HB 898: Continuing Insulin Safety Net Act; enact

Georgia does not currently require insulin manufacturers to run patient assistance programs. This bill, called the Continuing Insulin Safety Net Act, would add a new article to state law requiring manufacturers with more than $2 million in annual Georgia insulin sales to provide a 90 day supply of insulin at no charge to eligible residents, renewable for up to a year and renewable annually after that. To qualify, a person must show Georgia residency, have family income at or below 400 percent of the federal poverty line, and not have certain other coverage such as Medicaid or generous private insurance. Manufacturers must also offer at least one alternative plan, like cost-sharing help or emergency supplies. Pharmacies can charge up to $50 per 90 day supply to cover dispensing costs. The Department of Community Health would oversee eligibility appeals, information sheets, satisfaction surveys, and an annual public report. Manufacturers that fail to comply face penalties starting at $200,000 per month. Individuals who commit fraud to get insulin benefits could face misdemeanor or felony charges. The law would take effect July 1, 2025.

• Requires insulin manufacturers with over $2 million in Georgia sales to create a patient assistance program giving eligible residents a free 90 day insulin supply, renewable for up to one year.
• Sets income and coverage eligibility rules, including a cap of 400 percent of the federal poverty guidelines and exclusions for people with Medicaid or generous private drug coverage.
• Allows pharmacies to charge eligible individuals a copayment of up to $50 per 90 day supply to cover processing and dispensing costs.
• Creates an appeals process through the Department of Community Health for individuals denied eligibility, decided by a three-member panel within ten business days.
• Sets administrative penalties on noncompliant manufacturers starting at $200,000 per month and rising to $600,000 per month after a year of continued noncompliance.
• Requires annual reporting from manufacturers and pharmacies to the Department of Community Health, and an annual report from the department to the General Assembly starting August 15, 2027.

Insulin manufacturers doing significant business in Georgia, pharmacies that dispense insulin, and Georgia residents who need insulin and meet the income and coverage requirements. The Department of Community Health would administer eligibility appeals, information materials, and reporting under the new law.

Eligible Georgians who currently struggle to afford insulin could get a 90 day supply for free or for a small pharmacy fee, renewable for up to a year. Manufacturers would face new administrative duties and steep monthly penalties for not complying, while pharmacies gain a defined process and limited fee for participating.

• Section 49-4-201 defines key terms, exempting insulin priced at $8.00 or less per milliliter from the law's requirements.
• Section 49-4-202 requires each qualifying manufacturer to establish a patient assistance program plus at least one alternative plan such as cost-sharing or emergency supply assistance.
• Section 49-4-203 sets eligibility rules, including residency, income at or below 400 percent of the federal poverty guidelines, and exclusions for people with Medicaid, VA benefits, or generous insurance coverage.
• Section 49-4-204 requires pharmacies to dispense the free 90 day insulin supply to eligible individuals and caps pharmacy copayments at $50 per 90 day supply.
• Section 49-4-205 creates a department review panel for individuals who disagree with a manufacturer's eligibility denial, requiring a decision within ten business days.
• Section 49-4-209 sets penalties: a misdemeanor or felony for fraudulently obtaining insulin benefits, and manufacturer penalties starting at $200,000 per month for noncompliance, rising to $600,000 per month after a year.
• Section 49-4-210 requires manufacturers and pharmacies to report annual data to the department starting July 1, 2026, and requires 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
• prescription drug costs
• public assistance programs
• healthcare access
• pharmacy regulation