HB 1151: Social services; expansion of Medicaid; provide

Georgia currently has not expanded Medicaid under the Affordable Care Act to cover most low-income adults without children or disabilities. This bill would add a new section to Georgia's Medicaid law creating a 'Medicaid expansion program' for adults ages 19 to 64 with income at or below 138 percent of the federal poverty level, who are U.S. citizens or qualified immigrants, and who meet work or community engagement requirements set out in a 2025 federal tax law. The Department of Community Health would have to submit a waiver request to the federal Centers for Medicare and Medicaid Services by December 31, 2026, seeking approval to expand coverage through Medicaid managed care plans. If approved, the department would have to report annually to the General Assembly on enrollment numbers, costs, and recommendations for controlling those costs. The expansion is subject to state funding being appropriated, and the bill treats itself as the legislature's required notification and approval for related Medicaid provisions.

• Creates a new Medicaid expansion program in Georgia law for adults 19 to 64 with income at or below 138 percent of the federal poverty level.
• Requires eligible individuals to be U.S. citizens or qualified immigrants and to meet community engagement (work-related) requirements under a 2025 federal law.
• Directs the Department of Community Health to submit a federal waiver request by December 31, 2026 to implement the expansion through Medicaid managed care plans.
• Requires the department to report to the General Assembly once the expansion is operational and annually afterward on enrollment, costs, and cost-control recommendations.
• Makes the expansion subject to available state funding (appropriations) and any needed federal approvals.
• States that the Act itself counts as the legislature's required notification and approval under existing Medicaid oversight statutes.

Low-income adults ages 19 to 64 in Georgia who currently earn too much for existing Medicaid categories but too little for other coverage, the Department of Community Health, Medicaid managed care plan providers, and the General Assembly, which would receive annual reports on the program.

If implemented, this would extend Medicaid coverage to a large group of low-income Georgia adults who are not currently eligible, potentially changing access to health coverage for many residents, while adding new state reporting duties and depending on both state funding and federal approval to actually take effect.

• New Code Section 49-4-159.5(a) defines 'eligible individual' as an adult 19-64 earning up to 138 percent of the federal poverty level who is a citizen or qualified alien and meets federal community engagement (work) requirements.
• Subsection (b) makes the Medicaid expansion program part of the state Medicaid program, subject to appropriations and necessary approvals.
• Subsection (c) requires the Department of Community Health to submit a federal Section 1115 waiver request by December 31, 2026 for enrollment through Medicaid managed care plans.
• Subsection (d) requires immediate notification to the General Assembly once expansion becomes operational, plus annual reports by December 31 on enrollment, costs, projected costs, and cost-control recommendations.
• Subsection (e) authorizes the department to write rules and regulations to carry out the program.
• Section 2 states the Act serves as legislative notification and approval under existing Code Sections 49-4-142.1 and 49-4-142.2.

1. 2026-02-04House Second Readers (House)
2. 2026-02-03House First Readers (House)
3. 2026-02-02House Hopper (House)

• Samuel Park (D, HD-107)Primary sponsor
• Carolyn Hugley (D, HD-141)
• Tanya Miller (D, HD-062)
• Eric Gisler (D, HD-121)
• Tangie Herring (D, HD-145)
• Michelle Au (D, HD-050)

• Medicaid expansion
• health coverage
• low-income adults
• Department of Community Health
• Georgia Medicaid