HB 951: Insurance; require health benefit policy coverage for medically necessary orthotic and prosthetic devices and their materials and components

Georgia law already requires many health insurance policies to cover medically necessary orthotic devices (braces and other devices that support or correct body parts) and prosthetic devices (artificial limbs), along with their materials and components, under O.C.G.A. § 33-24-59.35. But that law currently exempts health plans the state itself runs for state employees, and it also exempts Medicaid contracts between insurers and the Department of Community Health. House Bill 951 changes the definition of 'health benefit policy' in that law so it now includes plans the state provides for state employees, public school teachers and employees, and members, employees, retirees, and dependents covered through the Board of Regents (which oversees Georgia's public colleges and universities). The bill also removes the separate exclusion for Medicaid managed care contracts. These changes take effect January 1, 2027. Self-funded employer health plans governed by the federal ERISA law remain excluded, since state law cannot regulate those plans.

• Removes the current exclusion that lets the State Health Benefit Plan skip covering orthotic and prosthetic devices, effective January 1, 2027.
• Adds public school teachers and employees, and Board of Regents members, employees, retirees, and dependents, to the group whose coverage must include these devices.
• Deletes the separate exclusion for Medicaid managed care contracts between insurers and the Department of Community Health, removing that carve-out from the definition.
• Keeps the existing exclusion for self-funded employer health plans regulated under the federal ERISA law, since the state cannot mandate coverage for those plans.
• Sets the effective date of the overall Act as the date the Governor signs it, while the coverage change itself only applies starting January 1, 2027.

State employees, public school teachers and staff, and Board of Regents employees, retirees, and dependents who get health coverage through state-run plans; people who need orthotic or prosthetic devices; the Department of Community Health, which administers Medicaid contracts; and insurers that issue these health benefit policies in Georgia.

State employees, teachers, and university system staff currently are not guaranteed coverage for medically necessary braces or artificial limbs under this specific mandate. Once this takes effect in 2027, their state-run health plans would have to cover these devices, similar to many private insurance policies already do.

• Section 1 amends paragraph (3) of subsection (a) of O.C.G.A. § 33-24-59.35 to redefine 'health benefit policy'.
• The revised definition states that, on or after January 1, 2027, the term includes plans the state provides for state employees, public school teachers and employees, and Board of Regents members, employees, retirees, and dependents.
• The amendment deletes prior language that excluded Medicaid contracts between insurers and the Department of Community Health from the definition.
• The exclusion for self-funded, employer-sponsored plans covered by the federal Employee Retirement Income Security Act of 1974 (ERISA) remains unchanged.
• Section 2 makes the Act effective upon the Governor's signature or upon it becoming law without signature.
• Section 3 repeals any conflicting laws.

1. 2026-03-09Senate Read and Referred (Senado)
2. 2026-03-06House Passed/Adopted (Cámara de Representantes)
3. 2026-03-06House Third Readers (Cámara de Representantes)
4. 2026-02-19House Committee Favorably Reported (Cámara de Representantes)
5. 2026-01-15House Second Readers (Cámara de Representantes)
6. 2026-01-14House First Readers (Cámara de Representantes)
7. 2026-01-13House Hopper (Cámara de Representantes)

• David Clark (R, HD-100)Patrocinador principal
• Karen Mathiak (R, HD-082)
• Deborah Silcox (R, HD-053)
• Trey Kelley (R, HD-016)
• Kim Schofield (D, HD-063)
• Steven Sainz (R, HD-180)

1. AprobadaVotación: Cámara de Representantes6 de marzo de 2026

   163 a favor, 2 en contra (4 sin votar, 8 ausentes)

   Passage: House Vote #671

• health insurance coverage
• prosthetic devices
• state employee benefits
• teacher health benefits
• Medicaid