HB 658: Insurance; certain consumer protections contingent upon repeal of Patient Protection and Affordable Care Act; provide

This bill responds to the possibility that the federal Patient Protection and Affordable Care Act could someday be repealed. Right now, protections like coverage for preexisting conditions, free preventive care, and letting young adults stay on a parent's health plan until age 26 come from federal law. If that federal law were repealed, those protections could disappear unless states step in. The bill adds a new section to Georgia's insurance code (O.C.G.A. § 33-24-59.34) that would require Georgia health insurance plans to keep offering these protections, but only once the federal Affordable Care Act is actually repealed. It defines terms like essential health benefits and preventive services, bars insurers from denying coverage or charging more for preexisting conditions, requires free preventive care, bans annual or lifetime coverage limits, requires coverage of dependents up to age 26, and limits when insurers can cancel or refuse to renew a policy. The whole Act only takes effect if and when the federal law is repealed.

• Creates a new Georgia insurance code section that only takes effect if the federal Patient Protection and Affordable Care Act is repealed.
• Bars health plans from denying coverage or charging higher premiums because of a preexisting medical condition.
• Requires health plans to cover preventive services like screenings and counseling with no copays, deductibles, or coinsurance charged to the insured.
• Prohibits health plans from imposing any annual or lifetime dollar limit on essential health benefits such as hospitalization, maternity care, and prescription drugs.
• Requires health plans to cover dependent children up to age 26 and gives them a 30 day window to get their own coverage once they age out.
• Limits when an insurer can cancel or refuse to renew a policy to only nonpayment of premiums or false information on the application.

Georgians who buy individual or group health insurance, insurance companies and HMOs operating in Georgia, young adults on a parent's health plan, people with preexisting medical conditions, and the state Insurance Commissioner, who would write rules defining essential health benefits.

If the federal Affordable Care Act were ever repealed, Georgians could otherwise lose protections like free preventive care, coverage for preexisting conditions, and the ability to stay on a parent's plan until 26. This bill would preserve those specific protections under state law, but only in that scenario, and has no effect while the federal law remains in place.

• Section 1 adds new Code section 33-24-59.34, defining terms such as cost-sharing amount, essential health benefits, health benefit plan, and preventive services.
• Subsection (b)(1) bans denying coverage or charging higher premiums based on a preexisting condition.
• Subsection (b)(2) requires preventive services be covered with no cost-sharing charged to the insured.
• Subsection (b)(3) prohibits annual or lifetime dollar limits on essential health benefits.
• Subsection (b)(4) requires coverage of dependent children up to age 26 and creates a 30 day special enrollment period once a dependent turns 26.
• Subsection (b)(5) restricts insurers from canceling or nonrenewing a plan except for nonpayment or false application information.
• Subsection (c) and Section 2 state that the new rules and the entire Act apply and take effect only upon repeal of the federal Patient Protection and Affordable Care Act.

1. 2025-03-03House Second Readers (Cámara de Representantes)
2. 2025-02-28House First Readers (Cámara de Representantes)
3. 2025-02-27House Hopper (Cámara de Representantes)

• Scott Holcomb (D, HD-101)Patrocinador principal
• Carolyn Hugley (D, HD-141)
• Tanya Miller (D, HD-062)
• Michelle Au (D, HD-050)
• Saira Draper (D, HD-090)
• Esther Panitch (D, HD-051)

• health insurance
• Affordable Care Act
• preexisting conditions
• preventive care
• insurance regulation