LEGISLATIVE UPDATE: WEEK 5

Will New PBM Reforms Lower Drug Prices in Georgia?

Pharmacy Benefit Managers (PBMs) are companies that help insurance plans manage prescription drug benefits. They decide which medications are covered, negotiate prices with drug manufacturers, and set payment rates for pharmacies. While PBMs can lower drug costs by getting discounts from drug makers and pharmacies, they also have significant control over medication pricing, patient access, and pharmacy reimbursements. Critics argue that PBMs’ business practices can drive up costs for consumers and independent pharmacies, while supporters believe they help manage drug spending and ensure affordability. Additionally, PBMs are often owned by an insurer or pharmacy, meaning these PBMs are managed by the same stakeholders that set drug prices for consumers.

LEGISLATIVE UPDATE: WEEK 4

New Bill Aims to Create Georgia’s First Community Health Worker Certification Program

This week, lawmakers introduced House Bill 291, a bill that would create a state certification process for Community Health Workers (CHWs) in Georgia. CHWs are trusted public health professionals who connect Georgians, especially those in underserved communities, to health care and essential services. People know them by titles such as Patient Navigator, Community Health Advocate, and Promotora de Salud. CHWs play a vital role in improving health outcomes, delivering culturally-relevant information and care, and addressing social determinants of health like housing, transportation, and food insecurity.

HB 291 would help build a skilled and stable CHW workforce by establishing a certification process. The bill expands CHW’s ability to serve in various health care and community settings. HB 291 could also pave the way for Georgia Medicaid to reimburse CHWs in more settings and roles. Currently, Medicaid only covers CHW services provided through the Resource Mothers program, which supports certain pregnant and postpartum individuals. Certification could allow Medicaid to fund CHW services in more health care teams, public health programs, and care coordination efforts statewide.

If passed, HB 291 would recognize CHWs as essential members of Georgia’s health care system. It would ensure they have the training, support, and financial sustainability needed to continue their work.

This is one of GHF’s 2025-2026 legislative priorities, and we support this bill. We’ll keep tracking HB 291 and advocating for strong policies that support CHWs and expand access to care. Keep reading for more updates!

LEGISLATIVE UPDATE: WEEK 3

New Medicaid Expansion Bill has Bipartisan Support

A new bill, Senate Bill 50, to expand health insurance to low-income Georgia adults was introduced in the Senate this week. For the first time since Medicaid expansion became available to states, four Republican senators joined Democrats in support of a legislative solution to close Georgia’s coverage gap! The bill would create a new program called “PeachCare Plus”. It is nearly identical to the PeachCare Plus bill introduced during last year’s legislative session, the first Medicaid expansion bill to receive a legislative hearing in Georgia. Rather than expanding the state-run Medicaid program, SB 50 would introduce a private insurance model, using federal dollars to purchase coverage for eligible individuals (adults with incomes below 138% of the federal poverty level) through Georgia’s health insurance marketplace.

Too many Georgians are forced to choose between medical care and paying their bills. Closing Georgia’s health insurance coverage gap would provide life-saving coverage to thousands of uninsured Georgians. We support this legislation and will keep you updated as it moves through the legislative process.

Read on for key takeaways from other bills on our radar, and opportunities to advocate with us and our partners at the Capitol. 

LEGISLATIVE UPDATE: WEEK 2

Severe Weather Closed the State Capitol for Most of the Week 

Severe weather disrupted last week’s legislative schedule, postponing budget hearings and other activities. As a result, some state agencies will now present their budget requests this week. Since there wasn’t much action at the Capitol last week, we’ve covered a few more health-related bills from the first week of session below. 

Update on State Agency Budget Presentations:

State agency budget presentations now begin this week. For the latest schedule, check out the legislative session schedule here. Two upcoming meetings on our radar are: 

• Appropriations Subcommittee on Human Resources (House)–where legislators will hear presentations about the human resource needs of the Departments of Human Services and Behavioral Health & Developmental Disabilities, as well as the Georgia Council on Developmental Disabilities
• Appropriations Subcommittee on Health (House)–where legislators will hear budget presentations from the Departments of Community Health and Public Health

What Does Georgia’s Health Care Future Look Like?

Imagine a Georgia where every family has access to affordable health care, where mental health services are readily available, and where no one falls through the cracks of a complex system. Achieving this vision requires bold ideas, collaborative solutions, and voices from every corner of the state. That’s exactly what happened on January 14, 2025, at Georgians for a Healthy Future’s 15th Annual Health Care Unscrambled.

With over 200 advocates, policymakers, and public health experts gathered at the Georgia Freight Depot, the event served as a catalyst for action, offering actionable insights and solutions to the challenges shaping Georgia’s health care landscape.

LEGISLATIVE UPDATE: WEEK 1

Georgia’s 2025 Legislative Session Has Officially Begun

On Monday, January 13th, the Georgia General Assembly convened to kick off the first year of the state’s two-year legislative cycle. During this period, lawmakers will introduce and consider bills that have two years (this session and next) to become law. The legislative session gives state lawmakers a chance to address key issues affecting Georgians, including health and health care.

The following day GHF hosted Health Care Unscrambled 2025 (our 15th annual HCU!), where we unveiled our 2025-2026 policy priorities. A heartfelt thank you to everyone who attended! If you missed the event or would like to revisit the discussions, you can find a full recap on our event page here, including a recording and presentation slides. 

On Thursday, Governor Kemp delivered his State of the State address and unveiled his budget proposals for the remainder of the current fiscal year and the next state fiscal year. Below, we’ve highlighted key health-related components of the Governor’s budget for your review.

This Week: Budget Week
House and Senate Appropriations Committee members are holding joint hearings to review state agency budget requests and spending this week. These hearings provide important insights into agency priorities and funding needs for the year ahead.

For more information, you can access the legislative session schedule here.

By: Knetta Adkins

On August 2nd, I had the opportunity to meet with Secretary Xavier Becerra, the 25th Secretary of the Department of Health and Human Services. During his August trip to Georgia, Secretary Becerra hosted a roundtable with community leaders to hear about the health care concerns and challenges most affecting Georgians. Congresswomen Carolyn Bordeaux, Lucy McBath, and Nikema Williams, state Representative Matthew Wilson, and Mayor Keisha Lance Bottoms participated in the roundtable, as well as representatives from Community Catalyst, Protect Our Care Georgia, and others. It was an exciting moment to represent Georgians for a Healthy Future and share on behalf of the marginalized Georgians for whom we advocate. 

Long-standing systemic and structural racism has led to the deep health disparities that as health advocates we regularly reference: 

Rates of COVID-19 among Black Georgians outpace their share of the state’s population.

Black mothers in Georgia are twice as likely to give birth to a low-birthweight baby as white Georgians.

Rates of HIV diagnosis are among Black Georgians are six times higher than among white Georgians and more than twice the state’s overall rate.

Black Georgians report higher rates of asthma, diabetes, and other chronic diseases compared to Georgians of other races and ethnicities.

Black Georgians experience higher levels of poverty, food insecurity, and joblessness, all of which impact their health.

The same racist systems & structures that have produced these health outcomes have led to the murders of black people in Georgia and across the country.

This reality and the systems that allow it to persist are not new. Both are unacceptable.

Georgians for a Healthy Future stands with its Black staff, board members, and partners to affirm that Black lives matter. Through our policy advocacy, coalition building and community engagement, GHF is committed to dismantling the racist structures that threaten the health and well-being of Black Georgians and their communities. GHF is also committed to examining our own organizational structures and practices for ways in which we can more fully embody equity, a process which we began earlier this year.

As GHF continues our imperfect work in pursuit of racial justice and health equity, we invite you to join us:

• Contact your elected officials, including your mayor, city council members, and district attorney to advocate for accountability and change, such as the policy changes recommended by the American Public Health Association and PolicyLink
• Want more advocacy? Contact Governor Kemp and your state legislators and ask them to expand Medicaid when they return to the state Capitol this month. More than one-third of uninsured, low-income Georgians who could gain health coverage through Medicaid are Black and more than half are people of color
• Donate to Black-led health advocacy and service organizations like the Black Mamas Matter, Black Women’s Health Imperative, Center for Black Women’s Wellness, Feminist Women’s Health Center, SisterSong, SOWEGA Rising, and other groups serving your community
• Vote, volunteer and seek other ways to be active in your community
• Build power in marginalized, predominantly Black communities: Support BVM Capacity Building Institute and help provide training and support for community‑based organizations
• For non-black allies: deepen your understanding of how racism affects all of us by reading anti‑racism resources and having conversations with your family and friends
• Take care of yourself and your loved ones

As Georgia faces the public health emergency of COVID-19, it can be hard to be optimistic about our health and our futures. However, Georgians for a Healthy Future believes that our state can successfully overcome this tremendous challenge if Georgians adhere to the advice of public health experts and our state’s leaders swiftly adopt evidence-based policies that protect the health and safety of all Georgians. At the same time, Georgia leaders must look ahead to ways they can promote the health and well-being of all Georgians in the economically challenging months to come. Georgians for a Healthy Future has identified policy priorities that we believe are necessary for success in addressing the immediate public health emergency and the emerging economic consequences. These are the policies that we will fight for as we continue our fight for the health and wellness of all Georgians.

Our recommendations are shaped by feedback from GHF’s board of directors, partner advocacy organizations, local groups helping Georgians in their communities, and stories from Georgians just like you. You can share your COVID-19 experiences with GHF here. Thank you for your generous input.

As the status of this crisis changes and we gather more information, you can find updates to these policy recommendations and actionable information here.

Health system capacity and public safety

GHF supports:

• Statewide and local shelter-in-place orders and other aggressive social distancing practices to slow the spread of the COVID-19 virus
• Funding to quickly expand the capacity of Georgia’s Department of Public Health to test and monitor the spread of COVID-19
• Funding to purchase personal protective equipment for health care workers
• Funding to purchase equipment for patient care like ventilators and respirators
• Maximizing the scope of practice for all qualified and licensed health care providers (e.g. physicians assistants, advanced practice registered nurses, registered nurses)
• Expanding options and health coverage of telehealth and virtual visits in all medically appropriate circumstances

Access to quality, affordable health care for all Georgians

GHF supports:

• Maximizing Medicaid flexibility and funding to increase access to care by:
  • Expanding Medicaid to all poor and near-poor Georgians (those making less than 138 percent of the federal poverty line)
  • Taking advantage of emergency 1135 waivers to increase the number of providers who can see Georgians with Medicaid coverage
  • Adopting administrative changes to preserve coverage for current Medicaid members and to enroll Georgians who are already eligible but unenrolled, including the expansion of presumptive and retroactive eligibility and a halt on the annual renewal process
  • Expanding coverage of home- and community-based services and long-term services and supports
• Expanding access and protections in comprehensive private health coverage
  • Promoting enrollment for people who qualify for private insurance, especially among those who are eligible for financial assistance through the Affordable Care Act (ACA) by:
    • Establishing a new Special Enrollment Period for people who wish to purchase health insurance now
    • Easing the enrollment and paperwork requirements for people enrolling in coverage due to job loss or income changes
    • Prohibiting health insurers from canceling a consumer’s coverage, even if they fall behind on premium payments
  • Eliminating cost-sharing for COVID-19 testing (and related tests) and treatment
  • Limiting the sale of plans that do not offer comprehensive benefits or follow the standards set by the ACA
  • Establishing comprehensive surprise billing protections
• Promoting access to mental health services and substance use recovery supports for all Georgians
• Easing limits on prescription drugs so that consumers can more easily access 90-day supplies of medications

Equity at the center of the response

This pandemic will hit some Georgia communities harder than others. All federal and state policy remedies should endure to offer the most help to those who are disadvantaged due to income, race or ethnicity, disability or health status, age, geography, and other factors. Georgia’s response must proactively address health equity concerns. Among other strategies, this should include disseminating public health messages that include information about affected groups and communities in languages and contexts they understand and directing additional funding to community health centers and other providers that serve disproportionately impacted communities.

Meeting the basic needs of Georgians and their families

As evidenced by yesterday’s job loss statistics, it is imperative that the public health response to the COVID-19 crisis be followed by an ambitious economic response. GHF supports policies that provide equitable opportunities for stability, dignity, and well-being for all Georgia families. While not an exhaustive list, these policies include:

• Expanded access to Georgia’s unemployment insurance system, including 26 weeks of benefits and the easing of eligibility requirements and activities.
• A moratorium on foreclosures and evictions, the provision of rental assistance and mortgage forbearance, and other supports that keep Georgians in their homes
• Improved access to nutritious foods through SNAP, WIC, school system food programs, and other public programs
• Universal paid family leave that allows workers regardless of income to take time off to care for themselves and their loved ones in times of sickness and crisis
• A moratorium on utility shut offs, including internet access so that families can keep the lights on and children can continue to learn remotely

GHF will support partner organizations in their efforts to advocate for these policies and supports for Georgia families and individuals.

Some of these policies have been adopted or partially adopted by federal officials, Governor Kemp, and state agency officials. GHF thanks Georgia leaders for the actions they have already taken. In the coming weeks, GHF will track which policies are fully implemented, partially adopted, or not taken up at all, and will provide updates accordingly.

Thank you for your support and advocacy. We wish you health and safety!

Legislative Update: Week 8

General Assembly continues work on budgets ahead of Crossover Day

Last week the Senate passed their version of the FY2020 state budget (the “little budget”). This week the House and Senate will appoint a conference committee to work out the remaining differences in their versions of the little budget before it gets a final approval by both chambers. This morning the House Appropriations committee has passed its version of the FY2021 budget, which will begin July 1st of this year and run through June 30, 2021. The big budget will be considered by the full House chamber later this week.

Committee hearings will continue in earnest as legislators try to move their priority bills ahead of this week’s Crossover Day deadline. (Crossover Day is the 28th day of session and the deadline by which bills must pass the House or the Senate in order to remain viable to become law.) In next week’s legislative update, we will run down which health bills were left on the cutting room floor and which ones remain viable for this year.

Bill introduced to extend postpartum Medicaid coverage

Legislation would allow moms to keep Medicaid coverage up to six months after giving birth

HB 1114, sponsored by Rep. Sharon Cooper, would allow new mothers to receive Medicaid coverage for six months after giving birth. Currently, pregnant women covered by Medicaid are covered only up to 60 days after their birth or miscarriage. Due to restrictive Medicaid eligibility requirements for Georgia parents and because Georgia has not expanded Medicaid to all low-income adults, many mothers who try to apply for Medicaid after the 60 days are ineligible and become uninsured. The bill has been referred to the House Health & Human Services committee and has the support of Healthy Mothers Healthy Babies Coalition of Georgia, GHF, and other consumer health advocacy groups.

Learn more about this legislation and maternal health in Georgia in a new blog from the Georgia Budget & Policy Institute.

Surprise billing and Gracie’s Law approved

Surprise billing protections are another step closer to passage

Companion bills were introduced in the House and Senate last month to ban surprise out-of-network medical billing (also called surprise billing) in emergency and non-emergency situations. Last week the House passed its version of this important consumer-focused legislation, HB 888. The Senate has already approved SB 359, which closely mirrors the House bill. The Senate bill is expected to be amended in the House Special Committee on Access to Quality Health Care so that it exactly matches the House version and better protects against surprise bills in emergency situations. Both bills are expected to be considered up by their respective committees after Crossover Day.

Gracie’s Law moves on to Senate

Gracie’s Law (HB 842), sponsored by Rep. Rick Williams, would protect people with disabilities from being removed from organ donor waiting lists because of their disabilities. Gracie’s Law was approved by the House on February 28th and is now in the Senate Health and Human Services Committee. The bill is supported by The Arc of Georgia, the Georgia Council on Developmental Disabilities, and other disability advocacy organizations.

(For more on this bill, please read our earlier legislative update.)

Pharmacy benefit manager legislation keeps moving

Four bills to reform PBM practices in Georgia move forward ahead of Crossover Day

Georgia’s House and Senate continued their efforts last week to change how pharmacy benefit managers operate in Georgia. Pharmacy benefit managers (commonly called PBMs) are companies that manage prescription drug benefits for health insurance companies. 

HB 946 and HB 947, both sponsored by Rep. Matt Knight and HB 918, sponsored by Rep. Sharon Cooper, were passed by the House on Wednesday. HB 946 was referred to the Senate Insurance and Labor committee, and HB 918 and HB 947 were referred to the Senate Health and Human Services committee. Similarly, SB 313sponsored by Senator Dean Burke, was approved by the Senate on Thursday.

(For an overview of the bills, please read our March 2nd legislative update.)

GHF has you covered

Stay up-to-date with the legislative session

GHF will be monitoring legislative activity on a number of critical consumer health care topics. Along with our weekly legislative updates and timely analysis of bills, we have the tools you need to stay in touch with health policy under the Gold Dome.

• Sign up for the Georgia Health ActionNetwork (GHAN) to receive action alerts that let you know when there are opportunities for advocacy and action
• Track health-related legislation
• GHF’s 2019-2020 legislative priorities