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TN bill would prohibit healthcare companies that work with TennCare from giving gender-affirming care

The bill would apply regardless of whether the company covers care in Tennessee, or in another state.

NASHVILLE, Tenn. — A bill introduced in the Tennessee legislature would restrict healthcare organizations that contract with TennCare from providing gender-affirming care — regardless of whether that care is in the state.

The bill specifies companies that work with TennCare would not be allowed to provide reimbursement or coverage for gender-affirming care. It specifically restricts TennCare from working with organizations that cover gender-affirming care through insurance programs in other states.

The bill, SB 1339, was introduced by Lt. Gov. Randy McNally (R - Oak Ridge). The senator was recently the subject of "Saturday Night Live," after social media activity was revealed between him and LGBTQ personalities, including posts that included nearly-nude photos of a young gay model.

The bill would also prevent TennCare from working with companies using similar names or trademarks to provide gender-affirming care in another state. The state's Medicaid program would also be barred from working with subsidiaries of a barred healthcare organization.

"It's being introduced to reflect and protect the values of Tennesseans. The purpose of this bill is to prevent a Managed Care Organization contracted with the Bureau of TennCare from covering a medical procedure anywhere in the country, for the purpose of artificially changing a person's sex," said Representative Tim Rudd (R - Murfreesboro), who spoke about the bill during a meeting with the House Insurance Subcommittee.

He said that there were three organizations that would be affected by the bill. He also said that the bill would not prohibit or discourage counseling.

Representative Bo Mitchell (D - Nashville) asked how the bill would affect the state's responsibilities under the federal 14th Amendment, which requires equal protection under the law. The state's counsel said he did not believe there was an equal protection issue. He also said that there could be a possible commerce clause issue.

"TennCare already does not allow for gender-affirming serves through the healthcare plans that are provided for Tennesseans ... This could lead to not having any managed care organizations who are willing to contract with the state, since these organizations need to comply with the Affordable Care and Medicaid Acts," said Ray Holloman from the Tennessee Equality Project. 

TennCare would have 30 days after the bill takes effect to change contracts between organizations. Healthcare companies would also need to stop providing gender-affirming care in other states and prove it to the state within 120 days after the bill takes effect.

The Department of Commerce and Insurance would also periodically review healthcare organizations to make sure they stay in compliance with the bill. If it finds violations, it would need to notify the organization and TennCare. After 90 days, the healthcare organization would be able to contest the finding.

According to the bill, organizations that could be affected include behavioral health organizations, health insurance companies and health maintenance organizations. It also specifically prevents those companies from providing gender-affirming care through surgeries or prescribing minors drugs that suppress hormone production.

Its House version, HB 1215, was introduced by Speaker Cameron Sexton. If passed, the bill would take effect immediately. It is expected to be discussed in the House Finance, Ways and Means Subcommittee on Wednesday.

The bill's fiscal note said it could "result in changes to contract structures and negotiated prices with the TennCare program which would result in an increase in state expenditures."

"What is the gain of this bill except to hurt Tennesseans who want to be able to use the insurance they pay for to provide services they need? This bill takes away necessary healthcare from transgender Tennesseans, like me, while other Tennesseans can receive the care they need," said Holloman. "This is just another prong on the attack against my community."

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