Georgia CommonsHB 258: PeachCare for Adults Act; enact
Introduced version, the latest LegiScan holds · Last action February 6, 2025 · Introduced
The text as LegiScan holds it, read from the PDF the legislature publishes with its margin line numbers, running heads, and page footers removed. Line breaks are joined into paragraphs here; no word is changed.
Underlined words are what the bill adds to current law and struck-through words are what it removes, as the printed bill shows them.
House Bill 258
By: Representatives Buckner of the 137th, Holcomb of the 101st, Hugley of the 141st, Mitchell of the 88th, Bennett of the 94th, 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 public assistance, so as to establish the PeachCare for Adults Program; to provide for a short title; to provide for definitions; to provide for submission of federal waiver requests; to provide for requirements; to provide for providers; to provide for administration of the program; to provide for rules and regulations; to provide for related matters; to repeal conflicting laws; and for other purposes.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:
SECTION 1.
Chapter 4 of Title 49 of the Official Code of Georgia Annotated, relating to public assistance, is amended by adding a new article to read as follows:
"ARTICLE 10
49-4-200.
This article shall be known and may be cited as the 'PeachCare for Adults Act.'
49-4-201.
As used in this article, the term:
(1) 'Board' means the Board of Community Health.
(2) 'Department' means the Department of Community Health.
(3) 'Eligible person' means an individual between and including the ages of 18 and 64 years who has income less than or equal to 133 percent of the federal poverty level and who is not enrolled in Medicaid.
(4) 'Enrolled person' means an eligible person who is enrolled in the PeachCare for Adults Program.
(5) 'Medicaid' means the program of medical assistance conducted pursuant to Article 7 of this chapter, the 'Georgia Medical Assistance Act of 1977.'
(6) 'PeachCare for Adults Program' or 'program' means the program for health coverage established pursuant to this article.
49-4-202.
(a) In order to implement the PeachCare for Adults Program pursuant to this article, the board shall submit any waiver request to the Centers for Medicare and Medicaid Services of the United States Department of Health and Human Services pursuant to Section 1115 of the federal Social Security Act necessary to add coverage for adults between and including the ages of 18 and 64 years with incomes less than or equal to 133 percent of the federal poverty level.
(b) The board shall take all necessary steps to secure the enhanced federal match available under the applicable provisions of Section 2001 of the federal Patient Protection and Affordable Care Act (P.L. 111-148).
(c) The board shall submit all necessary waiver requests pursuant to this Code section no later than January 1, 2026.
49-4-203.
(a) The department shall establish the PeachCare for Adults Program. Such program shall be implemented no later than January 1, 2027.
(b) The program shall include, at a minimum:
(1) The same coverage provided to recipients of Medicaid, including, but not limited to, the essential health benefits as provided in 42 U.S.C. Section 18022;
(2) Any healthcare benefits specified in the federal Patient Protection and Affordable Care Act (P.L. 111-148) with respect to health insurance coverage or health insurance products;
(3) Coverage for all vaccinations recommended for children and for adults by the Advisory Committee on Immunization Practices of the federal Centers for Disease Control and Prevention; and
(4) Coverage for the treatment of mental health and substance use disorders at least as extensive as that provided for the treatment of physical illnesses.
(c) Only eligible persons may enroll in the program.
(d) The program shall include an affordability scale for premium based on income:
(1) For an enrolled person with an income greater than 100 percent of the federal poverty level, the premium shall be the amount of premium for an enrolled person with an equivalent income to enroll in the second-lowest cost silver-level plan offered in the state's health insurance marketplace or 2 percent of an enrolled person's gross income, whichever is lesser; and
(2) An enrolled person with an income less than or equal to 100 percent of the federal poverty level shall not be charged a premium.
(e) Enrollment in the program shall not be contingent on work requirements.
(f) The department shall publish in print or electronically an annual report, a copy of which shall be provided to the Governor, setting forth the number of enrolled persons in the program, the health services provided, the amount of money paid to providers, and other pertinent information with respect to the administration of the program. The department shall not be required to distribute copies of the annual report to the members of the General Assembly but shall notify such members of the availability of the report in the manner which it deems to be most effective and efficient.
49-4-204.
(a) Any healthcare provider that is a Medicaid provider shall be deemed to be a provider in the program.
(b) Healthcare provider reimbursement rates shall be based on the Medicaid fee schedule. Contingent upon available funds, the department may increase reimbursement rates for healthcare providers.
(c) The department, through the Department of Administrative Services or any other appropriate entity, may contract for any or all of the following: the collection of premiums, processing of applications, verification of eligibility, outreach, data services, and evaluation, provided that such contracting achieves administrative or service cost efficiency. The department, and other state agencies, as appropriate, shall provide necessary information to any entity which has contracted with the department for services related to the administration of the program upon request.
(d) All state agencies shall cooperate with the department and its designated agents by providing requested information to assist in the administration of the program.
(e) As necessary to enforce the provisions of this article, the department or its duly authorized agents may submit to the state revenue commissioner the names of applicants for healthcare benefits or payments provided under this article, as well as the relevant income threshold specified therein. If the department elects to contract with the state revenue commissioner for such purposes, the state revenue commissioner or his or her agents or employees shall notify the department of whether or not each submitted applicant's income exceeds the relevant income threshold provided. The department shall pay the state revenue commissioner for all costs incurred by the Department of Revenue pursuant to this subsection. No information shall be provided by the Department of Revenue to the department without an executed cooperative agreement between such departments. Any tax information secured from the federal government by the Department of Revenue pursuant to express provisions of Section 6103 of the Internal Revenue Code shall not be disclosed by the Department of Revenue pursuant to this subsection. Any person receiving any tax information under the authority of this subsection is subject to the provisions of Code Section 48-7-60 and to all penalties provided under Code Section 48-7-61 for unlawful divulging of confidential tax information.
49-4-205.
The department shall be authorized to promulgate rules and regulations consistent with and necessary to carry out the provisions of this article."
SECTION 2.
All laws and parts of laws in conflict with this Act are repealed.