Rep. Kelly Keisling: Capitol Hill Review
The General Assembly adjourns
The 112th General Assembly ended its first session May 5 following passage of landmark legislation that supports Tennessee families, strengthens the economy, increases access to health care, reforms criminal justice, protects the Second Amendment and makes historic investments in education.
The year began with a special session focused on improving childhood literacy rates and addressing learning losses Tennessee’s K-12 students suffered because of the coronavirus pandemic. Tennessee’s standing as the most fiscally stable state in the nation allowed Republicans to return to many pre-pandemic legislative priorities during the first session of the 112th General Assembly.
Following the passage of a debt-free $42.6 billion balanced budget, House Republicans in the last week of session gave final approval for legislation related to health care, education and public safety and reforms to the state’s judicial system.
General Assembly establishes a Medical Cannabis Commission
The General Assembly approved legislation this week creating the Tennessee Medical Cannabis Commission. The commission will serve as a nonpartisan, medically-focused entity that will study federal and state laws regarding legalization of medical marijuana. House Bill 490 requires the commission to make recommendations to the General Assembly on ways to implement an effective, patient-centered medical cannabis program in Tennessee upon the reclassifying of marijuana on the Drug Enforcement Administration’s list of Schedule I drugs. The current classification of marijuana by the federal government makes it illegal to use the drug, even for medicinal purposes.
The bill adds to the list of current patients who are legally allowed to bring .9 percent THC oil-only products into the state of Tennessee for personal use. Currently those with epilepsy and seizures qualify. This legislation adds eight other qualifying conditions to the list including cancer, ALS and Multiple Sclerosis. Patients with qualifying conditions must obtain a letter from their doctor showing evidence of their specific condition.
The bill now heads to Governor Bill Lee’s desk and will become effective upon his signature.
Truth in Sentencing bill strengthens protections for victims, ensures criminals serve full sentences
Both chambers unanimously approved House Bill 1047 which requires ‘truth in sentencing’ for violent criminals and sex offenders.
The bill requires any person convicted of violent or sexual offenses that typically target women and children to serve their full sentencing term as assigned by a jury or judge. It applies to offenses like rape, sexual battery, continuous sexual abuse of a child, sexual battery by an authority figure, incest, promoting prostitution, aggravated child abuse, domestic assault, aggravated sexual exploitation of a minor and trafficking for a commercial sex act.
While House Bill 1047 does not remove judicial discretion, it ensures that parole or probation are not options for those found guilty of crimes that fall into these categories of offenses. This legislation strengthens protections for victims and their families by ensuring offenders serve their full sentences.
Republicans ban teaching of systematic racism
The General Assembly this week banned the teaching of divisive concepts and systematic racism in Tennessee schools.
House Bill 580 ensures public schools do not violate the Civil Rights Act or the 14th Amendment to the U.S. Constitution by prohibiting instruction that teaches students the U.S. is innately racist or that an individual’s moral character is determined by race. The measure rejects any curriculum that teaches children they are superior or guilty of prejudice simply because of their race or gender.
House Bill 580 encourages curriculum that teaches impartial instruction on historical oppression of certain groups, while maintaining a belief in the constitution and American democracy.
This legislation ensures that curriculum like Critical Race Theory, which teaches that racism is ingrained in U.S. institutions and that the history of the country is defined by power relationships based on race, is not taught in K-12 public Tennessee schools.
If local school districts are found to be in violation of this law, state education funds will be withheld until the district is no longer teaching separatist and divisive concepts.
Tennessee patients gain greater access and control over prescriptions
House Bill 1398 brings integrity back to health care by addressing a lack of transparency among Pharmacy Benefit Managers (PBMs) and giving consumers greater access and choice when it comes to managing their health.
The Patient Access Choice and Transparency Act prioritizes patient-centered care by making reforms to how PBMs operate in Tennessee. It helps ensure patients may use the pharmacies they choose and trust rather than being forced by their insurance companies to use specialty pharmacies that often don’t meet patients’ needs. This is particularly important for patients with chronic, complex or rare diseases.
PBMs are companies that manage prescription drug benefits on behalf of health insurers, Medicare Part D drug plans, large employers and others. They are owned by insurance companies and often own pharmacies as well. As a big industry in the U.S., the top three PBMs in America service 230 million patients.
This bill does five important things:
Protects rural hospitals that utilize programs providing lifesaving medication to Tennessee’s most marginalized citizens
Prohibits PBMs from steering patients away from their community pharmacies to PBM-owned pharmacies which is particularly important to patients with chronic, complex and rare diseases like Multiple Sclerosis, cystic fibrosis, cancer, and ALS.
Ensures that pharmacies are at least paid their acquisition cost for medications and instructs PBMs to establish a process for pharmacies to appeal their reimbursements from PBMs if it is below the cost.
Provides greater transparency to employers who want to gain a better understanding of how their pharmacy benefit expenses are being impacted by spread pricing and rebate retention which ultimately impacts their premiums.
Provides more transparency for patients in real time when they are in a physician’s office as to what medications cost and their formulary.
Bill strengthens Tennessee’s workforce by transforming unemployment insurance
Before adjourning the 2021 session, Republicans transformed the state’s unemployment benefit insurance program. This measure provides more money for people who have lost their job through no fault of their own, while giving businesses greater opportunity to recruit and retain workers. Effective December 2023, House Bill 1039 raises unemployment benefits up to $50 per week based on eligibility. It sets the number of weeks a person can receive them on a sliding scale based on the state’s unemployment rate. The legislation limits the duration of benefits at 12 weeks if the state’s unemployment rate is 5.5 percent or less to promote transition back to work. The number of weeks benefits are available goes up one week per half percentage increase in the state’s unemployment rate until it reaches a 20-week maximum.
This action brings Tennessee in line with surrounding states in both the benefit amount and the number of weeks a person is qualified to receive them. Several surrounding states have also indexed their programs based on their jobless rate to keep their unemployment trust funds solvent and make it less likely they will need to borrow from the federal government to pay for benefits. Tennessee’s jobs website currently lists more than 250,000 available job openings in the state and an unemployment rate of 5 percent. For current job opening in Tennessee, visit, www.jobs4tn.gov.
General Assembly ensures Covid-19 vaccines remain voluntary
Legislation that aims to ensure Covid-19 vaccines remain voluntary passed in the House chamber this week and now heads to Gov. Bill Lee’s desk for his signature. House Bill 575 will ensure that medical information reflecting the status of a person’s vaccination cannot be required by any state entities in Tennessee. The legislation prohibits a state or local governmental official, entity, department or agency from mandating a private business to require a “vaccine passport” or proof of a Covid-19 vaccine as a condition for entering their premises or using their services.
House Bill 575 also removes authority from county boards of health to enforce and adopt rules and regulations regarding Covid-19, preserving their role as an advisory body to the elected county mayor. The bill defines quarantine in Tennessee law as the limitation of a person's freedom of movement, isolation, or preventing or restricting access to premises upon which the person, cause or source of a disease may be found for a period of time as may be necessary to confirm or establish a diagnosis, determine the cause or source of a disease or prevent the spread of a disease.
Tennessee’s CON process improves health care access and cost
Reforms to Tennessee’s Certificate of Need (CON) program was approved by both chambers of the General Assembly this week. House Bill 948 seeks to eliminate bureaucratic red tape by making the CON process quicker, easier and less expensive to improve access and cost of health care services in Tennessee. It reduces CON regulation of certain facilities and services, eliminates protectionist aspects of the CON process and creates greater regulatory flexibility. The reform legislation comes as a result of a two-year collaboration from various stakeholders and legislators in a joint House and Senate working group that focused on benefiting patients.
Hospitals and health care facilities that want to locate or expand its capacity are required to obtain a legal document known as a CON. Whether it is the number of hospital beds it makes available or the types of imaging it can conduct, the facility must apply to the state’s Health Services and Development Agency (HSDA) for permission through the CON process.
Certain CON regulations would be reduced or eliminated for certain facilities and services under House Bill 948. Economically distressed counties which do not currently have a hospital would be completely exempt from CON regulations, making it easier for health care companies to offer new health services to patients in those counties. Non-pediatric MRI services and PET Scan services would also no longer be regulated by CON in counties with a population above 175,000. Because of an increasing focus and need for mental health services in Tennessee, mental health hospitals would no longer be subject to CON regulations as well. The legislation further eliminates protectionist aspects of CON by reducing the power competitors have over new applicants and holding CON-holders more accountable.
Bill aims to increase state’s physicians in rural communities
A bill designed to increase the number of primary care physicians in Tennessee’s rural communities was approved by the General Assembly this week. Current workforce projections show Tennessee will experience a doctor shortage of 1,050 by 2025. House Bill 443 aims to curb the shortage by establishing residency opportunities focusing on family practice, general pediatrics, internal medicine and psychiatry to provide medical and behavioral health services in Tennessee’s underserved and distressed rural counties.
The residencies will be open to all graduates of University of Tennessee schools, Meharry Medical College and Vanderbilt University in Nashville.
Residents will be approved by the National Accreditation Agency for Graduate Medical Education (GME). The program requires the residencies be open to all qualified candidates and filled through the existing matching process employed by the GME. In addition, the bill establishes residencies through Lincoln Memorial University in Claiborne County which offers osteopathic medicine instruction. The recently approved 2021-22 fiscal year budget provides $5.5 million to fund the residencies, which will be distributed across the state. The Tennessee Department of Health and the Tennessee Higher Education Commission (THEC) will oversee the programs.
Legislation creates judicial panel for cases related to the state
House Bill 1130 creates parameters for a three-judge panel to hear challenges regarding the constitutionality of a state statute, an executive order or an administrative rule or regulation. One existing trial court judge will be selected based on the jurisdiction where the case was filed, and the Tennessee Supreme Court will select two existing trial court judges from the other two grand divisions that are not yet represented to hear and decide the civil action.
The panel will sit in the State Supreme Court Building in either Jackson, Nashville or Knoxville depending on the grand division in which the civil action was filed, unless a location is otherwise designated by the Tennessee Supreme Court.
Republicans protect Tennesseans’ Second Amendment rights
House Republicans passed major legislation this week protecting Tennesseans’ Second Amendment rights.
Legislation making Tennessee a Second Amendment sanctuary state passed in both the House and Senate chambers. House Bill 928, the ‘Tennessee Second Amendment Sanctuary Act,’ makes a law, treaty, executive order, rule or regulation of the government that the Tennessee or U.S. Supreme Court has found to violate the Second Amendment null, void and unenforceable.
The ‘Tennessee Firearm Protection Act’ has passed the General Assembly, barring any government entity from taking a firearm away from a citizen of Tennessee. House Bill 446 prohibits the state or local government body from allocating personnel, public funds to regulate ownership, use, sale or possession of firearms, ammunition or firearm accessories.
A bipartisan measure making it less expensive for gun owners to safely store their firearms passed the House this week. House Bill 761 exempts the purchase of gun safes and gun locking devices from state retail sales tax in Tennessee, expanding gun-owners’ ability to safely store firearms in a more affordable manner. The one-year tax exemption begins July 1 and ends June 30, 2022.
House Republicans remain committed to preventing the federal government from infringing upon the Second Amendment rights of all Tennesseans.
Budget recap: 2021 legislative investments
A no-debt $42.6 billion for 2021-22.
The 2021-22 fiscal year budget invests $100 million into the Rainy-Day fund, bringing our state’s savings account to $1.55 billion.
Republicans have ensured the state honors its commitment to state employees and teachers by setting aside $250 million through the Tennessee Consolidated Retirement System. Tennessee remains on solid financial ground as one of the indebted states in the nation with a AAA bond-rated state rating.
The budget provides $730 million in new spending for education, including the spending from the special session. This includes more than $480 million on K-12 education and more than $240 million on higher education.
The Basic Education Plan (BEP) is fully funded at $62 million.
Tennessee educators will receive $120 million to provide a pay increase in addition to $43 million allocated for teacher salary increases during January’s special session.
$79 million to address the growing needs of Tennessee Colleges of Applied Technology campuses.
$250 million for a Mental Health Trust Fund to provide mental health assistance and support for K-12 students.
The budget cuts more than $50 million for a sales tax holiday on grocery sales and prepared foods from July 30-Aug. 5.
A significant $100 million investment to expand high-speed broadband to underserved Tennessee communities. These funds are in addition to federal coronavirus stimulus money provided for this purpose. In other jobs investments, the budget provides $190 million for Fast Track Infrastructure Grants to add high-quality jobs throughout the state. It also provides $7 million to help support Tennessee entrepreneurs and innovators with promising start-up companies.
Health care is another essential priority for next year’s budget. It provides $37.9 million to fully fund medical inflation in the state’s TennCare program and adds $5 million to further widen the state’s Health Care Safety Net. The Health Care Safety Net focuses on services that help uninsured patients get preventative and disease management care and avoid more costly hospitalizations.
Other highlights include:
$100 million for cities and counties with funds available in July for any non-recurring needs
$931 million for capital improvements to keep the state’s infrastructure strong without incurring debt for such needs
$30 million for deferred maintenance for Tennessee’s state parks which had a record number of visitors in 2020
$9.5 million to improve salaries for probation and parole officers to offer competitive pay with other states and to keep Tennessee safe
$4.4 million for new agents in the Tennessee Bureau of Investigations (TBI) to meet increased investigative needs
$17 million for a new radio communication system, $2.3 million for body cameras and full funding of the salary plan and survey for state troopers
$18 million to improve Tennessee’s statewide disaster communications system
$24 million to provide additional funding for rural projects as part of the Rural Economic Opportunity Fund
$8 million to expand marketing and tourism initiatives
$145 million for air and rail transportation infrastructure
$5.3 million to fight human trafficking and support victims
$50 million for a sales tax holiday on grocery sales, restaurants and all prepared foods on July 30 – Aug. 5
$400,000 for senior citizens centers to be distributed through the Tennessee Commission on Aging;
$450,000 for Big Brothers and Big Sisters organizations
The FY21-22 budget takes effect July 1, 2021.