---
title: SB 50. "PeachCare Plus Act of 2025"; enact
collection: bills
id: 2025-2026/sb50
cite_as: SB 50, 2025-2026 Regular Session (Ga.)
canonical_url: https://georgiacommons.org/bills/2025-2026/sb50
md_url: https://georgiacommons.org/bills/2025-2026/sb50.md
text_url: https://georgiacommons.org/bills/2025-2026/sb50/text
source_url: https://www.legis.ga.gov/legislation/69603
date: 2025-01-29
status: introduced
corpus_version: bills-2026-09-13
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/sb49.md
next: https://georgiacommons.org/bills/2025-2026/sb51.md
index: https://georgiacommons.org/bills/index.md
omitted: votes and history
omitted_chars: 95
omitted_url: https://georgiacommons.org/bills/2025-2026/sb50.md?full=1
bill_number: SB 50
session: 2025-2026 Regular Session
session_slug: 2025-2026
chamber: Senate
bill_type: bill
status_date: 2025-01-28
last_action: Senate Read and Referred
sponsors:
  - David Lucas
  - Carden Summers
  - Russ Goodman
  - Harold Jones
  - Elena Parent
  - Jason Esteves
  - Kim Jackson
  - Sonya Halpern
  - Ed Harbison
  - Emanuel Jones
  - Gail Davenport
  - Kenya Wicks
  - Josh McLaurin
  - RaShaun Kemp
  - Tonya Anderson
  - Freddie Sims
  - Sally Harrell
  - Nikki Merritt
  - Nan Orrock
  - Derek Mallow
  - Sam Watson
  - Sheikh Rahman
  - Randal Mangham
text_version: Introduced
has_text: true
legiscan_url: https://legiscan.com/GA/bill/SB50/2025
upstream_id: 1945184
summaries_model: claude-sonnet-5
topic_tags:
  - Medicaid expansion
  - health insurance coverage
  - PeachCare Plus
  - Indigent Care Trust Fund
  - state health policy oversight
---

# SB 50. "PeachCare Plus Act of 2025"; enact

## Text

Senate Bill 50
By: Senators Lucas of the 26th, Summers of the 13th, Goodman of the 8th, Jones II of the
22nd, Hickman of the 4th and others
A BILL TO BE ENTITLED
AN ACT
To amend Article 7 of Chapter 4 of Title 49 of the Official Code of Georgia Annotated,
relating to medical assistance generally, so as to provide for Medicaid expansion; to provide
for the submission of a waiver request, necessary amendments, and other documents; to
provide for savings to be deposited into the Indigent Care Trust Fund; to create the Advisory
Commission on the PeachCare Plus Program; to provide for members and duties; to provide
for definitions; to provide for a short title; to provide for legislative findings; to provide for
related matters; to provide for legislative notification and approval; to repeal conflicting
laws; and for other purposes.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:
SECTION 1.
This Act shall be known and may be cited as the "PeachCare Plus Act of 2025."
SECTION 2.
The General Assembly finds that:
(1) Expanding access to coverage for essential healthcare needs to Georgians earning up
to 138 percent of the federal poverty limit will improve the quality and availability of
healthcare services in this state;
(2) It is important that federal reimbursement remain at current rates to allow the State of
Georgia to provide such coverage;
(3) Providing coverage via fully subsidized commercial insurance products on the
Section 1332 marketplace in Georgia will give individuals more options in coverage and
help ensure that healthcare providers may commercially contract for services and receive
fair reimbursement for providing such services;
(4) The request for a federal waiver to provide these services should protect the fiscal
stability of the state, avoid tax increases, not contain matters that would diminish the
likelihood of approval, and be bipartisan in nature;
(5) Fair reimbursement rates and added flexibility to innovate in healthcare delivery will
help attract essential healthcare providers to Georgia; and
(6) The General Assembly, through the Advisory Commission on the PeachCare Plus
Program, should maintain an active oversight role in preparation and submission of the
waiver.
SECTION 3.
Article 7 of Chapter 4 of Title 49 of the Official Code of Georgia Annotated, relating to
medical assistance generally, is amended by revising Code Section 49-4-142.2, relating to
expansion of Medicaid eligibility through an increase in the income threshold, as follows:
"49-4-142.2.
<ins>(a)</ins> On and after July 1, 2014, neither the department, the board, nor any other
representative of the state shall expand Medicaid eligibility under this article through an
increase in the income threshold without prior legislative approval; provided, however, that
this shall not apply to any increase resulting from a cost-of-living increase in the federal
poverty level. The legislative approval required under this Code section shall be by Act
of the General Assembly or the adoption of a joint resolution of the General Assembly.
<ins>(b) This Code section shall not apply to a waiver request along with other necessary
amendments for the creation of the PeachCare Plus Program pursuant to Code
Section 49-4-142.6 and submitted between July 1, 2025, and October 31, 2026."
</ins> SECTION 4.
Said article is further amended by adding new Code sections to read as follows:
<ins>"49-4-142.6.
(a) As used in this Code section, the term 'program' means the PeachCare Plus Program
that expands Medicaid eligibility as provided in this Code section.
(b) On or before October 31, 2026, in consultation with the office of the Commissioner of
Insurance, the department shall submit to the United States Department of Health and
Human Services Centers for Medicare and Medicaid Services pursuant to Section 1115 of
the federal Social Security Act a waiver request along with other necessary amendments
for the creation of the PeachCare Plus Program. The waiver request shall provide for:
(1) The enrollment of certain low-income individuals making less than 138 percent of
the federal poverty level in the eligibility category created by
Section 1902(a)(10)(A)(i)(VIII) of the federal Social Security Act, 42 U.S.C.
Section 1396a, into qualified healthcare plans offered on the state marketplace established
under Section 1332 of the federal Patient Protection and Affordable Care Act or the
federal marketplace, as applicable at implementation; and
(2) The full payment of any premiums or other direct costs associated with enrolling in
qualified healthcare plans for certain individuals making less than 138 percent of the
federal poverty level.
</ins>
<ins>(c) 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.
(d) All savings to the state as a result of the implementation of the program shall be
deposited into the Indigent Care Trust Fund created pursuant to Code Section 31-8-152 and
shall be used for any additional costs and expenses associated with the implementation of
the program.
(e) The program shall be administered by the department; provided, however, that the
department may consult the Advisory Commission on the PeachCare Plus Program and
other state agencies, including, but not limited to, the office of the Commissioner of
Insurance.
(f) The waiver provided for in this Code section shall take effect upon the expiration of the
current waiver or any extension of such waiver granted prior to December 31, 2025.
49-4-142.7.
(a) As used in this Code section, the term 'commission' means the Advisory Commission
on the PeachCare Plus Program.
(b) There is created the Advisory Commission on the PeachCare Plus Program. The
commission shall advise the department in drafting and submitting the waiver request and
implementing the PeachCare Plus Program as provided for in Code Section 49-4-142.6.
(c) The commission shall consist of 11 members, as follows:
(1) The commissioner or his or her designee, who shall also serve as chairperson;
(2) Five members of the House of Representatives to be appointed by the Speaker of the
House of Representatives, provided that three members shall be from the majority party
and two shall be from the minority party; and
</ins>
<ins>(3) Five members of the Senate to be appointed by the President of the Senate, provided
that three members shall be from the majority party and two shall be from the minority
party.
(d) Vacancies in the commission shall be filled in the same manner as the initial
appointments.
(e) The commission shall:
(1) Consult with the department during preparation of the waiver request authorized by
Code Section 49-4-142.6 and review such waiver request prior to submission;
(2) Seek to make all recommendations in a bipartisan manner, with the chairperson only
voting on any recommendation in the event of a tie;
(3) Issue a public report no fewer than 30 days after submission of the waiver request
that shall provide recommendations for the implementation and success of the program
authorized by the waiver; and
(4) Remain in place on an ongoing basis, with members serving at the pleasure of the
state official appointing them, to advise the department on the implementation of the
PeachCare Plus Program and related matters.
(f) The commission may conduct such meetings at such places and at such times as it may
deem necessary or convenient to enable it to exercise fully and effectively its powers,
perform its duties, and accomplish the objectives and purposes of this Code section. The
commission shall meet upon the call of the chairperson and shall meet at least once
quarterly.
(g) The legislative members of the commission shall receive the allowances provided for
in Code Section 28-1-8. The commissioner or his or her designee shall receive no
compensation for his or her services on the commission, but he or she shall be reimbursed
for expenses incurred in the performance of his or her duties as a member of the
commission in the same manner as he or she is reimbursed for expenses in his or her
capacity as a state official. The funds necessary for the reimbursement of the expenses of
</ins>
<ins>the state official shall come from funds appropriated to or otherwise available to the
department. All other funds necessary to carry out the provisions of this Code section shall
come from funds appropriated to the House of Representatives and the Senate."
</ins> SECTION 5.
This Act shall be considered legislative notification for purposes of Code Section 49-4-142.1
and legislative approval for purposes of Code Section 49-4-142.2.
SECTION 6.
All laws and parts of laws in conflict with this Act are repealed.

## 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.

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.

### Plain-language summary

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 it 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.

## Status

- Status: Introduced (2025-01-28)
- Last action: Senate Read and Referred (2025-01-29)
- Sponsors: David Lucas, Carden Summers, Russ Goodman, Harold Jones, Elena Parent, Jason Esteves, Kim Jackson, Sonya Halpern, Ed Harbison, Emanuel Jones, Gail Davenport, Kenya Wicks, Josh McLaurin, RaShaun Kemp, Tonya Anderson, Freddie Sims, Sally Harrell, Nikki Merritt, Nan Orrock, Derek Mallow, Sam Watson, Sheikh Rahman, Randal Mangham
- Official page: https://www.legis.ga.gov/legislation/69603

> The history, votes, and amendments (95 characters) are at https://georgiacommons.org/bills/2025-2026/sb50.md?full=1