House Speaker’s proposal to block TennCare contracts over trans health stopped in the Senate

By: - March 23, 2023 10:00 am
House Speaker Cameron Sexton, far right, with House Republican Caucus Chair Jeremy Faison to his left. (Photo: John Partipilo)

House Speaker Cameron Sexton, far right, with House Republican Caucus Chair Jeremy Faison to his left. (Photo: John Partipilo)

Legislation seeking to block Tennessee’s Medicaid program from contracting with any insurance company that covers gender transition health care in another state has stalled in the Senate. 

House Bill 1215, sponsored by House Speaker Cameron Sexton and Lt. Gov. Randy McNally, would eliminate all of TennCare’s contracts with managed care organizations covering gender affirming care in other states. BlueCross BlueShield, United Healthcare and Anthem are currently allowed to sell TennCare plans and all three cover gender transitions in other states — but not through TennCare. 

TennCare covers over 1.7 million income-qualifying Tennesseans, half of which are children. The bill carried a critical fiscal note, which said TennCare would have to eliminate its current managed care organization system, “forced to switch to a fee-for-service model.”

A fee-for-service model means health care providers would bill TennCare for every test, visit or procedure. Critics argue this model encourages doctors to order more tests and procedures regardless of the outcome.

Sexton, R-Crossville, said he disagreed with the idea that other insurance companies couldn’t step in.

A bill to prevent insurance companies from participating in TennCare if they cover transgender care in other states faces legal concerns, as the federal government must approve changes to the state’s Medicaid program.

“There would be a lot,” Sexton said. “There are a good dozen that could provide those services.”

Sexton’s office did not respond to a question asking for the names of insurance companies that could provide this coverage. Most major insurance companies cover gender transition care in other states. 

There were also questions about the bill’s legality because the federal government must approve all TennCare changes. 

The Senate has not moved the bill to a committee, and Adam Kleinheider, Lt. Gov. McNally’s spokesperson, said he has “no plans to run the bill in the Senate.”

The House deferred action on it to the end of the legislative session.

The bill comes as McNally, R-Oak Ridge, is under intense scrutiny over LGBTQ issues. The lieutenant governor used his official Instagram account to like and comment supportive messages on racy photos of a young gay Knoxville man. This led to a vote of confidence from the Senate Republican Caucus where he prevailed. 

Tennessee Republicans have passed several bills this year targeting the LGTBQ community. Legislation signed into law in 2023 included

banning gender-affirming care for minors and restricting drag shows that children can attend. 

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Adam Friedman
Adam Friedman

Adam Friedman is a reporter with the Tennessee Lookout. He has a particular love for data and using numbers to explain all kinds of topics. If you have a story idea, he'd love to hear it. Email him at [email protected] or call him at 615-249-8509.