Tennessee House passes measure barring TennCare providers from denying care over vaccine choice after heated debate

The Tennessee House on Thursday passed a bill that bars health-care providers who accept TennCare from denying treatment to patients because of their vaccination choices. Representative Charlie Karringer, the bill—s sponsor, moved to substitute and conform to Senate Bill 13-89 and pressed for its passage on third and final consideration.

Supporters said the measure is narrowly drawn to apply only to TennCare — the state—s Medicaid program — and is intended to protect low-income patients from being refused care. "This is only for those patients who are on TennCare," Representative Karringer said, adding the bill includes exemptions for transplants, oncology patients and others who are immunocompromised. She said the goal is to preserve the patient-provider relationship and ensure physicians will have the ability to treat TennCare patients without denying payment to providers who see them.

Opponents raised public-health and practical concerns. Representative Vincent Mitchell warned the bill would "continue to create harm mostly to children" and said the state has seen a decline in some childhood immunization rates. "Bills like this are going to continue to create this harm, mostly to children," Mitchell said. Representative V—n Salinas said infectious diseases "don't care if you're a TennCare patient or not," and argued the measure risks weakening herd immunity and placing transplant, oncology and other immune-compromised patients at greater risk.

Other members asked how the policy would operate in day-to-day clinical settings. Representative Todd and Representative Totten questioned whether clinics could adopt policies that restrict unvaccinated patients from waiting rooms to protect vulnerable patients and whether such policies would jeopardize TennCare payments for the provider. Karringer and others replied that the bill does not penalize physicians for maintaining clinic policies and that TennCare reimbursement rules, along with the exemptions in the amendment, would cover medical-sensitivity situations.

Representative Karringer said nurses— and physicians— associations helped craft amendments to address transplant patients, oncology patients and those with religious or moral objections. "We have worked with all of them that they should be covered," Karringer said, citing changes the sponsors added after stakeholder input.

The floor debate lasted nearly an hour and included sharp exchanges about public-safety trade-offs, the state—s vaccination history and the practical limits of controlling infectious disease exposure in mixed medical settings. Representative Salinas pressed colleagues to support Medicaid expansion to increase access to care, saying more people with coverage would reduce the kinds of conflicts the bill attempts to address.

After debate the House adopted the committee-substitute and passed the measure on third and final consideration. The bill passed with the required legislative majority and was recorded as approved on the House floor.