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