Healthcare (Medicaid)

SB 2118 would restrict Tennessee's Medicaid program (TennCare) from covering or reimbursing medical procedures intended to help an individual live as a gender inconsistent with their sex assigned at birth or to treat gender dysphoria. The bill defines "medical procedure" to include surgeries and the prescription of puberty blockers or hormones. Exceptions are allowed for procedures treating congenital defects, precocious puberty, or physical injuries (but not gender dysphoria), and for existing treatments started before the law's effective date (with coverage ending March 31, 2027). The law would take effect July 1, 2026.

SB 436 requires Tennessee's Medicaid program (TennCare) to consider using biosimilar drugs - cost-saving, FDA-approved versions of biologic medications - as part of its drug coverage strategy. It also allows health insurers to require patients to try a biosimilar before covering a branded drug, and directs the state's pharmacy advisory committee to factor biosimilar use into recommendations for the state drug formulary. The bill amends multiple Tennessee Code sections governing drug coverage, pharmacy practices, and formulary decisions. These changes aim to reduce prescription drug costs by expanding the use of biosimilars while maintaining FDA safety and efficacy standards. The bill directly affects TennCare patients, health insurers, and the state's drug formulary decision-making process.