TMA-backed legislation seeking to clarify the abortion “trigger” law passed overwhelmingly in the House Population Health subcommittee on Tuesday despite opposition from Tennessee Right to Life.
Sponsored by Rep. Esther Helton-Haynes (R-East Ridge), HB 883 would change the current law’s affirmative defense to a legal exception to allow doctors to terminate pregnancies in life-threatening situations without facing prosecution. It would also enable doctors to provide preventative care for medically futile pregnancies.
TMA member and obstetrician from Knoxville, Dr. Kim Fortner, testified in favor of the legislation, arguing that the current law endangers women and wastes precious resources like blood and ICU beds. As a high-risk maternal health expert, Dr. Fortner spoke specifically about complicated pregnancies and the importance of allowing physicians to use their good-faith medical judgment to address maternal health issues before they become life-threatening. She alluded to a recent patient who experienced previable preterm prelabor rupture of membranes (PPROM) and was forced to wait out medical intervention due to the law only to return to the hospital in septic shock and hemorrhaging blood.
Testimony from Right to Life’s lobbyist prompted a rare appearance from House Speaker Cameron Sexton (R-Crossville) who quietly slipped into the committee room nearly an hour into the debate. He denounced comments to “intimidate members” of the committee when it was suggested that Right to Life’s political action committee would “score” lawmakers negatively for voting in favor of the bill. Sexton further pledged he would support any colleague who voted for the measure.
Despite the highly unconventional hearing, lawmakers ultimately advanced the bill on a voice vote. TMA thanks all physicians who attended the committee hearing to show support. The bill now heads to the full House Health Committee where it will be considered next Wednesday, Feb. 22 at 3:30 PM CT.
The senate companion bill sponsored by Sen. Richard Briggs, MD (R-Knoxville) will be considered in the Senate Judiciary Committee the following week on Tuesday, Feb. 28. The measure has been dual-referred and will head to the Senate Health & Welfare committee, should it successfully advance. TMA and its coalition partners are asking all physicians to begin contacting your elected officials to educate them on the importance of this legislation and urge their support.
On Tuesday, TMA members and leaders of Tennessee Oncology, Drs. Stephen Schleicher and Natalie Dickson, joined the government affairs team on the Hill to give a presentation on prior authorization (PA) to the House Insurance Committee.
The subject matter hearing provided an overview on the PA process while highlighting the onerous nature and its impact on patient clinical outcomes. Dr. Dickson testified that Tennessee Oncology employees 30 full-time employees at a cost of $2.5 million in 2022 just to process and appeal PA decisions for patients. Dr. Dickson argued that these costs were especially unjustified given that the practice maintains a 99% overall approval rating for imaging and drugs.
As chair of TMA’s Insurance Committee, Dr. Dickson also spoke about longtime efforts to reform prior authorization with health plans without bringing legislation—pointing to the national Consensus Statement agreed upon in 2018 and the formation of TMA’s workgroup in 2020 as evidence of attempts at cross-sector collaboration. Despite assurances from the insurance industry to reform and streamline the PA process, Dr. Schleicher cited a 2022 TMA survey where 94% of physician respondents rated the administrative burden of prior authorization as high or extremely high.
Both doctors agreed that legislation was needed to address the serious burdens of prior authorization to ensure that patients gain quicker access to care through reduced denials. Specifically, Dr. Dickson identified five categories that warrant improvement: clinical validity; continuity of care; transparency and fairness; timely access and administrative efficiency; and alternative and exemptions.