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.

In June of this year, the Centers for Medicaid and Medicare Services (CMS) approved a change for Georgia’s Medicaid program that shifts how school nurses can bill for their services. Before June, Medicaid would only pay for school health services, including nursing services, if the student had a special education plan called an Individualized Education Program (IEP). IEPs are maps that lay out a program of tailored education instruction, supports, and services. These plans are required for all students receiving special education services like students with ADHD, autism, or a speech impairment. The approved change allows Medicaid to pay for more school health services provided to any student with Medicaid coverage.

Legislative Update: Week 7

The GHF team prides itself on being able deliver timely and accurate updates on health care happenings at the Capitol. We hope that you enjoy reading our weekly legislative updates and that they help you stay informed and connected. If you enjoy them, please consider supporting our work with a donation today. Thank you for your continued support!

In this week’s update:

• The General Assembly approves the calendar for the rest of session
• Action alerts: prior authorization, Medicaid expansion, & mental health & substance use updates!
• Legislation: telehealth, changes to nursing rules, & protecting the ACA 
• Advocacy events this week: transgender rights!
• Federal COVID-19 relief – including extra Medicaid expansion funding – passed by U.S. House
• GHF’s got you covered this session!

The ongoing COVID-19 crisis has damaged the mental health of many Georgians and exacerbated the use of alcohol and drugs. Financial stressors, the difficulties of parenting, and almost universal uncertainty brought about by COVID-19 have dramatically increased depression, anxiety, stress, and substance use among Georgians. Some will seek supports and services to manage their health, which may be provided in part by certified peer specialists.

Certified peer specialists (CPS) provide support and education to individuals and families while they navigate mental health and/or substance use recovery supports and services. CPS have played a vital role in Georgia’s mental health and substance use recovery systems for over 20 years.

A recent poll from the Kaiser Family Foundation found that 45% of Americans reported that the COVID-19 crisis has harmed their mental health. Anxiety and fear are common with people concerned about contracting the virus, a loved one getting sick, and the economic impact of the crisis, including job loss, lost income, and loss of health care coverage.

Georgia non-profits and state agencies have come together to ensure resources and supports are available for Georgians who need help with their mental health. The following list provides information and links to resources to help get all of us through these difficult times.

If you need to talk to someone:

• National Suicide Prevention Lifeline
  Call 1-800-273-8255 or use the chat option on their webpage
  en Espanol: 888-628-9454
  Deaf and hard-of-hearing: 1-800-799-4889
  Open 24/7. We can all help prevent suicide. The Lifeline provides free and confidential support for people in distress, prevention and crisis resources for you or your loved ones, and best practices for professionals.

• Georgia Mental Health Consumer Network’s Peer2Peer Warm Line
  Call 888-945-1414
  Open 24/7/365 providing peer support over the phone. Support is available to all Georgians experiencing anxiety or stress, or who need support through the pandemic. Please call any time.

• Georgia Council on Substance Abuse’s CARES Warm Line
  Call or text 844-326-5400
  Open every day, 8:30 am to 11 pm. FREE, confidential, and available to anyone who has questions about addiction and recovery, needs someone to listen to them or wants to talk with someone who is also in recovery from substance use disorders.

• Georgia COVID-19 Emotional support line
  Call 866-399-8938
  Open 24/7. This confidential line offers assistance for those needing emotional support or resource information as a result of the COVID-19 pandemic. The support line is staffed by volunteers, including mental health professionals and others who have been trained in crisis counseling. This is part of a partnership between the Georgia Department of Behavioral Health & Developmental Disabilities, Beacon Health Options, and Behavioral Health Link.

If you need a support group:

• The Georgia Council on Substance Abuse is offering a FREE and confidential series of virtual All Recovery Meetings for those who want to stay connected during COVID-19. To learn more about GCSA and find the most up-to-date meeting times, visit their FaceBook page.
• NAMI Georgia and their local chapters around the state offer virtual support meetings for people with mental illness and family members. To get more information about the meetings, call (770) 408-0625 or email programs@namiga.org.

If you want to learn skills or information about mental health:

COVID-19 and your mental health:

• Learn self-care strategies and get the care you need to help you cope with resources and tips from the Mayo Clinic.
• Mental Health and COVID-19 information and resources, Mental Health America
• Teach Kids Coping Skills, Children’s Healthcare of Atlanta Strong4Life

If you have health coverage:

• Medicaid – If you need mental health or substance use recovery services during this time, check with your Medicaid insurance company and doctor to see if you can schedule a safe, socially distanced in-person appointment or a “virtual appointment” using the internet, video call, or telephone call, instead of going in-person. The contact information for your Medicaid insurance company is on the back of your insurance card.
• Private insurance – If you need mental health or substance use recovery services during this time, call your insurance company using the number on the back of your insurance card or visit their website to search for an in-network health care provider near you who offers the services that you need.
• Uninsured – If you need mental health care services during this time, call the Georgia Crisis & Access Line at 800-715-4225, visit the GCAL website, or download the MyGCAL app to find free or low-cost, local mental health & substance abuse services. Georgians should not let their insurance status get in the way of getting needed support or treatment.
• You can find more insurance information and resources (including how your insurance will cover COVID-19 testing & treatment) on our COVID-19: Your health coverage, health care, & well-being blog.

If you want to help:

• If you have completed Mental Health First Aid training and are interested in volunteering to provide support via the Georgia COVID-19 Emotional Support Line please email your name and contact info to MHFAvolunteer@dbhdd.ga.gov