Tennessee House Bill HB1101

Tennessee 2025-2026 Regular Session

• Introduced: 2/5/25
• Refer: 2/10/25
• Failed: 2/17/26

Caption

AN ACT to amend Tennessee Code Annotated, Title 71, Chapter 5, relative to medicaid expansion.

Summary

HB1101 amends Tennessee law governing Medicaid expansion. The bill deletes and replaces Tennessee Code Annotated section 71-5-126 to expressly authorize the governor to expand Medicaid eligibility in accordance with the federal Affordable Care Act. It also authorizes the governor to negotiate with the federal Centers for Medicare and Medicaid Services over the terms of any expansion. In practical terms, the bill would give the executive branch clear statutory authority to pursue Medicaid expansion and to bargain with CMS on implementation details. The measure is framed as an immediate act taking effect upon becoming law, reflecting an intent to enable prompt action if enacted.

Impact

If enacted, HB1101 would change Title 71, Chapter 5 of the Tennessee Code by replacing the existing Medicaid-expansion provision with broader authorization for the governor. It would affect state Medicaid policy, the governor’s administrative authority, and the state’s relationship with federal Medicaid administrators, particularly CMS. The bill would not itself expand eligibility directly, but it would remove legal barriers and affirm executive power to negotiate expansion terms under the Affordable Care Act.

Sentiment

The available voting history suggests the bill faced opposition in committee, as it failed in the House TennCare Subcommittee by a 2-4 vote. No committee transcript is available, so there is no recorded floor or committee debate to show broader support or objections. Based on the bill’s subject matter and the failed vote, the measure appears to have been controversial rather than broadly accepted.

Contention

The main point of contention is Medicaid expansion itself, including whether Tennessee should authorize and pursue expansion under the Affordable Care Act. Supporters would likely view the bill as giving the governor flexibility to secure federal funding and broaden coverage, while opponents may object to expanding Medicaid eligibility, the fiscal and policy implications for the state, or granting the governor additional negotiating authority. The subcommittee defeat indicates that these concerns outweighed support at that stage.