"PeachCare Plus Act of 2025"; enact
SB 50, titled the “PeachCare Plus Act of 2025,” would create a new pathway for Georgia to expand Medicaid-like coverage for adults with incomes below 138% of the federal poverty level. Instead of a traditional Medicaid expansion, the bill directs the Department of Community Health to seek a federal waiver and related amendments to enroll eligible low-income individuals in qualified health plans on the state or federal marketplace, with premiums and other direct costs fully paid for by the program. The bill also conditions implementation on the federal matching rate remaining at or above 90% and ties the program to the expiration of the state’s current waiver or any extension granted before December 31, 2025.
The bill would amend Georgia law to carve out an exception to the existing prohibition on expanding Medicaid eligibility without prior legislative approval, specifically for the PeachCare Plus waiver request submitted between July 1, 2025, and October 31, 2026. It would also create the Advisory Commission on the PeachCare Plus Program, an 11-member bipartisan legislative-executive body charged with reviewing the waiver, advising on implementation, and issuing a public report. In addition, any state savings generated by the program would be deposited into the Indigent Care Trust Fund and used for costs associated with implementation.
The bill’s stated policy goal is to increase access to healthcare for low-income Georgians while preserving fiscal stability and avoiding tax increases. It reflects an effort to use federal waiver authority and marketplace-based coverage rather than a conventional Medicaid expansion. If enacted, it would change state law governing Medicaid expansion approvals, authorize a new waiver application process, and create ongoing legislative oversight of the program.
Overall sentiment in the bill text is supportive of expansion, but with strong emphasis on fiscal caution, bipartisan cooperation, and legislative control. The findings section frames the proposal as a way to improve healthcare access, attract providers, and maintain fair reimbursement while protecting the state budget. Because no committee transcripts or votes were provided, there is no recorded debate or vote history to indicate broader legislative sentiment beyond the bill’s own framing.
The main points of contention implied by the bill are likely to be the use of a waiver-based marketplace model instead of traditional Medicaid expansion, the requirement that federal matching funds remain at or above 90%, and the degree of legislative oversight versus executive administration. The bill also appears designed to avoid provisions that could reduce federal approval chances, suggesting sensitivity to federal waiver politics and to disagreements over how Georgia should structure coverage for low-income adults.
SB 50 would amend Georgia’s Medicaid statutes in Title 49 to authorize a new waiver-based coverage expansion program and create a statutory exception to the existing legislative-approval restriction on Medicaid expansion. It would establish the PeachCare Plus Program, require a federal waiver submission, create an advisory commission, and direct any state savings from the program into the Indigent Care Trust Fund for implementation-related costs. The bill would affect the Department of Community Health, the Office of the Commissioner of Insurance, the General Assembly, and low-income adults under 138% of the federal poverty level.
The bill is framed in strongly favorable terms toward expanding coverage, with repeated emphasis on improving access to healthcare, supporting providers, and helping low-income Georgians. At the same time, the proposal is cautious and conditional, stressing fiscal stability, no tax increases, bipartisan design, and federal approval thresholds. Because no committee discussion or votes are included, the available record shows the sponsor’s supportive intent but not any recorded legislative opposition or endorsement beyond the text itself.
The likely areas of contention are whether Georgia should expand coverage at all, whether a waiver-based marketplace model is preferable to traditional Medicaid expansion, and whether the state should commit to a program only if the federal match stays at or above 90%. Another likely issue is governance: the bill gives the General Assembly an ongoing oversight role through a bipartisan commission, which may appeal to supporters of legislative control but concern those favoring administrative flexibility. The bill’s reliance on federal waiver approval also creates uncertainty and may draw criticism from those skeptical of federal conditions or the feasibility of implementation.