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SB 501

TennCare - As introduced, authorizes the governor to expand medicaid eligibility solely for the purpose of providing treatment for a patient with a diagnosis of sickle cell disease in accordance with the federal Patient Protection and Affordable Care Act and to negotiate with the centers for medicare and medicaid services with respect to the terms of such expansion. - Amends TCA Title 4 and Title 71, Chapter 5.

114th Regular Session (2025-2026) Introduced by Raumesh Akbari

Bill authorizes Tennessee's governor to expand Medicaid solely for sickle cell disease patients using ACA provisions and negotiate terms with federal Medicare/Medicaid agencies.

Assigned to General Subcommittee of Senate Health and Welfare Committee
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Bill Summary · SB 501

Legislative bill overview

SB 501 would authorize Tennessee's governor to expand Medicaid eligibility specifically for patients diagnosed with sickle cell disease, leveraging provisions in the Affordable Care Act. The bill permits the governor to negotiate expansion terms directly with the Centers for Medicare and Medicaid Services (CMS).

Why is this important

Sickle cell disease is a serious genetic blood disorder with significant healthcare costs and complications; current Tennessee Medicaid eligibility rules may exclude some patients who need treatment. This targeted expansion would provide a pathway for affected individuals to access coverage without a broader, statewide Medicaid expansion—a politically sensitive issue in Tennessee, which has not adopted full ACA Medicaid expansion.

Potential points of contention

  • Fiscal impact uncertainty: The bill doesn't specify expected costs or federal matching rates; Tennessee would need to determine its financial obligation
  • Precedent concerns: Targeted disease-specific Medicaid expansions could create pressure for similar accommodations for other conditions, potentially complicating future budget planning
  • Federal negotiation outcomes: Success depends on CMS approval; unclear what terms the federal government would accept or whether this approach aligns with standard Medicaid expansion procedures under the ACA

Compiled from official sources — confirm details with the bill’s official record.

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