HB1151: HB1151 Social services; expansion of Medicaid; provide

Georgia is one of the states that has not expanded Medicaid to cover all low-income adults. This bill would add a new section to Georgia law creating a 'Medicaid expansion program' for adults ages 19 to 64 whose income is at or below 138 percent of the federal poverty level, who are not already eligible for other Medicaid coverage, who are U.S. citizens or qualified immigrants, and who meet federal work or community engagement requirements. The Department of Community Health would have to submit a waiver request to the federal Centers for Medicare and Medicaid Services by December 31, 2026, seeking approval to expand Medicaid through managed care plans. If approved, the department would have to report to the General Assembly on enrollment numbers, costs, and cost control recommendations every year. The expansion is subject to state funding being appropriated, and the bill counts as the legislature's required notification and approval for this kind of Medicaid change under existing Georgia law.

• Creates a new Medicaid expansion program in Georgia law for adults ages 19 to 64 earning up to 138 percent of the federal poverty level.
• Requires eligible individuals to be U.S. citizens or qualified immigrants and to meet federal community engagement (work-related) requirements.
• Requires the Department of Community Health to submit a federal waiver request by December 31, 2026 to implement the expansion through Medicaid managed care plans.
• Requires annual reports to the General Assembly on enrollment, state costs, projected costs, and cost-control recommendations once expansion begins.
• Makes the expansion subject to state funding being appropriated by the legislature.
• Designates the Act itself as the legislature's required notification and approval for this Medicaid change under existing law.

Low-income Georgia adults ages 19 to 64 who currently earn too much for traditional Medicaid but too little for other coverage, the Department of Community Health, Medicaid managed care companies, and the General Assembly, which would receive annual reports and must approve funding.

If implemented, tens of thousands of Georgia adults without children or disabilities who currently fall into a coverage gap could gain access to Medicaid health coverage, but eligibility would depend on state funding being approved and federal approval of the waiver, and enrollees would have to meet work-related requirements.

• New Code Section 49-4-159.5(a) defines 'eligible individual' by age, income (138% of federal poverty level), citizenship or qualified alien status, and compliance with federal community engagement requirements.
• Subsection (b) makes the Medicaid expansion program part of the state Medicaid program, subject to appropriations and necessary approvals.
• Subsection (c) requires the department to submit a Section 1115 federal waiver request by December 31, 2026 to expand Medicaid through managed care plans.
• Subsection (d) requires immediate and then annual reports to the General Assembly on enrollment, costs, projected costs, and cost-control recommendations.
• Subsection (e) authorizes the department to write rules and regulations needed to carry out the program.
• Section 2 states the Act itself satisfies legislative notification and approval requirements under existing Code Sections 49-4-142.1 and 49-4-142.2.

1. 2026-02-04House Second Readers (House)
2. 2026-02-03House First Readers (House)
3. 2026-02-02House Hopper (House)

• Samuel Park (D, HD-107)Primary sponsor
• Carolyn Hugley (D, HD-141)
• Tanya Miller (D, HD-062)
• Eric Gisler (D, HD-121)
• Tangie Herring (D, HD-145)
• Michelle Au (D, HD-050)

• Medicaid expansion
• health coverage
• low-income adults
• state budget
• federal waiver