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

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.