HB658: HB658 Insurance; certain consumer protections contingent upon repeal of Patient Protection and Affordable Care Act; provide

Right now, protections such as required coverage of preexisting conditions, free preventive care, coverage for dependents up to age 26, and bans on annual or lifetime coverage limits come from the federal Patient Protection and Affordable Care Act (42 U.S.C. Section 18001 et seq.). This bill adds a new section to Georgia's insurance code (O.C.G.A. Chapter 24 of Title 33) that would put similar protections into state law, but the new rules would only take effect if the federal Affordable Care Act is repealed. The bill defines terms like essential health benefits, cost-sharing amounts, and preventive services, largely by reference to the federal law as it existed before any repeal. It would bar health plans from denying coverage or charging more for preexisting conditions, require preventive services at no extra cost, require coverage of dependents to age 26 with a 30-day special enrollment window after that, ban annual or lifetime coverage limits, and limit when insurers can cancel or refuse to renew a policy. Section 2 makes the whole act effective only upon repeal of the federal law.

• Creates a new Georgia insurance code section (O.C.G.A. § 33-24-59.34) that mirrors several Affordable Care Act consumer protections, but only takes effect if that federal law is repealed.
• Bars health plans from denying coverage or charging higher premiums because of a preexisting medical condition.
• Requires health plans to cover preventive services, such as screening tests and preventive medicines, with no cost-sharing charged to the insured.
• Prohibits health plans from imposing annual or lifetime dollar limits on essential health benefits like hospitalization, maternity care, and prescription drugs.
• Requires coverage of dependent children up to age 26 and creates a 30-day special enrollment period once a dependent turns 26.
• Limits insurers to canceling or not renewing a policy only for nonpayment of premium or false information on the application.

Georgians who buy individual or group health insurance, including people with preexisting conditions, young adults up to age 26 covered as dependents, and anyone relying on preventive care; also health insurers and HMOs operating in Georgia, and the state Insurance Commissioner, who would write implementing regulations.

If the Affordable Care Act were ever repealed, Georgians could otherwise lose protections like guaranteed coverage for preexisting conditions, free preventive care, and coverage for dependents up to 26. This bill would keep those specific protections in place under state law even without the federal law.

• Section 1 adds O.C.G.A. § 33-24-59.34, defining terms such as 'cost-sharing amount,' 'essential health benefits,' 'health benefit plan,' and 'preventive services,' largely by reference to the pre-repeal federal Affordable Care Act.
• Subsection (b)(1) bars insurers from limiting benefits, denying coverage, or charging higher premiums based on a preexisting condition.
• Subsection (b)(2) requires coverage of preventive services with no cost-sharing amount charged to the insured.
• Subsection (b)(3) prohibits annual or lifetime dollar limits on essential health benefits.
• Subsection (b)(4) requires coverage of dependents up to age 26 and a 30-day special enrollment period after a dependent turns 26.
• Subsection (b)(5) restricts insurers from canceling or nonrenewing a plan except for nonpayment of premium or false application information.
• Subsection (c) and Section 2 state that the new rules and the Act as a whole apply and take effect only upon repeal of the federal Patient Protection and Affordable Care Act.

1. 2025-03-03House Second Readers (House)
2. 2025-02-28House First Readers (House)
3. 2025-02-27House Hopper (House)

• Scott Holcomb (D, HD-101)Primary sponsor
• Carolyn Hugley (D, HD-141)
• Tanya Miller (D, HD-062)
• Michelle Au (D, HD-050)
• Saira Draper (D, HD-090)
• Esther Panitch (D, HD-051)

• health insurance
• Affordable Care Act
• preexisting conditions
• preventive care
• insurance regulation