--- title: SB 360. Public Assistance; public option buy-in program to provide healthcare coverage to individuals not eligible for Medicaid coverage; provide collection: bills id: 2025-2026/sb360 cite_as: SB 360, 2025-2026 Regular Session (Ga.) canonical_url: https://georgiacommons.org/bills/2025-2026/sb360 md_url: https://georgiacommons.org/bills/2025-2026/sb360.md text_url: https://georgiacommons.org/bills/2025-2026/sb360/text source_url: https://www.legis.ga.gov/legislation/71668 date: 2025-03-27 status: introduced corpus_version: bills-2026-08-28 license: Public record of the Georgia General Assembly, via LegiScan; see about.md publisher: Georgia Commons, an independent project of Georgia Civic Data. Not the State of Georgia. Not legal advice. up: https://georgiacommons.org/bills/2025-2026.md previous: https://georgiacommons.org/bills/2025-2026/sb359.md next: https://georgiacommons.org/bills/2025-2026/sb361.md index: https://georgiacommons.org/bills/index.md omitted: votes and history omitted_chars: 95 omitted_url: https://georgiacommons.org/bills/2025-2026/sb360.md?full=1 bill_number: SB 360 session: 2025-2026 Regular Session session_slug: 2025-2026 chamber: Senate bill_type: bill status_date: 2025-03-25 last_action: Senate Read and Referred sponsors: - Sally Harrell - Jason Esteves - Josh McLaurin - Kim Jackson - Elena Parent - Sonya Halpern text_version: Introduced has_text: true legiscan_url: https://legiscan.com/GA/bill/SB360/2025 upstream_id: 2014752 summaries_model: claude-sonnet-5 topic_tags: - healthcare coverage - Medicaid - public option - health insurance - Affordable Care Act --- # SB 360. Public Assistance; public option buy-in program to provide healthcare coverage to individuals not eligible for Medicaid coverage; provide ## Text 25 LC 33 9819 Senate Bill 360 By: Senators Harrell of the 40th, Esteves of the 35th, McLaurin of the 14th, Jackson of the 41st, Parent of the 44th 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 public1 assistance, so as to provide for a public option buy-in program to provide healthcare2 coverage to individuals not eligible for Medicaid coverage or e nrollment through a health3 exchange; to provide for definitions; to provide requirements for the program; to provide for4 any necessary state plan amendments or waivers; to provide for rules and regulations; to5 provide for related matters; to repeal conflicting laws; and for other purposes.6 BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:7 SECTION 1.8 Chapter 4 of Title 49 of the Official Code of Georgia Annotated, relating to public assistance,9 is amended by adding a new article to read as follows:10 "ARTICLE 1011 12 49-4-200.13 As used in this article, the term:14 (1) 'Department' means the Department of Community Health.15 S. B. 360 - 1 - 25 LC 33 9819 (2) 'Eligible person' means:16 (A) An individual who is not otherwise eligible to be a recipient under Medicaid or to17 obtain healthcare coverage through an exchange; or18 (B) An individual who is not otherwise eligible to be a recipi ent under Medicaid, if19 subsidies under the federal Patient Protection and Affordable C are Act and extended20 tax credits are not funded by Congress.21 (3) 'Exchange' means a state, federal, or partnership exchange or marketplace operating22 in Georgia pursuant to Section 1311 of the federal Patient Protection and Affordable Care23 Act.24 (4) 'Medicaid' means the program of medical assistance provide d through care25 management organizations pursuant to Article 7 of this chapter, the 'Georgia Medical26 Assistance Act of 1977.' Such term also includes the health co verage for children27 provided pursuant to Article 13 of Chapter 5 of this title, the 'PeachCare for Kids Act.'28 (5) 'Public Option Buy-In Program' or 'program' means the program established pursuant29 to this article to provide healthcare coverage to eligible persons.30 49-4-201.31 (a) The department shall establish and implement the Public Option Buy-In Program. The32 program shall meet at least the same standards and provide at least the same benefits and33 levels of coverage as provided by care management organizations under Medicaid.34 (b) The program shall be available to eligible persons who res ide in this state for a cost35 equal to the amount that the state pays per capita to care mana gement organizations for36 Medicaid.37 49-4-202.38 (a) Whenever the department enters into a competitive bidding process, including, without39 limitation, a request for proposals, to solicit and enter into contracts with care management40 S. B. 360 - 2 - 25 LC 33 9819 organizations to provide Medicaid services, it shall require any and all bidders to also bid41 on the provision of healthcare services for the Public Option Buy-In Program.42 (b) When selecting one or more care management organizations to administer the program,43 the department shall prioritize applicants whose proposals demo nstrate alignment of44 networks of providers between the program and Medicaid, where applicable.45 49-4-203.46 The department shall submit any Medicaid state plan amendment o r waiver requests47 necessary to implement the provisions of this article to the Un ited States Department of48 Health and Human Services.49 49-4-204.50 The department shall be authorized to promulgate rules and regulations consistent with and51 necessary to carry out the provisions of this article."52 SECTION 2.53 All laws and parts of laws in conflict with this Act are repealed.54 S. B. 360 - 3 - ## Summaries written by Georgia Commons The following was written by claude-sonnet-5 from the text above and is not part of the bill. Quote the text, not the summary. A Georgia Senate bill would create a state-run 'public option' health insurance program, letting people who cannot get Medicaid or exchange coverage buy a plan at the state's per-person Medicaid cost. ### Plain-language summary Some Georgians do not qualify for Medicaid and cannot get coverage through the health insurance exchange, or could be left without financial help if federal subsidies under the Affordable Care Act are not renewed by Congress. This bill would direct the Department of Community Health to create a new Public Option Buy-In Program to cover those people. The program would have to match the benefits and coverage levels that Medicaid's care management organizations already provide, and it would be offered at a cost equal to what the state currently pays per person for Medicaid coverage. Whenever the department seeks bids from care management organizations for Medicaid contracts, it would have to require those bidders to also bid on running the new buy-in program, and would favor bidders whose provider networks overlap with Medicaid's. The department would also seek any federal approvals needed and could write rules to carry out the program. ### What it does - Creates a new Public Option Buy-In Program inside the Department of Community Health to cover people who cannot get Medicaid or exchange coverage. - Requires the program to match Medicaid's benefits and coverage standards through the same care management organizations. - Sets the buy-in cost at the same per-person amount the state currently pays for Medicaid coverage. - Requires any company bidding on Medicaid contracts to also bid on providing the buy-in program's services. - Directs the department to prioritize bidders whose provider networks overlap with Medicaid's when picking who runs the program. - Directs the department to seek any federal Medicaid waivers or state plan changes needed to start the program. ### Who it affects Georgians who do not qualify for Medicaid and cannot get coverage through the health insurance exchange, including those who could lose subsidies if Congress does not extend Affordable Care Act tax credits. It also affects the Department of Community Health and the care management organizations that bid on Medicaid contracts. ### Why it matters People currently stuck without Medicaid or exchange options, including those at risk of losing federal subsidies, would gain a new way to buy coverage priced at the state's Medicaid cost. Care management organizations would face new bidding requirements tied to their existing Medicaid contracts. ### Key provisions - Section 1 adds a new Article 10 to Chapter 4 of Title 49 of the O.C.G.A. establishing the Public Option Buy-In Program. - O.C.G.A. § 49-4-200 defines 'eligible person' as someone ineligible for Medicaid or exchange coverage, or ineligible for ACA subsidies if Congress does not fund them. - O.C.G.A. § 49-4-201 requires the program to match Medicaid's benefit standards and sets its cost at the state's per capita Medicaid payment rate. - O.C.G.A. § 49-4-202 requires Medicaid bidders to also bid on the buy-in program and gives priority to bidders with overlapping provider networks. - O.C.G.A. § 49-4-203 directs the department to seek federal Medicaid state plan amendments or waivers needed to implement the program. - O.C.G.A. § 49-4-204 authorizes the department to write rules and regulations to carry out the program. - Section 2 repeals conflicting laws. ## Status - Status: Introduced (2025-03-25) - Last action: Senate Read and Referred (2025-03-27) - Sponsors: Sally Harrell, Jason Esteves, Josh McLaurin, Kim Jackson, Elena Parent, Sonya Halpern - Official page: https://www.legis.ga.gov/legislation/71668 > The history, votes, and amendments (95 characters) are at https://georgiacommons.org/bills/2025-2026/sb360.md?full=1