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

25 LC 52 0690 Senate Bill 50 By: Senators Lucas of the 26th, Summers of the 13th, Goodman of the 8th, Jones II of the 22nd, Hickman of the 4th and others A BILL TO BE ENTITLED AN ACT To amend Article 7 of Chapter 4 of Title 49 of the Official Cod e of Georgia Annotated,1 relating to medical assistance generally, so as to provide for Medicaid expansion; to provide2 for the submission of a waiver request, necessary amendments, a nd other documents; to3 provide for savings to be deposited into the Indigent Care Trust Fund; to create the Advisory4 Commission on the PeachCare Plus Program; to provide for members and duties; to provide5 for definitions; to provide for a short title; to provide for legislative findings; to provide for6 related matters; to provide for legislative notification and ap proval; to repeal conflicting7 laws; and for other purposes.8 BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:9 SECTION 1.10 This Act shall be known and may be cited as the "PeachCare Plus Act of 2025."11 S. B. 50 - 1 - 25 LC 52 0690 SECTION 2.12 The General Assembly finds that:13 (1) Expanding access to coverage for essential healthcare needs to Georgians earning up14 to 138 percent of the federal poverty limit will improve the qu ality and availability of15 healthcare services in this state;16 (2) It is important that federal reimbursement remain at current rates to allow the State of17 Georgia to provide such coverage;18 (3) Providing coverage via fully subsidized commercial insuran ce products on the19 Section 1332 marketplace in Georgia will give individuals more options in coverage and20 help ensure that healthcare providers may commercially contract for services and receive21 fair reimbursement for providing such services;22 (4) The request for a federal waiver to provide these services should protect the fiscal23 stability of the state, avoid tax increases, not contain matter s that would diminish the24 likelihood of approval, and be bipartisan in nature;25 (5) Fair reimbursement rates and added flexibility to innovate in healthcare delivery will26 help attract essential healthcare providers to Georgia; and27 (6) The General Assembly, through the Advisory Commission on t he PeachCare Plus28 Program, should maintain an active oversight role in preparatio n and submission of the29 waiver.30 SECTION 3.31 Article 7 of Chapter 4 of Title 49 of the Official Code of Geor gia Annotated, relating to32 medical assistance generally, is amended by revising Code Section 49-4-142.2, relating to33 expansion of Medicaid eligibility through an increase in the income threshold, as follows:34 "49-4-142.2.35 (a) On and after July 1, 2014, neither the department, the board, nor any other36 representative of the state shall expand Medicaid eligibility under this article through an37 S. B. 50 - 2 - 25 LC 52 0690 increase in the income threshold without prior legislative approval; provided, however, that38 this shall not apply to any increase resulting from a cost-of-living increase in the federal39 poverty level. The legislative approval required under this Co de section shall be by Act40 of the General Assembly or the adoption of a joint resolution of the General Assembly.41 (b) This Code section shall not apply to a waiver request alon g with other necessary42 amendments for the creation of the PeachCare Plus Program pursu ant to Code43 Section 49-4-142.6 and submitted between July 1, 2025, and October 31, 2026."44 SECTION 4.45 Said article is further amended by adding new Code sections to read as follows:46 "49-4-142.6.47 (a) As used in this Code section, the term 'program' means the PeachCare Plus Program48 that expands Medicaid eligibility as provided in this Code section.49 (b) On or before October 31, 2026, in consultation with the office of the Commissioner of50 Insurance, the department shall submit to the United States Dep artment of Health and51 Human Services Centers for Medicare and Medicaid Services pursuant to Section 1115 of52 the federal Social Security Act a waiver request along with other necessary amendments53 for the creation of the PeachCare Plus Program. The waiver request shall provide for:54 (1) The enrollment of certain low-income individuals making less than 138 percent of55 the federal poverty level in the eligibility category created b y56 Section 1902(a)(10)(A)(i)(VIII) of the federal Social Security Act, 42 U.S.C.57 Section 1396a, into qualified healthcare plans offered on the state marketplace established58 under Section 1332 of the federal Patient Protection and Afford able Care Act or the59 federal marketplace, as applicable at implementation; and60 (2) The full payment of any premiums or other direct costs associated with enrolling in61 qualified healthcare plans for certain individuals making less than 138 percent of the62 federal poverty level.63 S. B. 50 - 3 - 25 LC 52 0690 (c) The provisions of this Code section shall only apply so lo ng as the federal medical64 assistance percentage for this state established pursuant to 42 U.S.C. Section 1396d65 remains at or above 90 percent.66 (d) All savings to the state as a result of the implementation of the program shall be67 deposited into the Indigent Care Trust Fund created pursuant to Code Section 31-8-152 and68 shall be used for any additional costs and expenses associated with the implementation of69 the program.70 (e) The program shall be administered by the department; provi ded, however, that the71 department may consult the Advisory Commission on the PeachCare Plus Program and72 other state agencies, including, but not limited to, the office of the Commissioner of73 Insurance.74 (f) The waiver provided for in this Code section shall take effect upon the expiration of the75 current waiver or any extension of such waiver granted prior to December 31, 2025.76 49-4-142.7.77 (a) As used in this Code section, the term 'commission' means the Advisory Commission78 on the PeachCare Plus Program.79 (b) There is created the Advisory Commission on the PeachCare Plus Program. The80 commission shall advise the department in drafting and submitting the waiver request and81 implementing the PeachCare Plus Program as provided for in Code Section 49-4-142.6.82 (c) The commission shall consist of 11 members, as follows:83 (1) The commissioner or his or her designee, who shall also serve as chairperson;84 (2) Five members of the House of Representatives to be appointed by the Speaker of the85 House of Representatives, provided that three members shall be from the majority party86 and two shall be from the minority party; and87 S. B. 50 - 4 - 25 LC 52 0690 (3) Five members of the Senate to be appointed by the President of the Senate, provided88 that three members shall be from the majority party and two shall be from the minority89 party.90 (d) Vacancies in the commission shall be filled in the same ma nner as the initial91 appointments.92 (e) The commission shall:93 (1) Consult with the department during preparation of the waiver request authorized by94 Code Section 49-4-142.6 and review such waiver request prior to submission;95 (2) Seek to make all recommendations in a bipartisan manner, with the chairperson only96 voting on any recommendation in the event of a tie;97 (3) Issue a public report no fewer than 30 days after submissi on of the waiver request98 that shall provide recommendations for the implementation and success of the program99 authorized by the waiver; and100 (4) Remain in place on an ongoing basis, with members serving at the pleasure of the101 state official appointing them, to advise the department on the implementation of the102 PeachCare Plus Program and related matters.103 (f) The commission may conduct such meetings at such places and at such times as it may104 deem necessary or convenient to enable it to exercise fully and effectively its powers,105 perform its duties, and accomplish the objectives and purposes of this Code section. The106 commission shall meet upon the call of the chairperson and shal l meet at least once107 quarterly.108 (g) The legislative members of the commission shall receive the allowances provided for109 in Code Section 28-1-8. The commissioner or his or her designe e shall receive no110 compensation for his or her services on the commission, but he or she shall be reimbursed111 for expenses incurred in the performance of his or her duties a s a member of the112 commission in the same manner as he or she is reimbursed for ex penses in his or her113 capacity as a state official. The funds necessary for the reimbursement of the expenses of114 S. B. 50 - 5 - 25 LC 52 0690 the state official shall come from funds appropriated to or oth erwise available to the115 department. All other funds necessary to carry out the provisions of this Code section shall116 come from funds appropriated to the House of Representatives and the Senate."117 SECTION 5.118 This Act shall be considered legislative notification for purposes of Code Section 49-4-142.1119 and legislative approval for purposes of Code Section 49-4-142.2.120 SECTION 6.121 All laws and parts of laws in conflict with this Act are repealed.122 S. B. 50 - 6 -