Georgia CommonsHouse · Engrossed · 2025-2026 Regular Session
HB 951: Insurance; require health benefit policy coverage for medically necessary orthotic and prosthetic devices and their materials and components
Last action March 9, 2026 · Senate Read and Referred
House Bill 951 would require Georgia's state employee health plan, teacher health plan, and Board of Regents health plans to cover medically necessary orthotic and prosthetic devices 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 Introduced version, the latest the General Assembly's website lists.
In plain language
Georgia law already requires many health insurance policies to cover medically necessary orthotic devices (braces and other devices that support or correct body parts) and prosthetic devices (artificial limbs), along with their materials and components, under O.C.G.A. § 33-24-59.35. But that law currently exempts health plans the state itself runs for state employees, and it also exempts Medicaid contracts between insurers and the Department of Community Health. House Bill 951 changes the definition of 'health benefit policy' in that law so it now includes plans the state provides for state employees, public school teachers and employees, and members, employees, retirees, and dependents covered through the Board of Regents (which oversees Georgia's public colleges and universities). The bill also removes the separate exclusion for Medicaid managed care contracts. These changes take effect January 1, 2027. Self-funded employer health plans governed by the federal ERISA law remain excluded, since state law cannot regulate those plans.
What the bill does
- Removes the current exclusion that lets the State Health Benefit Plan skip covering orthotic and prosthetic devices, effective January 1, 2027.
- Adds public school teachers and employees, and Board of Regents members, employees, retirees, and dependents, to the group whose coverage must include these devices.
- Deletes the separate exclusion for Medicaid managed care contracts between insurers and the Department of Community Health, removing that carve-out from the definition.
- Keeps the existing exclusion for self-funded employer health plans regulated under the federal ERISA law, since the state cannot mandate coverage for those plans.
- Sets the effective date of the overall Act as the date the Governor signs it, while the coverage change itself only applies starting January 1, 2027.
Who it affects
State employees, public school teachers and staff, and Board of Regents employees, retirees, and dependents who get health coverage through state-run plans; people who need orthotic or prosthetic devices; the Department of Community Health, which administers Medicaid contracts; and insurers that issue these health benefit policies in Georgia.
Why it matters
State employees, teachers, and university system staff currently are not guaranteed coverage for medically necessary braces or artificial limbs under this specific mandate. Once this takes effect in 2027, their state-run health plans would have to cover these devices, similar to many private insurance policies already do.
Key provisions
- Section 1 amends paragraph (3) of subsection (a) of O.C.G.A. § 33-24-59.35 to redefine 'health benefit policy'.
- The revised definition states that, on or after January 1, 2027, the term includes plans the state provides for state employees, public school teachers and employees, and Board of Regents members, employees, retirees, and dependents.
- The amendment deletes prior language that excluded Medicaid contracts between insurers and the Department of Community Health from the definition.
- The exclusion for self-funded, employer-sponsored plans covered by the federal Employee Retirement Income Security Act of 1974 (ERISA) remains unchanged.
- Section 2 makes the Act effective upon the Governor's signature or upon it becoming law without signature.
- Section 3 repeals any conflicting laws.
Discussed in meetings (9)
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, January 28, 2026
From 0:26:37 · Watch on the General Assembly's Vimeo channel
Summary by Georgia Commons: The sponsor said the bill would extend expanded prosthetic and orthotic coverage to the State Health Benefit Plan, matching coverage enacted for commercial insurance plans the previous year. The sponsor said additional devices would help people shower, exercise and perform everyday activities safely. Asked how state coverage differed, the sponsor said state-plan members remained excluded from the expanded benefits. Members also asked how often devices could be replaced. The sponsor generally described coverage of up to three devices every three years, based on physician recommendations. A prosthetics-clinic co-owner said physiological changes could justify replacement sooner, typically every six months under Medicare guidelines, with physician approval. The witness said the earlier law changed what counted as medically necessary and described patients previously denied showering or activity-specific devices. A special education teacher said the state plan covered only one prosthetic leg every three years for all activities. The teacher said a community fundraiser paid for a running blade and argued that shower and activity-specific devices support safety, health and continued work. The chair held the bill for an updated cost estimate, saying the committee could reconsider it once that estimate arrived. No vote was taken.
House Health Committee, February 18, 2026
From 0:18:44 · Watch on the General Assembly's Vimeo channel
Summary by Georgia Commons: The sponsor said HB 951 would extend orthotic and prosthetic coverage to the State Health Benefit Plan and Board of Regents plans, matching commercial coverage approved previously. The sponsor said a revised cost estimate was $1.4 million, compared with an earlier $55 million estimate. The chair said the bill had been held while awaiting that estimate. A member questioned whether deleting language excluding Medicaid care management organizations would also bring Medicaid into the bill. A Department of Community Health representative said the cost estimate covered only the State Health Benefit Plan and that the department interpreted the bill that way, but would need to verify the Medicaid question. The representative added that bills in this insurance section typically name Medicaid explicitly when intended to include it. The committee gave the bill a do-pass recommendation by voice vote.
House Rules Committee, February 25, 2026
From 1:14:55 · Watch on the General Assembly's Vimeo channel
Summary by Georgia Commons: The sponsor said HB 951 would extend orthotic and prosthetic coverage requirements to the state health plan and the Board of Regents, following earlier requirements for commercial health plans. The sponsor said this would provide consistent coverage and help people obtain devices for daily activities such as showering and exercise. No questions or scheduling decision followed.
House floor session, March 6, 2026 (legislative day 28, PM, part 2)
From 1:19:59 · Watch on the General Assembly's Vimeo channel · Confirmed by the 2026 House Journal, p. 2157
Summary by Georgia Commons: The sponsor said HB 951 would extend coverage for medically necessary prosthetic and orthotic devices to the state health benefit plan and Board of Regents system, matching protections previously adopted for commercial insurance. The sponsor said proper devices support mobility and can prevent more expensive medical complications. Asked what devices would qualify, the sponsor said coverage would depend on a physician's recommendation and could allow up to three devices for different needs, such as showering and exercise. Another member asked whether the bill would help an incarcerated person seeking prosthetics. The sponsor reiterated that this bill concerns state and university health plans. A supporting member praised an advocate who had testified in committee. The House passed the bill 163-2.
House Rules Committee, March 6, 2026
From 0:46:18 · Watch on the General Assembly's Vimeo channel · Confirmed by the 2026 House Journal, p. 2140
Summary by Georgia Commons: The committee placed HB 951 on the day’s supplemental floor calendar under a structured rule following a motion and second, with no opposition stated. No substantive discussion occurred.
- Read aloud: House floor session, January 14, 2026 (legislative day 3), 0:47:54
- Read aloud: House floor session, January 15, 2026 (legislative day 4), 0:46:57
- Read aloud: House floor session, February 19, 2026 (legislative day 21), 1:06:14
- Read aloud: Senate floor session, March 9, 2026 (legislative day 29), 0:26:37
Status timeline
- Senate Read and Referred (Senate)
- House Passed/Adopted (House)
- House Third Readers (House)
- House Committee Favorably Reported (House)
- House Second Readers (House)
- House First Readers (House)
- House Hopper (House)
Sponsors
- David Clark (R, HD-100)
- Karen Mathiak (R, HD-82)
- Deborah Silcox (R, HD-53)
- Trey Kelley (R, HD-16)
- Kim Schofield (D, HD-63)
- Steven Sainz (R, HD-180)
Votes
- House voteMarch 6, 2026
163 yea, 2 nay (4 not voting, 8 excused)
Topics
- health insurance coverage
- prosthetic devices
- state employee benefits
- teacher health benefits
- Medicaid