SB192: SB192 "Georgia Health Insurance Affordability and Consumer Protection Act"; enact

Enhanced federal tax credits that lower Affordable Care Act health insurance premiums are set to expire December 31, 2025 unless Congress acts. This bill, called the Georgia Health Insurance Affordability and Consumer Protection Act, tells the Georgia Department of Insurance to build a backup state program in case that happens. The program would offer premium subsidies for people earning up to 400 percent of the federal poverty level, extra cost-sharing help for those under 250 percent, and a no-premium plan for people under 200 percent of the poverty level. The department must convene a stakeholder group, study funding sources, write rules, and report to the Governor and General Assembly on set deadlines in 2025. The program itself would only take effect January 1, 2026, and only if the federal tax credits actually expire, and the new law section would automatically repeal on December 31, 2030.

• Requires the Department of Insurance to design a health insurance affordability program by September 30, 2025, in case federal ACA premium tax credits expire.
• Sets three benefit tiers: premium subsidies up to 400 percent of the federal poverty level, added cost-sharing help below 250 percent, and a premium-free plan below 200 percent.
• Requires a stakeholder working group of consumer advocates, insurers, providers, and employers to be convened by July 1, 2025 to shape the program.
• Requires a fiscal impact analysis and funding plan, including possible charges on insurers offering plans on Georgia Access, submitted by September 1, 2025.
• Makes the program's start conditional: it only takes effect January 1, 2026, if Congress lets the enhanced federal tax credits expire on December 31, 2025.
• Automatically repeals this new Code section on December 31, 2030.

Low- and middle-income Georgians who buy coverage through Georgia Access, especially those under 400 percent of the federal poverty level, along with health insurers, healthcare providers, employers, the Department of Insurance, and the Office of Planning and Budget, which share duties under the bill.

If federal premium tax credits lapse, many Georgians could see sharp premium increases; this bill sets up a state backstop with subsidies and a premium-free option for lower earners, but only activates if Congress does not renew the federal credits and funding sources are still being worked out.

• Section 2 lays out legislative findings that expiring federal enhanced premium tax credits would raise costs, especially for people under 250 percent of the federal poverty level.
• Section 3 adds new O.C.G.A. § 33-24-59.34, defining terms like 'affordability program,' 'cost-sharing reductions,' and 'qualified health plan.'
• Subsection (b) requires the department to design premium subsidies, cost-sharing reductions, and a no-premium plan by September 30, 2025.
• Subsection (c) requires a stakeholder working group by July 1, 2025, and subsection (d) requires its plan submitted to the Governor and General Assembly by September 30, 2025.
• Subsection (f) requires a fiscal impact analysis and funding recommendations, including possible insurer charges, by September 1, 2025.
• Subsection (j) makes the whole program effective January 1, 2026 only if Congress allows the federal tax credits to expire on December 31, 2025.
• Subsection (k) repeals this Code section on December 31, 2030.
• Section 4 makes the Act effective immediately upon the Governor's signature or becoming law without signature.

1. 2025-02-19Senate Read and Referred (Senate)
2. 2025-02-18Senate Hopper (Senate)

• Jason Esteves (D, SD-035)Primary sponsor
• Sonya Halpern (D, SD-039)
• Harold Jones (D, SD-022)
• Kim Jackson (D, SD-041)
• Elena Parent (D, SD-044)
• Nan Orrock (D, SD-036)
• Tonya Anderson (D, SD-043)
• Sally Harrell (D, SD-040)
• RaShaun Kemp (D, SD-038)
• Gail Davenport (D, SD-017)
• Josh McLaurin (D, SD-014)
• Michael Rhett (D, SD-033)
• Nikki Merritt (D, SD-009)
• Kenya Wicks (D, SD-034)
• Randal Mangham (D, SD-055)
• Donzella James (D, SD-028)
• Sheikh Rahman (D, SD-005)
• Freddie Sims (D, SD-012)
• Nabilah Islam Parkes (D, SD-007)
• David Lucas (D, SD-026)
• Ed Harbison (D, SD-015)
• Emanuel Jones (D, SD-010)

• health insurance
• Affordable Care Act
• premium tax credits
• insurance affordability
• Georgia Access