2,044 events on record Subscribe September 10, 2026
Standing Record home The Standing Record A non-partisan record of US democratic norms —
and the events that erode them.

Tennessee Gov. Bill Lee signed HB2498, barring TennCare from covering gender-affirming care

On April 16, 2026, Tennessee Gov. Bill Lee signed HB2498/SB2118 (Public Chapter 765) into law, prohibiting the state Medicaid program, TennCare, from covering or reimbursing any procedure intended to help a person live consistently with a gender identity inconsistent with their sex. The measure passed the House 73-14 and the Senate 27-6 and takes effect July 1, 2026, cutting off public-insurance funding for gender-affirming care for TennCare enrollees of all ages. Treatment for congenital defects, precocious puberty, disease, or physical injury remains covered, and enrollees already in treatment may continue through March 31, 2027.

Jurisdiction
Tennessee
Location
Nashville, Tennessee

Abuses documented

Actors

On April 16, 2026, Tennessee Gov. Bill Lee signed HB2498/SB2118, enacted as Public Chapter 765, prohibiting the state's Medicaid program, TennCare, from providing coverage or reimbursement for any medical procedure whose purpose is to enable a person "to identify with, or live as, a purported identity inconsistent with the individual's sex," or to treat distress arising from that discordance. The exclusion applies to TennCare enrollees of all ages, extending beyond the state's existing restrictions on gender-affirming care for minors to cut off public-insurance funding across the program.

The bill, sponsored in the House by Rep. Kip Capley and in the Senate by Sen. Lowe, passed the House 73-14 on March 12, 2026, and the Senate 27-6 on March 30, 2026, before reaching the governor's desk. It preserves coverage for treatment of congenital defects, precocious puberty, disease, or physical injury, and allows enrollees already receiving treatment for gender dysphoria to continue through March 31, 2027. The law takes effect July 1, 2026, and was enacted as part of a broader 2026 package of Tennessee legislation addressing transgender health care and gender identity.

Why we recorded this

Civil rights law holds that government may not use public programs to disadvantage people because of who they are. Tennessee wrote a categorical exclusion into its Medicaid program, TennCare, barring coverage of medical care sought to live consistently with a gender identity — singling out transgender enrollees for a benefit denial that applies to no one else. This archive records when a state deploys the administration of a public-insurance program to target a marginalized group, withdrawing a benefit on the basis of identity rather than medical need.

Sources

  1. Tennessee HB2498 (2025-2026), 114th General Assembly — LegiScan primary accessed July 11, 2026
  2. Tennessee to track transgender patients, put trans women in male prisons — WPLN News (Nashville Public Radio) investigative accessed July 11, 2026
  3. New State Laws Taking Effect July 1 — Nashville Scene secondary accessed July 11, 2026
  4. Bill That Prohibits TennCare From Covering Trans "Gender Affirming" Procedures Advances In House — The Tennessee Conservative secondary accessed July 11, 2026

See also