Senate · Introduced · 2025-2026 Regular Session

SB50: SB50 "PeachCare Plus Act of 2025"; enact

Last action January 29, 2025 · Senate Read and Referred

Senate Bill 50 would direct Georgia's Medicaid agency to seek federal approval for a new program, called PeachCare Plus, that would put low-income adults into private marketplace health plans instead of traditional Medicaid.

In plain language

Georgia currently blocks any expansion of Medicaid eligibility without prior approval from the General Assembly. This bill, the "PeachCare Plus Act of 2025," would use that legislative approval to authorize a specific expansion plan. It directs the Department of Community Health to apply to the federal government by October 31, 2026, for a waiver creating the PeachCare Plus Program, which would enroll adults earning up to 138 percent of the federal poverty level into subsidized private health plans sold on Georgia's insurance marketplace, with the state covering their premiums and other direct costs in full. The program would only continue as long as the federal government keeps paying at least 90 percent of the cost. Any state savings from the switch would go into the Indigent Care Trust Fund. The bill also creates an 11-member Advisory Commission on the PeachCare Plus Program, made up of legislators and the insurance-program commissioner, to help draft the waiver and oversee the program afterward.

What the bill does

Directs the Department of Community Health to submit a federal Section 1115 Medicaid waiver request by October 31, 2026, to create the PeachCare Plus Program.
Would enroll low-income adults earning under 138 percent of the federal poverty level into private marketplace health plans rather than traditional Medicaid, with the state paying their premiums and direct costs.
Limits the program's operation to periods when the federal government's matching payment rate for Georgia stays at or above 90 percent.
Creates the 11-member Advisory Commission on the PeachCare Plus Program, made up of legislators and the state insurance commissioner's designee, to help draft the waiver and oversee the program.
Requires state savings from the program to be deposited into the Indigent Care Trust Fund (O.C.G.A. § 31-8-152) to help cover the program's costs.
Carves out an exception to Georgia's existing rule (O.C.G.A. § 49-4-142.2) requiring legislative approval before any Medicaid eligibility expansion, treating this bill itself as that approval.

Who it affects

Low-income Georgia adults earning up to 138 percent of the federal poverty level who would gain access to subsidized private insurance, the Department of Community Health, the Commissioner of Insurance's office, healthcare providers seeking reimbursement, and the House and Senate members who would serve on the new advisory commission.

Why it matters

If approved by federal regulators, thousands of low-income Georgians who currently lack affordable coverage options could gain subsidized private health insurance instead of traditional Medicaid, potentially changing which doctors and plans they can use and how providers get paid for their care.

Key provisions

Section 3 revises O.C.G.A. § 49-4-142.2 to exempt a PeachCare Plus waiver request submitted between July 1, 2025 and October 31, 2026 from the usual ban on expanding Medicaid income eligibility without legislative approval.
Section 4 adds new Code Section 49-4-142.6, requiring the waiver request to cover enrollment of people under 138 percent of the federal poverty level into marketplace health plans and full state payment of their premiums and direct costs.
Section 4 also caps the program's operation to periods when Georgia's federal medical assistance percentage stays at or above 90 percent (42 U.S.C. § 1396d).
Section 4 requires program savings to be deposited into the Indigent Care Trust Fund and used for costs tied to implementing the program.
Section 4 adds new Code Section 49-4-142.7, creating the 11-member Advisory Commission on the PeachCare Plus Program with legislative and executive branch members, chaired by the insurance commissioner or a designee.
The commission must issue a public report within 30 days of the waiver's submission and meet at least quarterly on an ongoing basis.
Section 5 states that the Act itself counts as the legislative notification and approval required under existing law (O.C.G.A. §§ 49-4-142.1 and 49-4-142.2).

Status timeline

2025-01-29Senate Read and Referred (Senate)
2025-01-28Senate Hopper (Senate)

Topics

Medicaid expansion
health insurance
PeachCare Plus
state healthcare policy
federal waiver