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HB 258

PeachCare for Adults Act; enact

2025-2026 Regular Session Introduced by Karen Bennett and 5 co-sponsors

House Bill 258 creates the PeachCare for Adults Program, offering health coverage to uninsured Georgians aged 18-64 with incomes up to 133% of poverty, enhancing access to care.

House Second Readers
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Bill Summary · HB 258

Summary of House Bill 258: PeachCare for Adults Act

Bill Number: HB 258
Introduced: February 4, 2025
Current Status: House Second Readers
Classification: Bill

Purpose and Intent

House Bill 258, titled the PeachCare for Adults Act, aims to establish a new health coverage program for adults in Georgia. The primary goal of this legislation is to provide health insurance to individuals aged 18 to 64 who have incomes at or below 133% of the federal poverty level and are not currently enrolled in Medicaid.

Key Provisions

Establishment of the Program

  • Program Name: The program will be known as the PeachCare for Adults Program.
  • Eligibility: Individuals aged 18-64 with incomes ≤ 133% of the federal poverty level.
  • Enrollment: Enrollment is open to eligible persons without work requirements.

Coverage and Benefits

  • The program will offer coverage equivalent to Medicaid, including:
    • Essential health benefits as defined in the Affordable Care Act (ACA).
    • Coverage for vaccinations recommended by the CDC.
    • Comprehensive mental health and substance use disorder treatment.

Financial Aspects

  • Premium Structure:
    • Individuals with incomes > 100% of the federal poverty level will pay a premium based on the lesser of:
    • The premium for the second-lowest cost silver-level plan in the state marketplace.
    • 2% of their gross income.
    • Individuals with incomes ≤ 100% of the federal poverty level will not be charged a premium.

Administration and Reporting

  • The Department of Community Health will oversee the program's implementation and administration.
  • An annual report will be published detailing enrollment numbers, services provided, and financial expenditures.

Federal Waiver Requests

  • The Board of Community Health is tasked with submitting necessary waiver requests to the Centers for Medicare and Medicaid Services (CMS) by January 1, 2026, to secure federal funding and compliance.

Implementation Timeline

  • The program is scheduled to be implemented by January 1, 2027.

Impact

Who Will Be Affected?

  • Eligible Individuals: Adults aged 18-64 with low income who are currently uninsured.
  • Healthcare Providers: Providers that are part of the Medicaid system will also be included in the PeachCare for Adults Program, with reimbursement rates based on the Medicaid fee schedule.

Administrative Efficiency

  • The Department of Community Health may contract with external entities for various administrative functions, aiming to enhance efficiency in program management.

Conclusion

House Bill 258 represents a significant step towards expanding healthcare access for low-income adults in Georgia. By establishing the PeachCare for Adults Program, the state aims to provide comprehensive health coverage, reduce the number of uninsured individuals, and align with federal healthcare initiatives. The bill is currently under consideration in the House, having passed the first and second readers.

Compiled from official sources — confirm details with the bill’s official record.

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