HB 988: State employees; require health benefit plan to cover hormone replacement therapy for biological women experiencing perimenopause and menopause when such therapy is ordered or prescribed

Currently the state employees' health insurance plan does not specifically guarantee coverage for hormone replacement therapy related to perimenopause and menopause. This bill adds a new section to Georgia law (O.C.G.A. § 45-18-4.3) requiring the state health benefit plan to cover this therapy for biological women when it is ordered or prescribed by a licensed physician. The bill defines hormone replacement therapy broadly, covering synthetic, biological, or bioidentical hormones used to replace hormones lost during perimenopause and menopause, control symptoms, or protect against related health conditions. Coverage would begin January 1, 2027, and would be subject to the same deductibles, coinsurance, copayments, and utilization review rules that apply to other similar benefits under the plan. The bill itself would take effect July 1, 2026, and apply to policies issued or renewed in Georgia on or after that date.

• Adds a new Code section requiring the state health benefit plan to cover hormone replacement therapy for biological women experiencing perimenopause and menopause.
• Defines hormone replacement therapy to include synthetic, biological, or bioidentical hormones that replenish diminished hormones, control symptoms, or protect against related post-menopause conditions.
• Limits the coverage requirement to therapy that is ordered or prescribed by a licensed physician.
• Allows the plan to apply the same deductibles, coinsurance, copayments, and utilization review used for other comparable covered benefits.
• Sets the coverage requirement to begin January 1, 2027, while the Act itself takes effect July 1, 2026.

State employees and retirees enrolled in Georgia's state health benefit plan, particularly biological women experiencing perimenopause or menopause, along with the state agencies and insurers that administer the plan and the physicians who prescribe the therapy.

State employees who need hormone replacement therapy during perimenopause or menopause would have a guaranteed path to coverage under their state health plan starting in 2027, rather than coverage depending on the plan's own discretionary choices, though they could still face standard deductibles, copays, and utilization review.

• Section 1 adds new Code Section 45-18-4.3 to Title 45, defining 'hormone replacement therapy' and 'state health benefit plan.'
• Subsection (b) requires the state health benefit plan to cover this therapy for biological women with perimenopause or menopause when prescribed by a licensed physician, beginning January 1, 2027.
• Subsection (c) states the new coverage is subject to the same deductibles, coinsurance, copayments, and utilization review as other similar benefits under the plan.
• Section 2 sets the Act's effective date as July 1, 2026, applying to policies issued, delivered, or renewed on or after that date.
• Section 3 repeals any conflicting laws.

1. 2026-01-27House Second Readers (Cámara de Representantes)
2. 2026-01-16House First Readers (Cámara de Representantes)
3. 2026-01-15House Hopper (Cámara de Representantes)

• Beth Camp (R, HD-135)Patrocinador principal
• Jan Jones (R, HD-047)
• Leesa Hagan (R, HD-156)
• Bethany Ballard (R, HD-147)
• Kimberly New (R, HD-040)
• Carmen Rice (R, HD-139)

• health insurance
• state employee benefits
• menopause
• women's health
• hormone therapy