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HB 2498

TennCare - As introduced, prohibits the division from providing coverage or reimbursement for a medical procedure performed on, or administered to, an individual if the performance or administration of the procedure is for the purpose of enabling the individual to identify with, or live as, a purported identity inconsistent with the individual's sex, or treat purported discomfort or distress from a discordance between the individual's sex and asserted identity. - Amends TCA Title 71, Chapter 5.

114th Regular Session (2025-2026) Introduced by Kip Capley

Tennessee prohibits TennCare from covering gender-identity-related medical procedures, restricting Medicaid access to treatments while potentially facing constitutional challenges.

Signed by Governor.
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Bill Summary · HB 2498

Legislative bill overview

HB 2498 would prohibit Tennessee's TennCare program (the state's Medicaid system) from covering or reimbursing medical procedures related to gender identity transition or treatment of gender dysphoria. The bill has passed the Tennessee Senate and restricts coverage regardless of medical necessity or physician recommendation.

Why is this important

This directly affects healthcare access for Tennessee residents on Medicaid, including minors and low-income adults who depend on the program for medical care. It represents a significant state-level restriction on gender-related healthcare and may influence coverage decisions in other states, while also raising questions about medical autonomy and insurance regulation.

Potential points of contention

  • Medical vs. political authority: Opponents argue medical decisions should be made by physicians and patients, not legislatures, while supporters contend legislatures should control public program spending
  • Scope and definition: The bill's language around "procedures" and "purposes" is broad and could potentially affect mental health treatment, hormone therapy, or surgical interventions—critics worry about unintended consequences
  • Constitutional challenges: Multiple similar laws face federal court challenges on free speech, equal protection, and due process grounds; Tennessee may face litigation costs
  • Coverage gaps for vulnerable populations: Restricting coverage for low-income Medicaid patients while private insurers may cover procedures creates a two-tiered system based on wealth

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

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