HB178: HB178 Social services; treatment services under Medicaid to persons with HIV; provisions

Georgia currently has no dedicated Medicaid pathway specifically for treating people living with HIV who lack insurance and have low incomes. This bill would require the Department of Community Health to ask the federal government for permission to create one. Specifically, the department would have to submit a Section 1115 waiver request to the federal Centers for Medicare and Medicaid Services by December 31, 2025. The waiver would seek approval for a demonstration project offering Medicaid treatment services, including antiretroviral medications, to Georgians diagnosed with HIV who earn less than 138 percent of the federal poverty level and have no health insurance. If the federal government approves the waiver, the department would then be required to put its terms into effect.

• Requires the Department of Community Health to submit a Section 1115 Medicaid waiver request to the federal Centers for Medicare and Medicaid Services by December 31, 2025.
• Directs that the waiver seek approval for a demonstration project providing Medicaid treatment services, including antiretroviral drugs, to people with HIV.
• Sets eligibility criteria for the program: a confirmed HIV diagnosis, income below 138 percent of the federal poverty level, and no existing health insurance.
• Requires the department to implement the waiver's terms and conditions once the federal government approves it.
• Repeals any existing state laws that conflict with this new requirement.

The bill affects the Department of Community Health, which must apply for and later implement the waiver, and low-income, uninsured Georgians living with HIV who could become eligible for Medicaid-funded treatment, including antiretroviral medication, if the waiver is approved.

If approved by federal regulators, this could give uninsured, low-income Georgians with HIV access to Medicaid-covered treatment, including antiretrovirals, that they currently may not be able to afford, potentially improving early treatment and health outcomes statewide.

• Section 1 adds a new Code section, O.C.G.A. § 49-4-142.6, requiring the waiver request be submitted by December 31, 2025.
• The demonstration project must aim to provide more effective, early HIV treatment through a package of services including antiretrovirals.
• Eligibility is limited to those with an HIV diagnosis, income under 138 percent of the federal poverty level, and no health insurance.
• Subsection (b) requires the department to implement the waiver's terms once it is approved, but does not specify a timeline for federal approval.
• Section 2 repeals any conflicting state laws.

1. 2025-02-03House Second Readers (House)
2. 2025-01-30House First Readers (House)
3. 2025-01-29House Hopper (House)

• Sharon Cooper (R, HD-045)Primary sponsor
• Lee Hawkins (R, HD-027)
• Ron Stephens (R, HD-164)
• Darlene Taylor (R, HD-173)
• Karla Drenner (D, HD-085)

• Medicaid
• HIV treatment
• health insurance
• public health funding