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

25 LC 33 9819 Senate Bill 360 By: Senators Harrell of the 40th, Esteves of the 35th, McLaurin of the 14th, Jackson of the 41st, Parent of the 44th and others A BILL TO BE ENTITLED AN ACT To amend Chapter 4 of Title 49 of the Official Code of Georgia Annotated, relating to public1 assistance, so as to provide for a public option buy-in program to provide healthcare2 coverage to individuals not eligible for Medicaid coverage or e nrollment through a health3 exchange; to provide for definitions; to provide requirements for the program; to provide for4 any necessary state plan amendments or waivers; to provide for rules and regulations; to5 provide for related matters; to repeal conflicting laws; and for other purposes.6 BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:7 SECTION 1.8 Chapter 4 of Title 49 of the Official Code of Georgia Annotated, relating to public assistance,9 is amended by adding a new article to read as follows:10 "ARTICLE 1011 12 49-4-200.13 As used in this article, the term:14 (1) 'Department' means the Department of Community Health.15 S. B. 360 - 1 - 25 LC 33 9819 (2) 'Eligible person' means:16 (A) An individual who is not otherwise eligible to be a recipient under Medicaid or to17 obtain healthcare coverage through an exchange; or18 (B) An individual who is not otherwise eligible to be a recipi ent under Medicaid, if19 subsidies under the federal Patient Protection and Affordable C are Act and extended20 tax credits are not funded by Congress.21 (3) 'Exchange' means a state, federal, or partnership exchange or marketplace operating22 in Georgia pursuant to Section 1311 of the federal Patient Protection and Affordable Care23 Act.24 (4) 'Medicaid' means the program of medical assistance provide d through care25 management organizations pursuant to Article 7 of this chapter, the 'Georgia Medical26 Assistance Act of 1977.' Such term also includes the health co verage for children27 provided pursuant to Article 13 of Chapter 5 of this title, the 'PeachCare for Kids Act.'28 (5) 'Public Option Buy-In Program' or 'program' means the program established pursuant29 to this article to provide healthcare coverage to eligible persons.30 49-4-201.31 (a) The department shall establish and implement the Public Option Buy-In Program. The32 program shall meet at least the same standards and provide at least the same benefits and33 levels of coverage as provided by care management organizations under Medicaid.34 (b) The program shall be available to eligible persons who res ide in this state for a cost35 equal to the amount that the state pays per capita to care mana gement organizations for36 Medicaid.37 49-4-202.38 (a) Whenever the department enters into a competitive bidding process, including, without39 limitation, a request for proposals, to solicit and enter into contracts with care management40 S. B. 360 - 2 - 25 LC 33 9819 organizations to provide Medicaid services, it shall require any and all bidders to also bid41 on the provision of healthcare services for the Public Option Buy-In Program.42 (b) When selecting one or more care management organizations to administer the program,43 the department shall prioritize applicants whose proposals demo nstrate alignment of44 networks of providers between the program and Medicaid, where applicable.45 49-4-203.46 The department shall submit any Medicaid state plan amendment o r waiver requests47 necessary to implement the provisions of this article to the Un ited States Department of48 Health and Human Services.49 49-4-204.50 The department shall be authorized to promulgate rules and regulations consistent with and51 necessary to carry out the provisions of this article."52 SECTION 2.53 All laws and parts of laws in conflict with this Act are repealed.54 S. B. 360 - 3 -