HB1111: HB1111 Sales and use tax; new special purpose local option sales tax dedicated to certain healthcare purposes; provide

Georgia counties already use special purpose local option sales taxes (SPLOSTs) for roads, buildings, and other capital projects. This bill creates a new, separate version of that tax reserved specifically for healthcare. It would let a county's governing authority put a referendum before voters asking to impose a sales tax of up to 1 percent, with the money going toward hospital construction, hospital operating costs, and covering bad debt or indigent care costs hospitals absorb. Before calling the referendum, a county could sign an intergovernmental agreement with a hospital authority spelling out how the money will be split and spent. The tax would generally run up to five years (six if debt is issued), and the county could also seek voter approval to issue general obligation bonds tied to the tax. The bill spells out how the tax is collected by the state revenue commissioner, how proceeds are distributed, annual public reporting requirements, and a process for changing the approved healthcare purposes if they later become impractical.

• Creates a brand new local sales and use tax, capped at 1 percent, that counties can put to a referendum specifically to fund hospitals and healthcare costs.
• Allows counties to sign agreements with hospital authorities spelling out how tax proceeds get divided among healthcare projects before asking voters to approve the tax.
• Sets the tax's maximum duration at five years, or six years if the county also issues general obligation debt backed by the tax.
• Requires the state revenue commissioner to collect and administer the tax and keep 1 percent of proceeds to cover state administrative costs.
• Requires counties to publish an annual public report on how the healthcare tax money was spent, including projects that are underfunded or behind schedule.
• Creates a process, including a new referendum, for changing the approved healthcare purposes if they become impractical or unrealistic, including using leftover money to pay down county debt or lower property taxes.

County governments and county election officials who would run the referendums, hospital authorities and nonprofit hospitals that could receive the tax proceeds, and county voters and taxpayers who would decide whether to approve the tax and would pay it on purchases if approved.

If counties adopt this tax after voter approval, shoppers in that county would pay slightly more sales tax, and that money would flow directly to local hospitals for buildings, operations, or covering unpaid patient bills, giving hospitals a new, dedicated funding stream separate from existing county sales taxes.

• Section 1 adjusts the overall cap on combined local sales taxes (O.C.G.A. § 48-8-6) to fold in this new healthcare tax alongside other existing local option taxes.
• Section 2 adds a new Article 7 to Chapter 8 of Title 48, creating 159 special tax districts, one per county, that can each independently adopt the tax.
• New Code Section 48-8-281 sets the tax rate at up to 1 percent and applies special rules for motor fuel sales, capping the fuel tax base at $3.00 per gallon.
• New Code Section 48-8-282 requires a county resolution specifying the healthcare purpose, duration (up to five years, six with debt), estimated cost, and any bond details before a referendum can be called.
• New Code Section 48-8-286 sets how proceeds are divided: 1 percent to the state for administration, with the rest going to the county or split with hospital authorities under a formal agreement.
• New Code Section 48-8-290 requires an annual public report published in a local newspaper and on the county website detailing project costs, spending, and delays.
• New Code Section 48-8-291 lays out how a county or hospital authority can seek voter approval to redirect tax proceeds if a funded healthcare purpose later becomes 'infeasible.'

1. 2026-02-03House Second Readers (House)
2. 2026-02-02House First Readers (House)
3. 2026-01-29House Hopper (House)

• Rob Leverett (R, HD-123)Primary sponsor
• Noel Williams (R, HD-148)
• Trey Rhodes (R, HD-124)
• Stan Gunter (R, HD-008)

• sales tax
• hospital funding
• healthcare funding
• local referendums
• county government