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SB 1356

TennCare - As introduced, directs the governor to seek a new TennCare waiver within 180 days of the effective date of this act to provide medical assistance coverage for individuals whose gross annual income is equal to or less than 138 percent of the federal poverty level; clarifies that the amendment takes effect upon federal approval. - Amends TCA Title 71, Chapter 5.

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

Bill directs Tennessee governor to seek federal waiver expanding TennCare Medicaid coverage to low-income residents earning up to 138% of poverty level within 180 days.

Passed on Second Consideration, refer to Senate Health and Welfare Committee
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Bill Summary · SB 1356

Legislative bill overview

SB 1356 directs Tennessee's governor to request a federal waiver within 180 days to expand TennCare (Tennessee's Medicaid program) to cover individuals earning up to 138% of the federal poverty level. The expansion would take effect only upon federal approval of the waiver request.

Why is this important

This bill addresses healthcare coverage gaps for low-income Tennesseans who currently fall outside TennCare eligibility. The 138% poverty threshold aligns with the Medicaid expansion threshold established by the Affordable Care Act, which Tennessee has not adopted, meaning approximately 275,000+ uninsured state residents could gain coverage if approved.

Potential points of contention

  • Federal approval uncertainty: The waiver requires federal CMS approval, which is not guaranteed and depends on the current federal administration's Medicaid policies
  • State budget impact: While federal funding typically covers expansion costs initially, long-term state expenditures could increase significantly depending on waiver terms and future federal matching rates
  • Political ideology: Medicaid expansion remains contentious in Tennessee, with some legislators opposing federal health program participation and others supporting coverage expansion

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

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