SB379: SB379 "Georgia Health Insurance Affordability and Consumer Protection Act"; enact

26 LC 46 1320 Senate Bill 379 By: Senators McLaurin of the 14th, Parkes of the 7th, Jones II of the 22nd, Jackson of the 41st, Parent of the 44th and others A BILL TO BE ENTITLED AN ACT To amend Chapter 24 of Title 33 of the Official Code of Georgia Annotated, relating to1 insurance generally, so as to require the Department of Insuran ce to implement a certain2 insurance affordability program in response to the recent expir ation of certain Patient3 Protection and Affordable Care Act tax credits; to provide for definitions; to provide for4 automatic repeal; to provide for related matters; to provide fo r a short title; to provide for5 legislative findings; to provide for an effective date; to repeal conflicting laws; and for other6 purposes.7 BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:8 SECTION 1.9 This Act shall be known and may be cited as the "Georgia Health Insurance Affordability10 and Consumer Protection Act."11 SECTION 2.12 The General Assembly finds and declares that:13 (1) The enhanced premium tax credits (ePTCs) under the federal Patient Protection and14 Affordable Care Act, also known as the "ACA," significantly increased the affordability15 S. B. 379 - 1 - 26 LC 46 1320 of health insurance for low- and middle-income Georgians, reducing the state's uninsured16 rate;17 (2) Due to Congressional inaction, the ePTCs expired on Decemb er 31, 2025, and18 thousands of Georgians, particularly those earning under 250 percent of the federal poverty19 level, are experiencing drastic premium increases, making health insurance unaffordable20 and increasing the number of uninsured individuals;21 (3) The expiration of these tax credits has disproportionately harmed rural communities,22 small business owners, gig workers, and historically marginalized populations;23 (4) Several states, including New Mexico, Colorado, and Washington, have implemented24 state based affordability programs to provide premium and cost- sharing assistance to25 mitigate rising health insurance costs;26 (5) Georgia must act swiftly to prevent a more extensive gap in affordability and ensure27 access to affordable health insurance for its residents; and28 (6) The purpose of this Act is to direct the Georgia Department of Insurance to establish29 a program within statutory requirements established by law to l essen the impact of the30 ePTCs' expiration, ensuring Georgians continue to have access to affordable, high quality31 health coverage.32 SECTION 3.33 Chapter 24 of Title 33 of the Official Code of Georgia Annotate d, relating to insurance34 generally, is amended by adding a new Code section to read as follows:35 "33-24-59.37.36 (a) As used in this Code section, the term:37 (1) 'Affordability program' means the program administered by the department to reduce38 the cost of health insurance for Georgians through premium assi stance, cost-sharing39 reductions, reinsurance, or other financial mechanisms.40 S. B. 379 - 2 - 26 LC 46 1320 (2) 'Cost-sharing reductions' means state or federal subsidies that lower out-of-pocket41 costs, such as deductibles and copayments, for eligible individuals.42 (3) 'Federal poverty level' means the income thresholds updated annually by the United43 States Department of Health and Human Services.44 (4) 'Georgia Access' means the state based health insurance ma rketplace established45 under the federal Patient Protection and Affordable Care Act.46 (5) 'Plan' means a health insurance plan certified to be offered through Georgia Access.47 (b) The department shall develop an affordability program by September 30, 2026, which48 shall include:49 (1) State premium subsidies to replace or supplement federal p remium tax credits for50 enrollees earning up to 400 percent of the federal poverty level;51 (2) Other cost-sharing reductions for individuals earning belo w 250 percent of the52 federal poverty level which may include lower deductibles, copa yments, and other53 out-of-pocket expenses; and54 (3) A state funded plan for individuals earning below 200 percent of the federal poverty55 level that does not require the payment of any premiums.56 (c) The department shall convene a stakeholder working group b y August 1, 2026,57 consisting of consumer advocates, health insurers, healthcare providers, and employers to58 develop a consumer centered approach to the affordability program.59 (d) The department shall submit the stakeholder working group's plan for the affordability60 program to the Governor and General Assembly by September 30, 2026. Such submission61 shall include recommendations for additional ways to reduce the cost of health insurance.62 (e) The department shall promulgate rules and regulations for implementation of the63 affordability program by December 1, 2026.64 (f) The department, in coordination with the Office of Planning and Budget, shall conduct65 a fiscal impact analysis by August 1, 2026, and identify sustainable funding mechanisms66 for the affordability program, including appropriations by the General Assembly and67 S. B. 379 - 3 - 26 LC 46 1320 charges on health insurers offering plans on Georgia Access. The results of such analysis68 shall be contained in a report, along with the financial structure and projected impact of the69 affordability program, which shall be submitted to the Governor and General Assembly by70 September 1, 2026.71 (g) Beginning on January 1, 2028, the department shall provide annual reports to the72 General Assembly detailing:73 (1) The number of Georgians receiving assistance through the affordability program;74 (2) The impact of the affordability program, enrollment rates, and health outcomes; and75 (3) Any recommended changes or expansions to such program.76 (h) The department shall implement consumer education and outreach initiatives to ensure77 eligible Georgians are aware of and can access the affordability program.78 (i) The department shall conduct a comprehensive evaluation in 2030 to assess the79 program's impact and determine the need for continuation or adjustments. The results of80 such evaluation shall be submitted to the Governor and General Assembly in a report by81 January 1, 2031.82 (j) The affordability program shall only become effective on January 1, 2027, in the event83 that the Congress and President of the United States have failed to reestablish the enhanced84 premium tax credits as they existed under the federal Patient P rotection and Affordable85 Care Act but expired on December 31, 2025. In the event that the affordability program86 does not become effective, none of the reports required in this Code section shall be87 applicable.88 (k) This Code section shall stand repealed on December 31, 2031."89 SECTION 4.90 This Act shall become effective upon its approval by the Governor or upon its becoming law91 without such approval.92 S. B. 379 - 4 - 26 LC 46 1320 SECTION 5.93 All laws and parts of laws in conflict with this Act are repealed.94 S. B. 379 - 5 -