HB898: HB898 Continuing Insulin Safety Net Act; enact

Georgia currently has no state law requiring insulin manufacturers to offer a formal assistance program to residents who struggle to afford insulin. This bill, called the Continuing Insulin Safety Net Act, would change that by adding a new article to Georgia's public assistance code (O.C.G.A. Title 49, Chapter 4). Manufacturers with more than $2 million in annual insulin sales in Georgia would have to run a patient assistance program giving eligible residents a 90 day supply of insulin at no charge, plus at least one backup option such as a cost-sharing plan or emergency supply. Residents qualify based on income, insurance status, and residency, and apply directly to the manufacturer. Pharmacies distribute the insulin and may charge up to $50 per 90 day supply to cover their costs. The bill sets penalties for fraud and for manufacturers that do not comply, and requires yearly reporting to the Department of Community Health and the General Assembly. It would take effect July 1, 2025.

• Requires insulin manufacturers with more than $2 million in annual Georgia insulin sales to run a patient assistance program offering a free 90 day supply of insulin to eligible residents.
• Sets eligibility rules based on Georgia residency, family income at or below 400 percent of the federal poverty level, and lack of other adequate insurance coverage.
• Lets pharmacies charge eligible individuals a co-payment of up to $50 per 90 day supply to cover dispensing costs.
• Creates an appeals process through the Department of Community Health for people denied eligibility by a manufacturer.
• Imposes escalating administrative penalties on noncompliant manufacturers, starting at $200,000 per month and rising to $600,000 per month.
• Makes it a misdemeanor, or a felony if the value exceeds $1,500, to fraudulently obtain insulin assistance under the program.

Insulin manufacturers with more than $2 million in annual Georgia sales, Georgia residents who need insulin and meet income and insurance eligibility rules, pharmacies that dispense the insulin, and the Department of Community Health, which oversees eligibility appeals and reporting.

Eligible Georgians who currently pay high out-of-pocket costs for insulin could receive a 90 day supply at no charge from participating manufacturers, with a pharmacy co-payment capped at $50. Manufacturers face large fines for failing to comply, and pharmacies and manufacturers must report usage data each year.

• Section 49-4-201 defines key terms, exempting insulin priced at $8.00 or less per milliliter and manufacturers with $2 million or less in Georgia insulin sales.
• Section 49-4-202 requires each manufacturer to run a patient assistance program plus at least one alternative plan, and to publish program information and a hotline.
• Section 49-4-203 sets eligibility criteria, including income at or below 400 percent of the federal poverty level and exclusions for people with other adequate insurance.
• Section 49-4-204 requires pharmacies to dispense insulin at no charge to the individual except for a co-payment capped at $50 per 90 day supply.
• Section 49-4-205 creates a three member department review panel to hear appeals of eligibility denials, with a final decision within ten business days.
• Section 49-4-209 sets penalties: fraud is a misdemeanor (a felony above $1,500 in value), and noncompliant manufacturers face monthly fines from $200,000 up to $600,000.
• Section 49-4-210 requires manufacturers and pharmacies to report usage data annually starting July 1, 2026, and the department to report to the General Assembly starting August 15, 2027.
• Section 2 sets the effective date as July 1, 2025.

1. 2026-01-12House Second Readers (House)
2. 2025-04-04House First Readers (House)
3. 2025-04-02House Hopper (House)

• Michelle Au (D, HD-050)Primary sponsor
• Carolyn Hugley (D, HD-141)
• Samuel Park (D, HD-107)
• Tanya Miller (D, HD-062)
• Spencer Frye (D, HD-122)
• Saira Draper (D, HD-090)

• insulin affordability
• diabetes care
• prescription drug assistance
• public health policy
• pharmacy regulation