It seems the 2023 legislative session focused on how not to provide health care for Tennesseans — especially when it comes to the type of care that GOP leaders deem immoral.
In February, Gov. Bill Lee signed into law a bill effectively banning gender-affirming care for minors, following through on a promise from legislators who took the stage at a Daily Wire-led anti-trans rally in the fall. The American Civil Liberties Union and others have since sued the state on behalf of trans youth and their families, including one Nashville family, and last week the U.S. Department of Justice asked the U.S. District Court for Middle Tennessee to issue an immediate order to prevent the law from going into effect. Republican legislators also attempted to take the so-called slate of hate directed toward transgender people one step further with a bill that would prohibit TennCare from contracting with insurers that cover gender-affirming treatment. That effort failed.
Lawmakers also kept promises to anti-abortion group Tennessee Right to Life. A bill originally introduced to allow physicians to use “good faith judgment” in performing abortions was edited to compromise (their words, not mine) with Tennessee Right to Life. What’s left is a narrow carve-out for physicians to use “reasonable medical judgment” to prevent death of a pregnant patient or spare them from the irreversible, severe impairment of a major bodily function. Before this law, there was no exception in the abortion ban, only an affirmative defense in court for doctors who performed the procedure to save the life of a patient. It’s a small step in the right direction, physicians tell the Scene, but they preferred the original language that allowed “good faith judgment.”
In addition, despite public approval for abortion-ban exceptions in the case of rape and incest, a bill that would allow exactly that failed.
On the maternal health front, the state legislature voted down a bill that would allow for people on TennCare to have doula services covered, but did establish a doula advisory committee to explore reimbursement rates for doulas. It’s something health advocacy organization Healthy and Free Tennessee sees as a step in the right direction on the path to getting necessary infrastructure for pregnant people to be covered by TennCare.
Going into the session, TennCare renewals were front-of-mind. The organization started its first renewal process in more than three years on April 1. In the next 12 months, more than 300,000 Tennesseeans will lose coverage because they are no longer eligible, or as has happened previously, because of clerical errors. The first Tennesseans to lose coverage will be removed from the roll for lack of response on June 12. The latest waiver the Centers for Medicare and Medicaid Services granted to Tennessee allows those reported under 100 percent federal poverty level as of March 2019 to be automatically renewed if TennCare cannot find recent income data for them. In addition, TennCare will renew certain individuals’ eligibility based on SNAP enrollment or Temporary Assistance for Needy Families eligibility.
New health commissioner Ralph Alvarado was relatively quiet throughout the session, only showing face to not answer questions about refusing to take Centers for Disease Control and Prevention funding for HIV prevention centers. In a rare move, the CDC ultimately agreed to bypass the state and give $4 million (the original grant value was around $9 million total) directly to the United Way of Greater Nashville.
This year, the Republican supermajority showed its constituents that they don’t like abortion, HIV prevention or for youth to have access to gender-affirming care. It remains unclear what they do like.
With national attention trained on Tennessee, the state legislature passed laws punishing Metro and restricting gender-affirming care — but nothing on gun control
