Georgia 2025-2026 Regular Session

Georgia Senate Bill SB192 Compare Versions

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

Old	New	Differences
1	1	25 LC 46 1104
2	2	Senate Bill 192
3	3	By: Senators Esteves of the 35th, Halpern of the 39th, Jones II of the 22nd, Jackson of the
4	4	41st, Parent of the 44th and others
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	To amend Chapter 24 of Title 33 of the Official Code of Georgia Annotated, relating to
8	8	1
9	9	insurance generally, so as to require the Department of Insurance to implement a certain2
10	10	insurance affordability program in response to the pending expiration of certain Patient3
11	11	Protection and Affordable Care Act tax credits; to provide for definitions; to provide for4
12	12	automatic repeal; to provide for related matters; to provide for a short title; to provide for5
13	13	legislative findings; to provide for an effective date; to repeal conflicting laws; and for other6
14	14	purposes.7
15	15	BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:8
16	16	SECTION 1.9
17	17	This Act shall be known and may be cited as the "Georgia Health Insurance Affordability10
18	18	and Consumer Protection Act."11
19	19	SECTION 2.12
20	20	The General Assembly finds and declares that:13
21	21	(1) The enhanced premium tax credits (ePTCs) under the federal Patient Protection and14
22	22	Affordable Care Act, also known as the "ACA," have significantly increased the15
23	23	S. B. 192
24	24	- 1 - 25 LC 46 1104
25	25	affordability of health insurance for low- and middle-income Georgians, reducing the
26	26	16
27	27	state's uninsured rate;17
28	28	(2) Without Congressional action, the ePTCs will expire on December 31, 2025, and18
29	29	thousands of Georgians, particularly those earning under 250 percent of the federal19
30	30	poverty level, will experience drastic premium increases, making health insurance20
31	31	unaffordable and increasing the number of uninsured individuals;21
32	32	(3) The expiration of these tax credits would disproportionately harm rural communities,22
33	33	small business owners, gig workers, and historically marginalized populations;23
34	34	(4) Several states, including New Mexico, Colorado, and Washington, have implemented24
35	35	state based affordability programs to provide premium and cost-sharing assistance to25
36	36	mitigate rising health insurance costs;26
37	37	(5) Georgia must act swiftly to prevent gaps in affordability and ensure continued access27
38	38	to affordable health insurance for its residents; and28
39	39	(6) The purpose of this Act is to direct the Georgia Department of Insurance to establish29
40	40	a program within statutory requirements established by law to lessen the impact of the30
41	41	ePTCs' expiration, ensuring Georgians continue to have access to affordable, high quality31
42	42	health coverage in 2026.32
43	43	SECTION 3.33
44	44	Chapter 24 of Title 33 of the Official Code of Georgia Annotated, relating to insurance34
45	45	generally, is amended by adding a new Code section to read as follows:35
46	46	"33-24-59.34.
47	47	36
48	48	(a) As used in this Code section, the term:37
49	49	(1) 'Affordability program' means the program administered by the department to reduce38
50	50	the cost of health insurance for Georgians through premium assistance, cost-sharing39
51	51	reductions, reinsurance, or other financial mechanisms.40
52	52	S. B. 192
53	53	- 2 - 25 LC 46 1104
54	54	(2) 'Cost-sharing reductions' means state or federal subsidies that lower out-of-pocket41
55	55	costs, such as deductibles and copayments, for eligible individuals.42
56	56	(3) 'Federal poverty level' means the income thresholds updated annually by the United43
57	57	States Department of Health and Human Services.44
58	58	(4) 'Georgia Access' means the state based health insurance marketplace established45
59	59	under the federal Patient Protection and Affordable Care Act.46
60	60	(5) 'Qualified health plan' or 'plan' means a health insurance plan certified to be offered47
61	61	through Georgia Access.48
62	62	(b) The department shall develop an affordability program by September 30, 2025, which49
63	63	shall include:50
64	64	(1) State premium subsidies to replace or supplement federal premium tax credits for51
65	65	enrollees earning up to 400 percent of the federal poverty level;52
66	66	(2) Other cost-sharing reductions for individuals earning below 250 percent of the53
67	67	federal poverty level which may include lower deductibles, copays, and other54
68	68	out-of-pocket expenses; and55
69	69	(3) A state funded plan for individuals earning below 200 percent of the federal poverty56
70	70	level that does not require the payment of any premiums.57
71	71	(c) The department shall convene a stakeholder working group by July 1, 2025, consisting58
72	72	of consumer advocates, health insurers, healthcare providers, and employers to develop a59
73	73	consumer centered approach to the affordability program.60
74	74	(d) The department shall submit the stakeholder working group's plan for the affordability61
75	75	program to the Governor and General Assembly by September 30, 2025. Such submission62
76	76	shall include recommendations for additional ways to reduce the cost of health insurance.63
77	77	(e) The department shall promugate rules and regulations for implementation of the64
78	78	affordability program by December 1, 2025.65
79	79	(f) The department, in coordination with the Office of Planning and Budget, shall conduct66
80	80	a fiscal impact analysis by August 1, 2025, and identify sustainable funding mechanisms67
81	81	S. B. 192
82	82	- 3 - 25 LC 46 1104
83	83	for the affordability program, including appropriations by the General Assembly and68
84	84	charges on health insurers offering plans on Georgia Access. The results of such analysis69
85	85	shall be contained in a report, along with the financial structure and projected impact of the70
86	86	affordability program, which shall be submitted to the Governor and General Assembly by71
87	87	September 1, 2025.72
88	88	(g) Beginning on January 1, 2027, the department shall provide annual reports to the73
89	89	General Assembly detailing:74
90	90	(1) The number of Georgians receiving assistance through the affordability program;75
91	91	(2) The impact of the affordability program, enrollment rates, and health outcomes; and76
92	92	(3) Any recommended changes or expansions to such program.77
93	93	(h) The department shall implement consumer education and outreach initiatives to ensure78
94	94	eligible Georgians are aware of and can access the affordability program.79
95	95	(i) The department shall conduct a comprehensive evaluation in 2029 to assess the80
96	96	program's impact and determine the need for continuation or adjustments. The results of81
97	97	such evaluation shall be submitted to the Governor and General Assembly in a report by82
98	98	January 1, 2030.83
99	99	(j) The affordability program shall only become effective on January 1, 2026, in the event84
100	100	that the United States Congress allows the enhanced premium tax credits under the federal85
101	101	Patient Protection and Affordable Care Act to expire on December 31, 2025. In the event86
102	102	that the affordability program does not become effective, none of the reports required in87
103	103	this Code section shall be applicable.88
104	104	(k) This Code section shall stand repealed on December 31, 2030."89
105	105	SECTION 4.90
106	106	This Act shall become effective upon its approval by the Governor or upon its becoming law91
107	107	without such approval.92
108	108	S. B. 192
109	109	- 4 - 25 LC 46 1104
110	110	SECTION 5.
111	111	93
112	112	All laws and parts of laws in conflict with this Act are repealed.94
113	113	S. B. 192
114	114	- 5 -