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HB 1101

TennCare - As introduced, authorizes the governor to expand medicaid pursuant to the federal Patient Protection and Affordable Care Act; authorizes the governor to negotiate with the federal centers for medicare and medicaid services to determine the terms of the expansion. - Amends TCA Title 71, Chapter 5.

114th Regular Session (2025-2026) Introduced by Gabby Salinas

Bill authorizes Tennessee governor to negotiate and implement Medicaid expansion under the ACA, potentially extending coverage to 275,000 currently uninsured low-income adults.

Action Def. in s/c Tenncare Subcommittee to First Calendar of 2026
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Bill Summary · HB 1101

Legislative bill overview

HB 1101 would authorize Tennessee's governor to expand Medicaid under the Affordable Care Act and negotiate terms directly with federal Centers for Medicare and Medicaid Services. Currently, Tennessee has not adopted Medicaid expansion, leaving approximately 275,000 low-income adults without coverage through that program.

Why is this important

Medicaid expansion affects healthcare access for working-age adults earning up to 138% of the federal poverty line. The decision impacts hospital finances, state budget obligations, uninsured rates, and federal funding that flows to healthcare providers and state coffers.

Potential points of contention

  • State fiscal responsibility: Requires determining what state cost-sharing obligations Tennessee would accept; the federal government currently covers 90% but this could change
  • Work requirements and conditions: Debate over whether expansion should include work mandates or other eligibility requirements that differ from standard ACA provisions
  • Ideological divide: Conservative lawmakers may oppose expanding government health programs, while expansion advocates argue it addresses a coverage gap and supports rural hospitals financially

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

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