HB 1111: Sales and use tax; new special purpose local option sales tax dedicated to certain healthcare purposes; provide

Georgia counties already use special purpose local option sales taxes (SPLOSTs) to fund capital projects, but there is no dedicated version for hospitals. This bill creates a new type of county sales tax specifically for what it calls 'healthcare enhancement purposes,' including hospital construction, equipment, operating costs, and covering bad debt or indigent care costs. Each county is defined as its own special tax district, and county governments would need voter approval in a referendum before imposing the tax. The tax rate would be up to 1 percent and could last up to five years, or six years if certain conditions apply, with a required public vote to renew it. Counties could enter agreements with hospital authorities spelling out how the money is divided and spent, and money not covered by an agreement would go straight to the county government for hospital-related use. Counties may also pledge the tax revenue to back general obligation debt for hospital projects, subject to voter approval on the same ballot.

• Creates a new county sales tax of up to 1 percent, called the county hospital special purpose local option sales tax, dedicated to hospital funding.
• Requires county voters to approve the tax through a referendum before it can be imposed, following a specific ballot format set out in the bill.
• Allows counties to enter agreements with hospital authorities specifying how tax proceeds are divided and which hospital projects or costs are covered.
• Lets counties issue general obligation debt backed by the tax revenue for hospital projects, if approved by voters on the same ballot.
• Sets the tax term at up to five years, extendable to six years under certain conditions, and requires annual public reporting on how the money was spent.
• Adjusts the overall cap on combined local sales taxes in a county (O.C.G.A. § 48-8-6) to include this new hospital tax within the existing 1 percent aggregate ceiling.

County governments and county election officials who would run the referendums, hospital authorities and nonprofit hospitals that could receive funding, and residents and shoppers in any county that adopts the tax, who would pay the added sales tax on most purchases including some motor fuel.

If counties adopt this tax after a successful vote, hospitals could gain a dedicated funding stream for buildings, equipment, and covering unpaid patient bills, while shoppers in those counties would pay a bit more sales tax. Whether it happens depends entirely on local votes county by county.

• Section 1 updates the cap on combined local sales taxes (O.C.G.A. § 48-8-6) so the new hospital tax counts toward the existing 1 percent aggregate limit.
• Section 2 creates new Code Sections 48-8-280 through 48-8-291, establishing 159 special tax districts matching Georgia's counties for this hospital tax.
• New Code Section 48-8-281 sets the tax rate at up to 1 percent, with a special cap on motor fuel taxation at $3.00 per gallon retail price.
• New Code Section 48-8-282 requires a county referendum, sets a 5-year default term (6 years under certain conditions), and lays out required ballot language.
• New Code Section 48-8-283 sets rules for when the tax starts and stops, including automatic termination once revenue targets are met.
• New Code Section 48-8-286 governs how proceeds are split between counties and hospital authorities, requiring detailed intergovernmental agreements when used.
• New Code Section 48-8-290 requires annual public reporting on spending, costs, and completion status for each funded healthcare project.
• New Code Section 48-8-291 allows counties to redirect tax proceeds if a funded healthcare purpose becomes 'infeasible,' subject to a follow-up voter referendum.

1. 2026-02-03House Second Readers (House)
2. 2026-02-02House First Readers (House)
3. 2026-01-29House Hopper (House)

• Rob Leverett (R, HD-123)Primary sponsor
• Noel Williams (R, HD-148)
• Trey Rhodes (R, HD-124)
• Stan Gunter (R, HD-008)

• sales tax
• hospital funding
• healthcare
• SPLOST
• county government