Archives: Bills

HB 100 would require health insurers to pass at least 80% of all prescription drug rebates they receive to enrollees. This requirement means that when insurers negotiate discounts and rebates from drug manufacturers, a large portion of those savings must be used to lower out-of-pocket costs for patients at the pharmacy counter.

Key details:

• Rebates are price concessions that drug manufacturers provide to insurers or pharmacy benefit managers (PBMs) in exchange for covering certain medications. Currently, insurers and PBMs do not always pass these savings to consumers.
• Insurers must apply at least 80% of these rebates to reduce the cost-sharing amounts (copays, deductibles, and coinsurance) that patients pay for prescription drugs.
• Insurers who fail to comply could face penalties, including fines or losing their license.

Why it matters: HB 100 aims to lower prescription drug costs for consumers by ensuring that drug rebates benefit patients rather than insurers. The bill could make medications more affordable by requiring insurers to pass along at least 80% of rebates, especially for people with chronic conditions who rely on costly prescriptions. However, some insurers may argue that this policy could lead to higher premiums if they cannot retain a portion of the rebates to offset other costs.

SB 60 would require pharmacy benefits managers (PBMs) to act in the best interests of patients, health plans, and health care providers. PBMs are companies that manage prescription drug benefits for health insurance plans, including deciding which medications are covered and negotiating prices with drug manufacturers. This bill would create legal responsibilities for PBMs to ensure fairness, transparency, and accountability in their business practices.

SB 50 would create a new health coverage program in Georgia called PeachCare Plus. This program would cover low-income adults by enrolling them in fully subsidized private health insurance plans on Georgia’s state-based marketplace (Georgia Access).

Key details:

• The bill would allow adults earning up to 138% of the federal poverty level (FPL) to enroll in private health insurance plans, with the state covering all costs (premiums and other direct costs).
• The Georgia Department of Community Health (DCH) would oversee the program, with input from the Advisory Commission on the PeachCare Plus Program, a new bipartisan group that would monitor the waiver request and provide recommendations.
• Any state savings from the program would go into the Indigent Care Trust Fund, which helps to pay hospitals for  health care delivered to uninsured, low-income Georgians.

Why it matters: SB 50 could help expand health coverage for hundreds of thousands of low-income Georgians, many of whom currently fall into the coverage gap—earning too much for Medicaid but not enough to afford private insurance. By using private health plans instead of traditional Medicaid, the bill aims to increase provider participation and ensure fairer reimbursement rates for hospitals and doctors. However, the program’s long-term viability depends on federal funding staying at current levels. If successful, PeachCare Plus could be Georgia’s version of Medicaid expansion, improving access to care across the state.

HB 109 proposes a five-year pilot program to create Emergency Psychiatric Assessment, Treatment, and Healing (EmPATH) units in hospitals across Georgia. These units are designed to help people experiencing mental health crises by providing immediate, short-term treatment in a hospital-based setting. The goal is to offer an alternative to emergency rooms and inpatient hospitalization for individuals in crisis.

HB 104 would ban transgender students in middle school through college from participating in school sports that align with their gender identity.    The bill bans transgender students from using shared spaces, such as bathrooms or locker rooms, based on their gender identity. The bill would also legally define “sex” as a student’s biological sex, as defined by their birth certificate.

HB 101 would require yearly public reports on prescription drug discounts and savings (i.e., prescription drug rebates) for the state employees’ health insurance plan, which covers state workers and public school teachers. The report would show how much of the savings from these drug discount programs was used to reduce premiums in the State Health Benefit Plan. The savings would be detailed in both dollar amounts and percentages. The bill also removes any outdated laws that might conflict with these changes.

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.

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.

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.

The bill updates the law authorizing the Maternal Mortality Review Committee in three ways: 1) Gives the Department of Public Health the power to define the length of the terms that members of the MMRC serve; 2) Limits the reasons that MMRC committee members can be removed to Inability or neglect to perform the duties, incompetence, or dishonest conduct; and 3) specifies that MMRC members must comply with the federal Health Insurance Portability & Accountability Act (HIPPA).