Georgia 2025-2026 Regular Session

Georgia House Bill HB258 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	25 LC 52 0689
2	2	House Bill 258
3	3	By: Representatives Buckner of the 137
4	4	th
5	5	, Holcomb of the 101
6	6	st
7	7	, Hugley of the 141
8	8	st
9	9	, Mitchell
10	10	of the 88
11	11	th
12	12	, Bennett of the 94
13	13	th
14	14	, and others
15	15	A BILL TO BE ENTITLED
16	16	AN ACT
17	17	To amend Chapter 4 of Title 49 of the Official Code of Georgia Annotated, relating to public
18	18	1
19	19	assistance, so as to establish the PeachCare for Adults Program; to provide for a short title;2
20	20	to provide for definitions; to provide for submission of federal waiver requests; to provide3
21	21	for requirements; to provide for providers; to provide for administration of the program; to4
22	22	provide for rules and regulations; to provide for related matters; to repeal conflicting laws;5
23	23	and for other purposes.6
24	24	BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:7
25	25	SECTION 1.8
26	26	Chapter 4 of Title 49 of the Official Code of Georgia Annotated, relating to public assistance,9
27	27	is amended by adding a new article to read as follows:10
28	28	"ARTICLE 10
29	29	11
30	30	49-4-200.12
31	31	This article shall be known and may be cited as the 'PeachCare for Adults Act.'13
32	32	H. B. 258
33	33	- 1 - 25 LC 52 0689
34	34	49-4-201.14
35	35	As used in this article, the term:15
36	36	(1) 'Board' means the Board of Community Health.16
37	37	(2) 'Department' means the Department of Community Health.17
38	38	(3) 'Eligible person' means an individual between and including the ages of 18 and 6418
39	39	years who has income less than or equal to 133 percent of the federal poverty level and19
40	40	who is not enrolled in Medicaid.20
41	41	(4) 'Enrolled person' means an eligible person who is enrolled in the PeachCare for21
42	42	Adults Program.22
43	43	(5) 'Medicaid' means the program of medical assistance conducted pursuant to Article 723
44	44	of this chapter, the 'Georgia Medical Assistance Act of 1977.'24
45	45	(6) 'PeachCare for Adults Program' or 'program' means the program for health coverage25
46	46	established pursuant to this article.26
47	47	49-4-202.27
48	48	(a) In order to implement the PeachCare for Adults Program pursuant to this article, the28
49	49	board shall submit any waiver request to the Centers for Medicare and Medicaid Services29
50	50	of the United States Department of Health and Human Services pursuant to Section 111530
51	51	of the federal Social Security Act necessary to add coverage for adults between and31
52	52	including the ages of 18 and 64 years with incomes less than or equal to 133 percent of the32
53	53	federal poverty level.33
54	54	(b) The board shall take all necessary steps to secure the enhanced federal match available34
55	55	under the applicable provisions of Section 2001 of the federal Patient Protection and35
56	56	Affordable Care Act (P.L. 111-148).36
57	57	(c) The board shall submit all necessary waiver requests pursuant to this Code section no37
58	58	later than January 1, 2026.38
59	59	H. B. 258
60	60	- 2 - 25 LC 52 0689
61	61	49-4-203.39
62	62	(a) The department shall establish the PeachCare for Adults Program. Such program shall40
63	63	be implemented no later than January 1, 2027.41
64	64	(b) The program shall include, at a minimum:42
65	65	(1) The same coverage provided to recipients of Medicaid, including, but not limited to,43
66	66	the essential health benefits as provided in 42 U.S.C. Section 18022;44
67	67	(2) Any healthcare benefits specified in the federal Patient Protection and Affordable45
68	68	Care Act (P.L. 111-148) with respect to health insurance coverage or health insurance46
69	69	products;47
70	70	(3) Coverage for all vaccinations recommended for children and for adults by the48
71	71	Advisory Committee on Immunization Practices of the federal Centers for Disease49
72	72	Control and Prevention; and50
73	73	(4) Coverage for the treatment of mental health and substance use disorders at least as51
74	74	extensive as that provided for the treatment of physical illnesses.52
75	75	(c) Only eligible persons may enroll in the program.53
76	76	(d) The program shall include an affordability scale for premium based on income:54
77	77	(1) For an enrolled person with an income greater than 100 percent of the federal poverty55
78	78	level, the premium shall be the amount of premium for an enrolled person with an56
79	79	equivalent income to enroll in the second-lowest cost silver-level plan offered in the57
80	80	state's health insurance marketplace or 2 percent of an enrolled person's gross income,58
81	81	whichever is lesser; and59
82	82	(2) An enrolled person with an income less than or equal to 100 percent of the federal60
83	83	poverty level shall not be charged a premium.61
84	84	(e) Enrollment in the program shall not be contingent on work requirements.62
85	85	(f) The department shall publish in print or electronically an annual report, a copy of which63
86	86	shall be provided to the Governor, setting forth the number of enrolled persons in the64
87	87	program, the health services provided, the amount of money paid to providers, and other65
88	88	H. B. 258
89	89	- 3 - 25 LC 52 0689
90	90	pertinent information with respect to the administration of the program. The department66
91	91	shall not be required to distribute copies of the annual report to the members of the General67
92	92	Assembly but shall notify such members of the availability of the report in the manner68
93	93	which it deems to be most effective and efficient.69
94	94	49-4-204.70
95	95	(a) Any healthcare provider that is a Medicaid provider shall be deemed to be a provider71
96	96	in the program.72
97	97	(b) Healthcare provider reimbursement rates shall be based on the Medicaid fee schedule. 73
98	98	Contingent upon available funds, the department may increase reimbursement rates for74
99	99	healthcare providers.75
100	100	(c) The department, through the Department of Administrative Services or any other76
101	101	appropriate entity, may contract for any or all of the following: the collection of premiums,77
102	102	processing of applications, verification of eligibility, outreach, data services, and78
103	103	evaluation, provided that such contracting achieves administrative or service cost79
104	104	efficiency. The department, and other state agencies, as appropriate, shall provide80
105	105	necessary information to any entity which has contracted with the department for services81
106	106	related to the administration of the program upon request.82
107	107	(d) All state agencies shall cooperate with the department and its designated agents by83
108	108	providing requested information to assist in the administration of the program.84
109	109	(e) As necessary to enforce the provisions of this article, the department or its duly85
110	110	authorized agents may submit to the state revenue commissioner the names of applicants86
111	111	for healthcare benefits or payments provided under this article, as well as the relevant87
112	112	income threshold specified therein. If the department elects to contract with the state88
113	113	revenue commissioner for such purposes, the state revenue commissioner or his or her89
114	114	agents or employees shall notify the department of whether or not each submitted90
115	115	applicant's income exceeds the relevant income threshold provided. The department shall91
116	116	H. B. 258
117	117	- 4 - 25 LC 52 0689
118	118	pay the state revenue commissioner for all costs incurred by the Department of Revenue92
119	119	pursuant to this subsection. No information shall be provided by the Department of93
120	120	Revenue to the department without an executed cooperative agreement between such94
121	121	departments. Any tax information secured from the federal government by the Department95
122	122	of Revenue pursuant to express provisions of Section 6103 of the Internal Revenue Code96
123	123	shall not be disclosed by the Department of Revenue pursuant to this subsection. Any97
124	124	person receiving any tax information under the authority of this subsection is subject to the98
125	125	provisions of Code Section 48-7-60 and to all penalties provided under Code Section99
126	126	48-7-61 for unlawful divulging of confidential tax information.100
127	127	49-4-205.101
128	128	The department shall be authorized to promulgate rules and regulations consistent with and102
129	129	necessary to carry out the provisions of this article."103
130	130	SECTION 2.104
131	131	All laws and parts of laws in conflict with this Act are repealed.105
132	132	H. B. 258
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