SB 192: "Georgia Health Insurance Affordability and Consumer Protection Act"; enact

This bill responds to the possible expiration of enhanced federal premium tax credits under the Affordable Care Act, which are set to lapse December 31, 2025 unless Congress acts. It creates a new section of Georgia insurance law (O.C.G.A. § 33-24-59.34) directing the Department of Insurance to design a state affordability program offering premium subsidies, cost-sharing reductions, and a no-premium plan for lower-income residents who buy coverage through Georgia Access, the state's ACA marketplace. The department would have to convene a stakeholder working group, complete a fiscal impact analysis, write rules, and report plans to the Governor and General Assembly on a series of 2025 deadlines. The program would only take effect January 1, 2026 if Congress actually lets the federal tax credits expire; otherwise it stays dormant. The whole Code section automatically repeals on December 31, 2030. The bill would take effect immediately once signed.

• Creates a new Georgia law requiring the Department of Insurance to design a state health insurance affordability program with premium subsidies, cost-sharing help, and a free plan for the lowest earners.
• Makes the program's activation conditional: it only takes effect January 1, 2026 if Congress allows the federal enhanced premium tax credits to expire on December 31, 2025.
• Requires the department to convene a stakeholder working group by July 1, 2025 and submit a program plan to the Governor and General Assembly by September 30, 2025.
• Requires a fiscal impact analysis and funding recommendations, including possible charges on insurers selling plans on Georgia Access, due by September 1, 2025.
• Sets ongoing annual reporting starting January 1, 2027 and a full program evaluation in 2029, with the entire Code section automatically repealing December 31, 2030.

Low- and middle-income Georgians who buy coverage through Georgia Access, especially those earning up to 400 percent of the federal poverty level; the Department of Insurance, which must build and administer the program; health insurers offering marketplace plans; and consumer advocates, providers, and employers invited to a required stakeholder working group.

If federal premium tax credits expire, many Georgians buying ACA marketplace coverage could see sharp premium increases. This bill would set up a state backstop, subsidies, reduced cost-sharing, and a free plan for the poorest enrollees, but only if that federal expiration actually happens, and the whole program would sunset by the end of 2030.

• Section 1 names the bill the 'Georgia Health Insurance Affordability and Consumer Protection Act.'
• Section 2 lays out legislative findings about the expiring federal tax credits and cites other states with similar affordability programs.
• Section 3 adds O.C.G.A. § 33-24-59.34, defining key terms like 'affordability program,' 'cost-sharing reductions,' and 'qualified health plan.'
• Subsection (b) requires the department to build the program by September 30, 2025, including subsidies for those up to 400% of poverty, cost-sharing help under 250%, and a premium-free plan under 200%.
• Subsection (c) requires a stakeholder working group by July 1, 2025; subsection (e) requires implementing rules by December 1, 2025.
• Subsection (f) requires a fiscal impact analysis with the Office of Planning and Budget by August 1, 2025, exploring funding options including insurer charges.
• Subsection (j) makes the entire program's effectiveness contingent on Congress letting the federal enhanced premium tax credits expire on December 31, 2025.
• Subsection (k) automatically repeals the whole Code section on December 31, 2030.

1. 2025-02-19Senate Read and Referred (Senate)
2. 2025-02-18Senate Hopper (Senate)

• Jason Esteves (D, SD-035)Primary sponsor
• Sonya Halpern (D, SD-039)
• Harold Jones (D, SD-022)
• Kim Jackson (D, SD-041)
• Elena Parent (D, SD-044)
• Nan Orrock (D, SD-036)
• Tonya Anderson (D, SD-043)
• Sally Harrell (D, SD-040)
• RaShaun Kemp (D, SD-038)
• Gail Davenport (D, SD-017)
• Josh McLaurin (D, SD-014)
• Michael Rhett (D, SD-033)
• Nikki Merritt (D, SD-009)
• Kenya Wicks (D, SD-034)
• Randal Mangham (D, SD-055)
• Donzella James (D, SD-028)
• Sheikh Rahman (D, SD-005)
• Freddie Sims (D, SD-012)
• Nabilah Islam Parkes (D, SD-007)
• David Lucas (D, SD-026)
• Ed Harbison (D, SD-015)
• Emanuel Jones (D, SD-010)

• health insurance
• Affordable Care Act
• premium subsidies
• Georgia Access
• Department of Insurance