Senate · Introduced · 2025-2026 Regular Session

SB 50: "PeachCare Plus Act of 2025"; enact

Last action January 29, 2025 · Senate Read and Referred

Senate Bill 50 would direct Georgia's Department of Community Health to seek federal approval for a Medicaid expansion plan called the PeachCare Plus Program, covering people earning up to 138 percent of the federal poverty level through subsidized private insurance plans.

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In plain language

Georgia law currently blocks the state from expanding Medicaid eligibility without the General Assembly's approval first. This bill grants that approval for a specific plan: a waiver request, due by October 31, 2026, asking the federal government to let Georgia enroll low-income residents earning under 138 percent of the federal poverty level into private health plans sold on the state's insurance marketplace, with their premiums and other costs fully covered. The program would only continue if the federal government keeps paying at least 90 percent of the cost. Any state savings from the change would go into the Indigent Care Trust Fund to cover added expenses. The bill also creates an 11 member Advisory Commission on the PeachCare Plus Program, made up of legislators and the state health commissioner, to help write the waiver request, oversee its rollout, and issue a public report after it is submitted.

What the bill does

Authorizes the Department of Community Health to submit a federal waiver request by October 31, 2026 creating the PeachCare Plus Program to cover people earning up to 138 percent of the federal poverty level.
Requires the covered population to be enrolled in private health plans on Georgia's insurance marketplace (or the federal marketplace) rather than traditional Medicaid, with premiums fully paid.
Limits the program to periods when the federal government's share of Medicaid costs for Georgia stays at or above 90 percent.
Directs any state savings from the program into the Indigent Care Trust Fund to cover related implementation costs.
Creates an 11-member Advisory Commission on the PeachCare Plus Program, chaired by the health commissioner, with 5 House members and 5 Senate members, to help draft the waiver and oversee the program long-term.
Counts this Act itself as the legislature's required notification and approval for expanding Medicaid eligibility under existing Georgia law (O.C.G.A. §§ 49-4-142.1 and 49-4-142.2).

Who it affects

Low-income Georgians earning up to 138 percent of the federal poverty level who currently lack coverage, the Department of Community Health, the Commissioner of Insurance's office, state legislators appointed to the new advisory commission, and healthcare providers who would contract with the private insurance plans covering this population.

Why it matters

If the federal government approves the waiver, tens of thousands of low-income Georgians could gain health coverage through subsidized private insurance rather than traditional Medicaid, but the coverage would end if federal funding support drops below 90 percent, and full rollout depends on federal approval and the expiration of Georgia's current Medicaid waiver.

Key provisions

Section 3 amends O.C.G.A. § 49-4-142.2 to carve out an exception letting the department submit this specific waiver request between July 1, 2025, and October 31, 2026 without needing separate future legislative approval.
Section 4 creates new Code Section 49-4-142.6, requiring the department to submit the waiver request by October 31, 2026 covering people under 138 percent of the federal poverty level through marketplace health plans with fully paid premiums.
Section 4 ties the program's continuation to the federal government maintaining at least a 90 percent reimbursement rate for Georgia's Medicaid costs (new Code Section 49-4-142.6(c)).
Section 4 directs state savings from the program into the Indigent Care Trust Fund (new Code Section 49-4-142.6(d)).
Section 4 creates new Code Section 49-4-142.7 establishing the 11-member Advisory Commission on the PeachCare Plus Program, its bipartisan makeup, quarterly meeting requirement, and duty to issue a public report within 30 days of the waiver's submission.
Section 5 declares that this Act itself satisfies the legislature's notification and approval requirements under existing Georgia Medicaid law.
Section 4 specifies the new waiver would take effect only once the state's current Medicaid waiver, or any extension granted before December 31, 2025, expires.

From the bill

“The waiver request shall provide for: (1) The enrollment of certain low-income individuals making less than 138 percent of the federal poverty level”
This is the core group the new program would cover: people earning under 138 percent of the federal poverty level.

“The provisions of this Code section shall only apply so long as the federal medical assistance percentage for this state established pursuant to 42 U.S.C. Section 1396d remains at or above 90 percent.”
The program would automatically stop applying if federal funding support fell below 90 percent.

“All savings to the state as a result of the implementation of the program shall be deposited into the Indigent Care Trust Fund”
Any money the state saves from the program would go into a specific state healthcare fund.

Status timeline

2025-01-29Senate Read and Referred (Senate)
2025-01-28Senate Hopper (Senate)

Topics

Medicaid expansion
health insurance coverage
PeachCare Plus
Indigent Care Trust Fund
state health policy oversight

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