SB 50: "PeachCare Plus Act of 2025"; enact

Georgia law currently blocks the state from expanding Medicaid eligibility without the General Assembly's approval first. This bill grants that approval for a specific plan: a waiver request, due by October 31, 2026, asking the federal government to let Georgia enroll low-income residents earning under 138 percent of the federal poverty level into private health plans sold on the state's insurance marketplace, with their premiums and other costs fully covered. The program would only continue if the federal government keeps paying at least 90 percent of the cost. Any state savings from the change would go into the Indigent Care Trust Fund to cover added expenses. The bill also creates an 11 member Advisory Commission on the PeachCare Plus Program, made up of legislators and the state health commissioner, to help write the waiver request, oversee its rollout, and issue a public report after it is submitted.

• Authorizes the Department of Community Health to submit a federal waiver request by October 31, 2026 creating the PeachCare Plus Program to cover people earning up to 138 percent of the federal poverty level.
• Requires the covered population to be enrolled in private health plans on Georgia's insurance marketplace (or the federal marketplace) rather than traditional Medicaid, with premiums fully paid.
• Limits the program to periods when the federal government's share of Medicaid costs for Georgia stays at or above 90 percent.
• Directs any state savings from the program into the Indigent Care Trust Fund to cover related implementation costs.
• Creates an 11-member Advisory Commission on the PeachCare Plus Program, chaired by the health commissioner, with 5 House members and 5 Senate members, to help draft the waiver and oversee the program long-term.
• Counts this Act itself as the legislature's required notification and approval for expanding Medicaid eligibility under existing Georgia law (O.C.G.A. §§ 49-4-142.1 and 49-4-142.2).

Low-income Georgians earning up to 138 percent of the federal poverty level who currently lack coverage, the Department of Community Health, the Commissioner of Insurance's office, state legislators appointed to the new advisory commission, and healthcare providers who would contract with the private insurance plans covering this population.

If the federal government approves the waiver, tens of thousands of low-income Georgians could gain health coverage through subsidized private insurance rather than traditional Medicaid, but the coverage would end if federal funding support drops below 90 percent, and full rollout depends on federal approval and the expiration of Georgia's current Medicaid waiver.

• Section 3 amends O.C.G.A. § 49-4-142.2 to carve out an exception letting the department submit this specific waiver request between July 1, 2025, and October 31, 2026 without needing separate future legislative approval.
• Section 4 creates new Code Section 49-4-142.6, requiring the department to submit the waiver request by October 31, 2026 covering people under 138 percent of the federal poverty level through marketplace health plans with fully paid premiums.
• Section 4 ties the program's continuation to the federal government maintaining at least a 90 percent reimbursement rate for Georgia's Medicaid costs (new Code Section 49-4-142.6(c)).
• Section 4 directs state savings from the program into the Indigent Care Trust Fund (new Code Section 49-4-142.6(d)).
• Section 4 creates new Code Section 49-4-142.7 establishing the 11-member Advisory Commission on the PeachCare Plus Program, its bipartisan makeup, quarterly meeting requirement, and duty to issue a public report within 30 days of the waiver's submission.
• Section 5 declares that this Act itself satisfies the legislature's notification and approval requirements under existing Georgia Medicaid law.
• Section 4 specifies the new waiver would take effect only once the state's current Medicaid waiver, or any extension granted before December 31, 2025, expires.

1. 2025-01-29Senate Read and Referred (Senado)
2. 2025-01-28Senate Hopper (Senado)

• David Lucas (D, SD-026)Patrocinador principal
• Carden Summers (R, SD-013)
• Russ Goodman (R, SD-008)
• Harold Jones (D, SD-022)
• Elena Parent (D, SD-044)
• Jason Esteves (D, SD-035)
• Kim Jackson (D, SD-041)
• Sonya Halpern (D, SD-039)
• Ed Harbison (D, SD-015)
• Emanuel Jones (D, SD-010)
• Gail Davenport (D, SD-017)
• Kenya Wicks (D, SD-034)
• Josh McLaurin (D, SD-014)
• RaShaun Kemp (D, SD-038)
• Tonya Anderson (D, SD-043)
• Freddie Sims (D, SD-012)
• Sally Harrell (D, SD-040)
• Nikki Merritt (D, SD-009)
• Nan Orrock (D, SD-036)
• Derek Mallow (D, SD-002)
• Sam Watson (R, SD-011)
• Sheikh Rahman (D, SD-005)
• Randal Mangham (D, SD-055)

• Medicaid expansion
• health insurance coverage
• PeachCare Plus
• Indigent Care Trust Fund
• state health policy oversight