Healthcare (Medicaid)

SB 851 would authorize Tennessee's governor to expand Medicaid coverage for low-income residents under the federal Affordable Care Act (ACA), directly affecting thousands of Tennesseans currently ineligible for Medicaid. The bill specifically allows the governor to negotiate the terms of this expansion with federal officials at the Centers for Medicare and Medicaid Services (CMS). It amends state law to remove barriers to implementing the ACA's Medicaid expansion, which would extend health coverage to more adults with low incomes. The bill does not create new funding but provides the legal framework for the state to join the federal Medicaid expansion program.

SB 1356 directs Tennessee's governor to apply for a new federal waiver within 180 days of the bill's effective date. This waiver would expand TennCare coverage to cover individuals with gross annual incomes at or below 138% of the federal poverty level. The coverage would begin only after federal approval, as specified in the bill. The bill amends Tennessee Code Annotated, Title 71, Chapter 5, to implement this change.

HB 1104 removes a requirement that the Tennessee governor must obtain approval from the state legislature before making decisions about expanding Medicaid enrollment (TennCare). This change directly affects the governor's authority regarding Medicaid program expansions, eliminating the need for legislative authorization. The bill amends Tennessee Code Annotated Title 71 by deleting Section 71-5-126, which previously mandated that legislative approval be secured for such decisions. The policy change allows the governor to act independently on Medicaid expansion without prior consent from the General Assembly.

SB 403 requires Tennessee healthcare facilities receiving public funds (like Medicaid reimbursements) to cover uncompensated care costs to cancel debt equal to that funding for eligible patients. Facilities must notify patients whose debt is canceled and cannot pursue legal action for the canceled amount. The bill also mandates annual reports from the Department of Health and TennCare on uncompensated care payments to the legislature. It directly affects hospitals receiving public funds for charity care and patients with outstanding medical debt.

SB 334, the "Tennessee Medicaid Modernization and Access Act of 2025," requires TennCare to update reimbursement rates for key healthcare services - including obstetrics/gynecology, primary care, outpatient mental health, and substance use disorder treatment - to match either the Medicare fee schedule or average commercial rates (whichever is higher) starting in 2025. This directly affects Medicaid beneficiaries (by improving access to these services) and healthcare providers (by ensuring fairer payments). The bill mandates annual rate reviews to maintain alignment with federal guidelines and allows providers to request administrative hearings for payment disputes. It also includes provisions for quality-based incentive payments in underserved areas and requires annual reports on fiscal impacts and service access improvements.