Senate · Introduced · 2025-2026 Regular Session

SB360: SB360 Public Assistance; public option buy-in program to provide healthcare coverage to individuals not eligible for Medicaid coverage; provide

Last action March 27, 2025 · Senate Read and Referred

A Georgia Senate bill would create a state-run 'public option' health insurance program, letting people who cannot get Medicaid or exchange coverage buy a plan at the state's per-person Medicaid cost.

In plain language

Some Georgians do not qualify for Medicaid and cannot get coverage through the health insurance exchange, or could be left without financial help if federal subsidies under the Affordable Care Act are not renewed by Congress. This bill would direct the Department of Community Health to create a new Public Option Buy-In Program to cover those people. The program would have to match the benefits and coverage levels that Medicaid's care management organizations already provide, and it would be offered at a cost equal to what the state currently pays per person for Medicaid coverage. Whenever the department seeks bids from care management organizations for Medicaid contracts, it would have to require those bidders to also bid on running the new buy-in program, and would favor bidders whose provider networks overlap with Medicaid's. The department would also seek any federal approvals needed and could write rules to carry out the program.

What the bill does

Creates a new Public Option Buy-In Program inside the Department of Community Health to cover people who cannot get Medicaid or exchange coverage.
Requires the program to match Medicaid's benefits and coverage standards through the same care management organizations.
Sets the buy-in cost at the same per-person amount the state currently pays for Medicaid coverage.
Requires any company bidding on Medicaid contracts to also bid on providing the buy-in program's services.
Directs the department to prioritize bidders whose provider networks overlap with Medicaid's when picking who runs the program.
Directs the department to seek any federal Medicaid waivers or state plan changes needed to start the program.

Who it affects

Georgians who do not qualify for Medicaid and cannot get coverage through the health insurance exchange, including those who could lose subsidies if Congress does not extend Affordable Care Act tax credits. It also affects the Department of Community Health and the care management organizations that bid on Medicaid contracts.

Why it matters

People currently stuck without Medicaid or exchange options, including those at risk of losing federal subsidies, would gain a new way to buy coverage priced at the state's Medicaid cost. Care management organizations would face new bidding requirements tied to their existing Medicaid contracts.

Key provisions

Section 1 adds a new Article 10 to Chapter 4 of Title 49 of the O.C.G.A. establishing the Public Option Buy-In Program.
O.C.G.A. § 49-4-200 defines 'eligible person' as someone ineligible for Medicaid or exchange coverage, or ineligible for ACA subsidies if Congress does not fund them.
O.C.G.A. § 49-4-201 requires the program to match Medicaid's benefit standards and sets its cost at the state's per capita Medicaid payment rate.
O.C.G.A. § 49-4-202 requires Medicaid bidders to also bid on the buy-in program and gives priority to bidders with overlapping provider networks.
O.C.G.A. § 49-4-203 directs the department to seek federal Medicaid state plan amendments or waivers needed to implement the program.
O.C.G.A. § 49-4-204 authorizes the department to write rules and regulations to carry out the program.
Section 2 repeals conflicting laws.

Status timeline

2025-03-27Senate Read and Referred (Senate)
2025-03-25Senate Hopper (Senate)

Topics

healthcare coverage
Medicaid
public option
health insurance
Affordable Care Act