Georgia CommonsHouse · Introduced · 2025-2026 Regular Session
HB 326: State Health Benefit Plan Nonopioid Coverage Parity Act; enact
Last action February 24, 2026 · House Committee Favorably Reported By Substitute
A Georgia House bill would require the state health benefit plan, which covers state employees and teachers, to cover approved nonopioid pain medications on the same terms as opioid pain medications, starting January 1, 2027.
The summaries below were written by an AI model (claude-sonnet-5) from the text of the bill and are not part of it. Quote the text, not the summary. The stored text is the Comm Sub version, the latest the General Assembly's website lists.
In plain language
Georgia's state health benefit plan currently can cover opioid pain medications more favorably than nonopioid alternatives, through higher copays, deductibles, or extra approval hurdles for the nonopioid option. This bill adds a new section to Georgia law (O.C.G.A. § 45-18-4.3) requiring the plan to cover 'qualifying nonopioid pain management drugs,' meaning FDA-approved nonopioid drugs for acute or postoperative pain that are on the Department of Community Health's approved list, under the same deductibles, coinsurance, copayments, exclusions, and other limits that apply to similar opioid drugs. The plan could still offer better coverage for nonopioid drugs than opioid drugs, just not worse. It could not require patients to try an opioid first (a practice called step therapy) before getting a covered nonopioid drug, and it could not require prior authorization for the nonopioid drug unless it requires the same for the opioid version. The law states legislative findings about the costs of the opioid epidemic and would take effect January 1, 2027.
What the bill does
- Adds a new Georgia law (O.C.G.A. § 45-18-4.3) requiring the state health benefit plan to cover qualifying nonopioid pain drugs on par with opioid pain drugs.
- Bars the plan from requiring patients try an opioid first (step therapy) before covering an approved nonopioid pain drug.
- Bars the plan from requiring prior authorization for nonopioid pain drugs unless it requires the same for comparable opioid drugs.
- Allows the plan to offer even better coverage for nonopioid drugs than for opioids, but not worse.
- Sets an effective date of January 1, 2027 for the new coverage requirements.
Who it affects
State employees, teachers, and other members enrolled in Georgia's state health benefit plan; the Department of Community Health, which selects qualifying drugs for its formulary; pharmacies and physicians who prescribe or dispense pain medications; and the plan administrators who set coverage rules.
Why it matters
Patients on the state health benefit plan facing acute or postoperative pain could get nonopioid medications without paying more out of pocket or clearing extra approval hurdles compared to opioids, potentially giving doctors and patients more freedom to choose nonopioid options first.
Key provisions
- Section 1 gives the bill its short title, the 'State Health Benefit Plan Nonopioid Coverage Parity Act.'
- Section 2 states legislative findings that the opioid epidemic has cost Georgia money and that nonopioid coverage parity could reduce those costs.
- Section 3 adds O.C.G.A. § 45-18-4.3, defining 'qualifying nonopioid pain management drugs' as FDA-approved, non-opioid-receptor, non-Schedule I or II drugs chosen by the Department of Community Health for its formulary.
- Section 3(b) requires the same deductibles, coinsurance, copayments, exclusions, and utilization review for qualifying nonopioid drugs as for comparable opioid drugs.
- Section 3(d) bans step therapy requiring opioid use before nonopioid coverage and limits prior authorization requirements to match those for opioids.
- Section 3(e) clarifies the law does not restrict a healthcare provider's ability to prescribe medically appropriate treatment.
- Section 4 sets the effective date as January 1, 2027.
From the bill
“The state health benefit plan shall cover qualifying nonopioid pain management drugs and such drugs shall be subject to the same annual deductible, coinsurance, copayment, exclusions, reductions, or other limitations as to coverage, or utilization review applicable to similar covered opioid pain management drugs.”
“nor require prior authorization for qualifying nonopioid pain management drugs unless similar prior authorization is required for opioid pain management drugs.”
Discussed in meetings (4)
The House and Senate meetings that took this bill up, from their machine transcripts. Each account was written by Georgia Commons with AI and is not part of the record; the video is what was said.
House Health Committee, February 2, 2026
From 0:32:00 · Watch on the General Assembly's Vimeo channel
Summary by Georgia Commons: The sponsor said HB 326 would require State Health Benefit Plan coverage for qualifying nonopioid pain medicines on terms no less favorable than covered opioids. The sponsor said insurance restrictions can steer prescribing toward opioids, that over 180,000 Georgians have opioid use disorder, and that Georgia's annual burden from that disorder and fatal overdoses approaches $21 billion. The proposal would not cover Medicaid or nonmedication treatments. One member raised barriers facing chronic-pain patients. The sponsor said the bill would not restrict appropriate opioid treatment. Another asked about long-acting local anesthetics after surgery; the sponsor said improving access to those medicines was a goal. A third asked whether cheaper alternatives could retain favorable coverage; the sponsor said the language set a minimum, not a ceiling. A retired orthopedic surgeon representing the Medical Association of Georgia described insurance and hospital purchasing restrictions. An anesthesiology witness supported alternatives to reduce opioid use. A Georgia Dental Association witness supported more options after extractions. Witnesses for the Georgia Council for Recovery and Nick's New Beginnings supported the bill, describing recovery concerns and a family overdose loss. The chair held the bill without a vote while Department of Community Health wording and implementation discussions continued. The sponsor requested help obtaining a fiscal note.
House Health Committee, February 23, 2026
From 0:47:41 · Watch on the General Assembly's Vimeo channel
Summary by Georgia Commons: The sponsor said HB 326 would require State Health Benefit Plan coverage of nonopioid pain medications on terms no less favorable than coverage of opioids. The sponsor said the goal was to prevent insurance coverage from steering prescriptions toward opioids and increasing risks of dependence and addiction. The sponsor cited a study committee recommendation and support offered at an earlier hearing. Asked whether patients could receive less effective medication, the sponsor said the bill would not dictate treatment or prevent prescribing opioids when appropriate. A member noticed the effective date had already passed. The committee approved an amendment changing the effective-date year from 2026 to 2027, then approved the amended bill by voice vote.
House Rules Committee, February 25, 2026
From 0:42:14 · Watch on the General Assembly's Vimeo channel
Summary by Georgia Commons: The sponsor said HB 326 would require the State Health Benefit Plan to cover non-opioid pain medicines on terms no less favorable than opioid medicines. The sponsor said unequal coverage can steer prescribing toward opioids and that even three to five days of opioid use can increase addiction and dependence risks. One member asked whether the bill imposed a mandate, which the sponsor confirmed. Another requested an example. The sponsor described a long-acting local anesthetic used in joint replacement surgery, saying it can reduce or eliminate opioid use but may leave patients or facilities paying several hundred dollars when coverage is inadequate. No scheduling decision was shown.
Status timeline
- House Committee Favorably Reported By Substitute (House)
- House Second Readers (House)
- House First Readers (House)
- House Hopper (House)
Sponsors
- Michelle Au (D, HD-50)
- Ron Stephens (R, HD-164)
- Sharon Cooper (R, HD-45)
- Mary Margaret Oliver (D, HD-84)
- Lee Hawkins (R, HD-27)
Topics
- state health benefit plan
- opioid epidemic
- prescription drug coverage
- health insurance for state employees