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House Bill 13-93 to expand TennCare fails in subcommittee after debate
Summary
After more than an hour of debate about coverage gaps, federal matching funds and rural hospital closures, the TennCare Subcommittee voted 2–5 to defeat House Bill 13-93, a proposal to expand Medicaid/TennCare to adults with incomes up to 138% of the federal poverty level.
Representative Pearson presented House Bill 13-93 as a Medicaid expansion package intended to cover nearly all adults under 65 with incomes up to 138% of the federal poverty level, roughly $21,600 for a single person. He told the TennCare Subcommittee the proposal would close a coverage gap affecting about 340,000 Tennesseans and cited a fiscal note estimating the state’s share at roughly $234,000,000 with federal expenditures exceeding $2,000,000,000.
"This bill would cover nearly all adults under the age of 65 with incomes up to 138% of the poverty level," Representative Pearson said, calling the proposal a moral obligation and an investment that would reduce uncompensated care costs borne by hospitals and insured residents.
Several members pressed the sponsor on fiscal and operational details. Representative Sabida Kumar, a retired surgeon, said she was sympathetic to patients but warned about long-term state costs and the historical growth of state Medicaid obligations: "That baby elephant tends to grow," Kumar said, cautioning that initial federal incentives have stepped down in prior periods. Kumar also argued that, in practice, "patients generally do get care" and raised concerns that state governments ultimately assume new recurring costs.
Supporters, including Representative Antonio Parkinson and Representative Harold Love, emphasized potential economic-development effects and the strain on rural hospitals. Parkinson said expansion could spur new healthcare businesses and staffing in underserved areas; Love and others urged the committee to allow the bill to be heard by the full Insurance Committee for broader debate.
Committee members also discussed program design. The sponsor said the bill directs the governor, acting through the Commissioner of Finance and Administration, to submit a waiver application to the federal Centers for Medicare & Medicaid Services within 180 days if enacted, and cited matching-rate estimates and recent federal incentives under the American Rescue Plan that temporarily increase federal matching for expansion states.
The clerk opened the board for a final roll call vote. The clerk reported 2 ayes and 5 noes; the motion failed and House Bill 13-93 did not advance out of the TennCare Subcommittee. No individual roll-call votes were recorded in the transcript; the clerk provided only the final tally. The subcommittee adjourned following the vote.
