Healthcare

HB 18 proposes a temporary health coverage program for Tennesseans who don't qualify for existing TennCare or CoverKids. It would provide up to 60 months of medical assistance (resetting at age 21) to individuals under 21 with income ≤138% of the federal poverty level, or adults ≥21 with similar income, subject to strict 12-month/24-month usage limits. The program requires a federal waiver by December 2025, uses 90% federal/10% state funding, and explicitly states it does not replace eligibility for regular programs (benefits pause if enrollment becomes possible). The bill failed in the Insurance Committee on March 5, 2025, and remains inactive.

SB 610 requires TennCare to cover continuous glucose monitors (CGMs) for eligible members with specific diabetes conditions. It directly affects TennCare enrollees diagnosed with Type 1 diabetes, gestational diabetes, or Type 2 diabetes meeting documented criteria like frequent low blood sugar episodes, high A1C levels, or hospitalizations related to diabetes complications. The bill mandates coverage only when prescribed by an endocrinologist or diabetes specialist confirming the member meets the eligibility requirements. The law takes effect January 1, 2026.