plans must be paired with health savings accounts (HSAs), allowing employees to make pre-tax contributions directly from their paychecks. While HDHPs appear desirable to cost-conscious enrollees, they may face high out-of-pocket costs if they do not contribute to their HSA or do not contribute enough to offset the high deductible. The bill does not include a requirement to educate enrollees about the trade-offs of an HDHP and the importance of contributing to the HSA.
Homelessness Prevention Program
HB 689 creates a statewide homelessness prevention program under the Housing Trust Fund for the Homeless. The program is designed to prevent evictions, support housing stability for low-income individuals, and reduce homelessness. It establishes an application process, minimum program standards, and a funding structure for organizations that provide rental assistance, eviction diversion services, and other homelessness prevention efforts.
Hope for Georgia Patients Act
SB 72, also known as the “Hope for Georgia Patients Act,” expands access to investigational treatments for patients with severely debilitating or life-threatening illnesses. The bill builds on Georgia’s existing Right to Try Act by allowing patients to seek personalized, experimental medical treatments not fully approved by the U.S. Food & Drug Administration (FDA). While the bill could expand access to experimental treatments for patients with rare or terminal diseases, it also opens the door to further expansion of access to treatments not approved by the FDA. FDA approval ensures that drugs meet strict safety and efficacy standards, and bypassing this process could expose patients to unknown risks. Additionally, patients may pursue costly, unproven treatments that may not work or could worsen their condition.
House Study Committee on Cancer Care Access
This committee is charged with examining gaps in access to quality cancer care; how to increase prevention and early detection efforts; and needs related to care facilities and workforce. The study committee will be made up of five members of the House (appointed by the Speaker of the House) and an additional seven members. The additional members will be two representatives of Georgia’s medical or public health schools; one primary care physician; one community oncologist practicing in a rural community; and one representative from Georgia’s federally qualified health centers; and two others representing cancer survivors, hospitals or medical centers, caregivers, navigators, or other areas of expertise. The committee will complete its work by the end of 2025.
House Study Committee on Evaluating Funding for Public Health
HR 847 creates the House Study Committee on Evaluating Funding for Public Health to examine how Georgia’s public health system is structured, funded, and resourced. The committee will study whether current public health investments are adequate to support a sustainable public health infrastructure, improve health outcomes, and reduce preventable deaths. The resolution notes that Georgia has historically underfunded public health, and less than one in every ten state health dollars go to the Department of Public Health. The committee will consist of five members of the House, appointed by the Speaker, and will make recommendations for potential policy or funding changes. The committee would expire on December 1, 2025.
House Study Committee on Improving Access to Internal Medicine in Rural Areas
This study committee is charged with thoroughly evaluating the most prudent and cost-effective ways to increase access to internal medicine in rural Georgian communities, with particular focus on those rural communities experiencing health transportation shortages. The committee will have eight members, five of whom will be House members and three will be non-legislative members who are licensed health care providers and who are familiar with the needs of rural Georgia.
House Study Committee on Insurance Market Reform
HR 659 creates the House Study Committee on Insurance Market Reform to examine Georgia’s rising insurance premiums, reduced coverage options, and lack of competition in the insurance industry. In response to some of the concerns about insurance practices raised during the passage of SB 68 (tort reform legislation), the committee will study issues like rate-setting practices, industry profits, regulatory compliance, and models from other states to identify reforms that could protect consumers from unaffordable premiums and ensure fairness and transparency. The substitute changed the composition of the study committee from seven House members and four non-legislative members to eight House members and three non-legislative members.
Housing Trust Fund for the Homeless Commission Expansion
SB 96 expands the State Housing Trust Fund for the Homeless Commission, which oversees funding and programs to prevent and reduce homelessness. It operates under the Georgia Dept of Community Affairs (DCA). It provides grants, financial assistance, and support services to organizations that serve individuals experiencing homelessness or at risk of becoming homeless. The bill increases the commission’s membership from nine to 11 and makes structural updates to appointment terms, allowing for broader representation and expertise in homelessness prevention efforts. This expansion could strengthen policy direction and funding decisions related to affordable housing and homelessness services.
Increasing Insurance Enforcement Penalties
What HB 1262 does: Raises the maximum penalties the Commissioner of Insurance can impose on insurance companies for violations of mental health parity reporting requirements, general insurance law, and the Surprise Billing Consumer Protection Act. The bill increases the current per-violation standard from $2,000 to $10,000 and the knowing-violation standard from $5,000 to $25,000.
Consumer impact: Because all penalties remain discretionary, the bill’s real-world value depends entirely on whether Georgia’s Department of Insurance (DOI) chooses to use its expanded authority. DOI has expressed support for the bill, which suggests they want to hold insurers accountable when they violate the law.
Insurer Credentialing Reform Act
What HB 1354 does: Sets a 45-day deadline for commercial health insurers to complete credentialing of a provider after receiving a complete application and directs the Department of Insurance to create a standardized credentialing form aligned with Georgia Medicaid’s existing credentialing system. Slow and inconsistent credentialing is a major bottleneck to network adequacy, particularly for behavioral health providers, and the 45-day timeline matches Georgia’s own Medicaid standard. The bill currently lacks enforcement mechanisms and provisional credentialing provisions, which limit its real-world impact.
Interstate Compact for School Psychologists
HB 81 would allow Georgia to join the Interstate Compact for School Psychologists. This compact makes it easier for school psychologists to work in different states by simplifying the licensing process. It also helps address the shortage of these professionals in schools. The bill creates a commission to manage the compact. It also sets rules for sharing information, handling discipline issues (for school psychologists, not students), solving disputes, and how states can join or leave the compact. The goal is to give students better access to school psychologists while still allowing each state to set its own licensure requirements.
You can make a difference today in the outcome of this bill!
Medicaid Coverage for Children in Foster Care
What HB 1002 does: Would move Medicaid coverage for children in foster care from managed care (Georgia Families 360°) to fee-for-service Medicaid when current contracts expire, with an automatic repeal in 2028.
Consumer impact: Children in foster care have complex health care needs related to trauma. Some advocates believe direct access to any Medicaid provider (fee-for-service) would better serve these children than managed care’s more limited networks. However, managed care currently provides care coordination services that fee-for-service does not, which could lead to fragmented care. HB 1002 doesn’t address how to maintain care coordination during the transition.
Medicaid Coverage for Georgians Living with HIV
HB 178 directs Georgia’s Department of Community Health to seek federal approval to provide Medicaid coverage to low-income Georgians living with HIV. The program would offer comprehensive health services, including antiretroviral medications, to eligible individuals. To qualify, participants must have an HIV diagnosis, earn less than 138% of the federal poverty level, and lack other health coverage. This bill aims to improve health outcomes, reduce transmission rates, and lower health care costs by providing early access to treatment.
You can make a difference today in the outcome of this bill!
Medicaid Coverage for Tobacco Cessation Treatments
HB 506 requires Georgia Medicaid to cover tobacco cessation treatments, including FDA-approved medications and counseling services. It prohibits limits on the number of quit attempts covered, prior authorization requirements, and cost-sharing (such as copayments or deductibles) for recipients seeking treatment. The bill also directs the Georgia Department of Community Health (DCH) to seek federal approval if necessary to implement these changes.
Medicaid Eligibility Verification Requirements
What HB 1276 does: Prohibits Medicaid applicants and recipients from using self-attestation to verify income, residency, or identity and requires ongoing cross-checks of enrollees against multiple state and federal data sources. It also reduces retroactive Medicaid coverage from three months to two months, a change that likely requires federal CMS approval Georgia may not receive. If enacted as written, the bill risks erroneous disenrollments similar to the post-pandemic Medicaid unwinding and could expose Georgia to significant federal compliance liability.
Medicaid Home and Community-Based Services for Mental Health
What SB 428 does: Directs the state to seek federal approval by December 31, 2026, for a Medicaid waiver that would pay for home and community-based mental health services for adults over 21 who need ongoing support but don’t need institutional care. Eligibility would be based on risk factors like hospitalization history, psychiatric crises, emergency visits, prior incarceration, or homelessness.
Consumer impact: SB 428 would allow Medicaid to cover ongoing community-based support that helps people remain stable and avoid costly crisis situations.
Mental Health Parity Compliance Review Panel
SB 131 would create a parity compliance review panel within the Behavioral Health Coordinating Council to identify and address mental health parity violations by health insurers and state health care entities. The bill adds the Insurance Commissioner to the Coordinating Council and requires health care providers to report suspected parity violations to the panel using forms and processes the panel establishes. The panel would evaluate these reports, determine whether violations occurred, and recommend punitive actions to the Commissioner of Insurance (for private insurers) and the Commissioner of Community Health (for state-run insurance programs like Medicaid).
Over-the-Counter Access to Pre-Exposure Prophylaxis (PrEP)
What SB 195 does: SB 195 would allow pharmacists in Georgia to dispense Pre-Exposure Prophylaxis (PrEP) for HIV prevention without a prescription from a doctor. PrEP is a highly effective medication that reduces the risk of HIV transmission by up to 99% when taken as prescribed. However, barriers to accessing PrEP, such as requiring a doctor’s prescription, lack of insurance, or stigma, can prevent people at risk from getting preventive treatment. Expanding access through pharmacies allows individuals to obtain PrEP more quickly and conveniently, particularly in areas with limited health care providers. The bill establishes guidelines for pharmacists to provide PrEP under a statewide protocol, ensuring greater accessibility to the medication.
Pathway for Internationally Trained Physicians
What SB 427 does: Creates a pathway for qualified physicians trained outside the U.S. to practice in Georgia. Eligible physicians would receive provisional licenses, would work under a fully licensed provider for a specific time period, and must work in underserved areas for 2-4 years to qualify for full licensure.
Consumer impact: Georgia faces significant physician shortages, especially in rural areas. SB 427 would help address workforce gaps by allowing qualified international physicians to practice while meeting supervision and practice requirements.
PBM Price Transparency in the State Health Benefit Plan
HB 196 would require greater transparency and set standards for how Georgia’s State Health Benefit Plan (SHBP) reimburses pharmacies for prescription drugs. The bill establishes new rules for how pharmacy benefits managers (PBMs) and insurers must calculate drug reimbursements to ensure that pharmacies receive fair payment for dispensing medications. The Senate committee voted on an updated version of HB 196, which removed the ability for a pharmacy or beneficiary to sue the PBM if they violate the reimbursement guidelines outlined in the bill, including by adjusting the final price with a prescription drug discount card.
Peach Care Plus Act of 2025
SB 50 would establish PeachCare Plus, a new health coverage program for low-income adults in Georgia. The program would fully cover premiums and out-of-pocket costs for private health plans on Georgia Access, the state’s health insurance marketplace. Adults earning up to 138% of the federal poverty level would be eligible. The Department of Community Health would oversee the program, with guidance from a bipartisan advisory commission. Any state savings would support the Indigent Care Trust Fund, which helps hospitals care for uninsured patients.
You can make a difference today in the outcome of this bill!
PeachCare for Adults Act
HB 258 would create PeachCare for Adults, a program that would cover adults ages 18 to 64 with incomes up to 133% of the federal poverty level who are not eligible for Medicaid. Coverage would mirror Medicaid benefits, including mental health services and all recommended adult vaccines. The Department of Community Health would oversee the program and require a federal waiver. The program would cap premiums for some enrollees and impose no work requirements.
You can make a difference today in the outcome of this bill!
Peer-to-Peer Review Requirements
HB 197 strengthens the review requirements for health insurers and utilization review entities when they question whether a medical treatment is necessary. The bill ensures that treating health care providers have a fair chance to discuss their treatment decisions with an appropriately trained clinical peer before an insurance company or review entity makes an adverse determination (a decision that denies or limits coverage for treatment).
You can make a difference today in the outcome of this bill!
Penalties for Insurance Rate Manipulation
What SB 364 does: Creates new penalties for insurance companies that intentionally provide false or misleading information to state regulators to get higher premiums approved. The Commissioner could order violators to pay up to 10 times the amount they owe in refunds to policyholders.
Consumer impact: SB 364 creates a significant financial deterrent against insurance companies manipulating the rate-setting process. Combined with HB 1262’s general penalty increases, SB 364 would give regulators stronger tools to protect consumers from inflated premiums.
Preventive Services Protection Act
SB 262 would require health insurance plans in Georgia to continue to cover preventive health care services without cost-sharing, ensuring that individuals can access screenings, immunizations, and other preventive care without paying out-of-pocket costs. The bill aims to protect access to preventive care regardless of changes to federal requirements.
You can make a difference today in the outcome of this bill!
Prior Authorization Gold Card Program
SB 5 requires health insurers that use prior authorization requirements to create a Gold Card program that reduces or removes prior authorization requirements for health care providers who demonstrate a strong track record of following evidence-based medicine. The goal is to reduce administrative burdens for providers and insurers while ensuring high-quality care for patients. SB 5 was amended by the House to include the language from HB 124, which requires insurers to cover treatment for PANS and PANDAS (autoimmune diseases that can develop after a case of strep throat).
Protecting Consumers from Surprise Ambulance Bills
What SB 462 does: Extends Georgia’s surprise billing protections to emergency ground ambulance transportation. SB 462 would cap what patients pay for out-of-network ambulance rides at the same amount they’d pay for in-network rides, and prohibit ambulance companies from billing patients for the rest. The bill sets a minimum payment rate for ambulance companies at the locally negotiated rate, or, if none exists, at the lesser of 325% of Medicare rates or the billed charges.
Consumer impact: Georgians currently face unexpected ambulance bills ranging from hundreds to thousands of dollars, even with insurance. SB 462 would close that gap in Georgia’s surprise billing law.
Recovery Community Organizations and Peer Specialist Certification
What HB 657 does: Codifies DBHDD’s existing peer support specialist certification system in state law, defines five categories of certified peer specialists, and establishes a statutory framework for recovery community organizations (RCOs). The bill would also authorize DBHDD to designate a single statewide RCO to coordinate the network.
Consumer impact: Peer support from people with lived experience helps people in recovery. HB 657 would formalize the system to protect the integrity of community-based peer programs.
Required insurance coverage of prostate cancer screenings
The original language from SB 91 was removed and replaced with two bills that passed out of the House – HB 373 to require insurers to cover prostate cancer screening and HB 323 to make Medicare Advantage plans available to Georgians under the age of 65 with ALS or end-stage renal disease.
Requires health care providers, health care facilities, and pharmacies to provide the Maternal Mortality Review Committee with psychiatric or other clinical records
HB 89 aims to improve how the state of Georgia collects information on maternal deaths and provides care for mothers and babies. It gives the Maternal Mortality Review Committee more access to patient records, including mental health and pharmacy records, to better understand why mothers pass away during pregnancy or childbirth. The bill also creates a Regional Perinatal Center Advisory Committee, which will help make sure hospitals and doctors have the right resources to care for high-risk pregnancies and births. Lastly, the bill simplifies the process for investigating the deaths of pregnant women, so medical examiners don’t always have to go through a regional perinatal center unless special circumstances require it.
You can make a difference today in the outcome of this bill!
Requires health insurers to cover fertility preservation services for individuals undergoing treatment for cancer, sickle cell disease, or lupus that may impact fertility
HB 94 would require state-regulated health plans to cover fertility preservation services for people undergoing medical treatments for cancer, sickle cell disease, or lupus that could lead to infertility. These services include procedures like freezing eggs, sperm, or embryos to help individuals have children in the future. The bill also sets guidelines and limits for what insurance must cover, such as evaluation costs, medications, and one year of storage for reproductive cells. Limits include restrictions based on age and the number of procedures covered.
You can make a difference today in the outcome of this bill!
Respite Care for Families of Youth with Behavioral Health Needs
What HB 1238 does: Directs the state to seek federal approval for Medicaid to pay for respite care services for families caring for children under 21 with serious behavioral health conditions who are at risk of going into foster care.
Consumer impact: Families caring for children with significant behavioral health needs often reach a breaking point. Respite care gives families temporary relief while keeping kids in their homes and communities, rather than resorting to foster care or residential facilities. Respite care costs less than institutional placements and produces better outcomes for children.
Rural Hospital Authority Antitrust Immunity
What HB 1393 does: HB 1393 would allow hospital authorities in small rural counties (under 50,000 population) to coordinate on pricing, insurance negotiations, staffing, and services without facing antitrust liability. Supporters say this could help struggling rural hospitals survive by pooling resources and negotiating better rates. However, the bill lacks oversight or transparency requirements and raises serious legal questions by attempting to preempt federal antitrust laws, which is an authority that has not been given to a state legislature before. The bill’s antitrust protections also extend beyond public hospital authorities to private entities that collaborate with them, meaning for-profit hospital systems or other commercial partners could use these arrangements to shield pricing and market conduct from legal accountability.
Rural Hospital Joint Venture Outpatient Facilities
What HB 1299 does: Allows hospital authorities in rural counties (under 50,000 population) to jointly own outpatient healthcare facilities with a single group of specialty physicians. The hospital authority must own at least 51% of the facility.
Consumer impact: Could expand access to outpatient specialty care in rural communities where patients currently travel long distances. However, the bill does not require joint ventures to serve uninsured or Medicaid patients, and physician-hospital joint ventures raise questions about whether financial incentives align with community health needs.
Small Business Health Insurance Tax Credit
What HB 1110 does: Creates a state tax credit for small employers (10 or fewer employees) that contribute at least $100 per month toward employees’ individual health insurance through an Individual Coverage Health Reimbursement Arrangement (ICHRA).
Consumer impact: Many small businesses want to help workers with health coverage, but can’t afford traditional group plans. ICHRAs let employers contribute to employees’ individual health insurance costs. HB 1110 would make that approach more affordable for the smallest businesses. ICHRAs can negate and/or complicate an employee’s eligibility for financial assistance under the Affordable Care Act; the specifics of each employer’s ICHRA matter a lot to the actual financial impact on employees.
State Agency Financial Accountability
What HB 1192 does: Requires the Department of Human Services and the Department of Community Health to keep funds designated for specific purposes in separate accounts and report annually to the legislature on cost savings and efficiency improvements.
Consumer impact: Greater transparency could help ensure that money designated for specific health programs actually goes to those purposes.
Strengthening Utilization Review for Medical Necessity
What HB 1236 does: Requires that when an insurer denies coverage based on medical necessity, a Georgia-licensed clinical peer with training in a related specialty must affirmatively agree to the denial. Current law allows insurers to deny care after a discussion with a clinical peer; HB 1236 requires the clinical peer to sign off on the decision. The bill also requires reviewers to attempt to contact the treating provider before issuing a denial.
Consumer impact: Georgians whose insurance companies deny coverage for medical treatment would gain a stronger safeguard. Requiring a Georgia-licensed specialist to agree to the denial, rather than simply participate in a discussion, could be a meaningful check on insurer decisions. Patients and providers would also receive clearer explanations for denials, supporting more effective appeals.
Student Safety, Health, and Well-Being Act
HB 268 proposes a range of policies to try to improve school safety, including creating mental health supports, requiring behavioral threat assessments and management, and establishing a state-wide threat assessment database for Georgia’s elementary and secondary schools. The bill includes funding for school-based mental health coordinators, new student behavioral assessments, and expanded school safety measures. It also enhances information sharing between schools, law enforcement, and state agencies to improve student support and security. The Senate’s version of the bill removed the S3 Database, which would have been a statewide database run by the Georgia Emergency Management and Homeland Security Agency (GEMA) containing information about credible threats to school safety and the students involved in making them. The substitute added language defining a “terroristic threat of a school” as when someone threatens harm pertaining to school in a way that causes fear, disruption, or evacuation and defines criminal punishments for such an act ranging from a misdemeanor to a felony (if a threat of death is made). The substitute also defines a “terroristic act upon a school” as committing a violent or dangerous act with the intent to terrorize or force an evacuation on school property. The language also adds terroristic acts on a school to the list of crimes for which children (ages 13-17) can be tried as adults.
Surprise Billing Consumer Protection Act
What HB 961 does: Extends surprise out-of-network billing protections to emergency ground ambulance rides. Patients would pay no more than in-network rates for out-of-network ambulance services.
Consumer impact: Georgia’s current surprise billing law doesn’t cover ground ambulances, leaving patients vulnerable to unexpected bills of hundreds or thousands of dollars, even when they have insurance.
TANF Eligibility and Benefit Update
HB 500 updates Georgia’s Temporary Assistance for Needy Families (TANF) program by increasing the maximum benefit amount, lifetime eligibility limits, and asset exclusions for applicants. It raises cash assistance levels to 40% of the federal poverty level (FPL) and allows recipients to receive benefits for up to 60 months, an increase from the previous 48-month limit. The bill also increases the asset limit to $5,000. It exempts one primary vehicle from asset calculations, with an additional $4,650 equity exclusion for a second vehicle if used for work, education, or job search.
Third-Party Payer Accountability for Medicaid Claims
Senate Bill 276 strengthens accountability for third-party payers(such as private insurance companies and pharmacy benefit managers) when paying health care costs for Medicaid beneficiaries. The bill requires these payers to respond promptly to claims and inquiries and prohibits denials of payment based on prior authorization issues.
Transfer Medicaid Eligibility to DCH
What SB 460 does: Would transfer Medicaid eligibility determination from the Department of Human Services to the Department of Community Health. Currently, DHS and DCH share responsibility for Medicaid enrollment.
Consumer impact: The bill’s focus on fraud prevention through aggressive data matching and verification requirements could create barriers for eligible Georgians, particularly if data discrepancies produce false positives that result in coverage loss for Medicaid members. Implementation is further uncertain because the transfer requires federal approval, relies on a Gateway eligibility system that has experienced technical challenges, and grants DCH broad discretion over reevaluation frequency.
Transfer Medicaid Program to DHS
What SB 461 does: Takes the opposite approach from SB 460, proposing to make DHS the single agency responsible for Medicaid administration. SB 460 and SB 461 represent competing visions for how Georgia should organize its Medicaid program.
Consumer impact: Moving Medicaid to DHS would separate coverage policy from health care delivery expertise, requiring DHS to build new capacity in complex areas such as care management contracts, provider reimbursement, and quality oversight, where the agency lacks deep experience. The transition faces uncertain federal approval timelines and significant implementation risks, as Medicaid has grown substantially more complex since Georgia last housed the program within DHS.
Transgender Sports Ban
SB 1 mandates that students participate in school sports and use facilities based on their biological sex at birth, as documented on their birth certificate. The bill explicitly excludes transgender students from joining teams or using shared spaces aligning with their gender identity and outlines financial penalties for schools that violate the transgender athlete ban. Among other changes, the substitute language replaces all references to “gender” in the code section with “sex”, allows for someone who believes they’ve been harmed by another person violating this law to seek damages, and expands the application to include private schools that receive state funding.
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Updates to the Behavioral Health Reform and Innovation Commission (BHRIC)
SB 233 makes several updates to the Behavioral Health Reform and Innovation Commission (BHRIC), including expanding its membership, restructuring its subcommittees, and extending its existence by 18 months (until Dec. 31, 2026). The commission is responsible for evaluating and recommending improvements to Georgia’s behavioral health system. Key changes to the committee include adding to the Commission’s membership a certified addiction recovery specialist with lived experience, a provider specializing in intellectual and developmental disabilities (IDD), a parent of an individual with IDD or an individual with IDD, an individual who has lost an immediate family member to drug overdose or fentanyl poisoning, a leader of an IDD advocacy organization, and an executive director of a Georgia nonprofit focused on addiction and recovery. The bill also removes the Involuntary Commitment and Workforce & System Development committees and replaces them with the Addictive Diseases and Intellectual & Developmental Disabilities committees, respectively.