This story was updated April 19, 2018, at 11:45 p.m. with more information.

NASHVILLE — The Tennessee Senate sent a controversial Medicaid work requirement to Gov. Bill Haslam Thursday, approving the bill on a 23-2 vote.

The bill, which previously passed the House, requires the administration to seek a federal waiver of Medicaid rules, operated here as TennCare, in order to implement "reasonable work and community engagement" requirements on able-bodied, working-age adult enrollees without dependent children under the age of 6.

Senate Democratic Caucus Chairman Jeff Yarbro of Nashville unsuccessfully sought to amend the bill to have the state also seek federal approval to expand Medicaid to an estimated 180,000 working Tennesseans under the federal Affordable Care Act.

Senators "in this chamber never had the chance to vote for Medicaid expansion," Yarbro said, alluding to Gov. Bill Haslam's 2015 failed effort to expand Medicaid only to see fellow Republicans in the GOP-controlled Senate kill it twice. "This amendment would allow us to right that."

"The governor obviously had some discussion earlier this year about whether it was time to re-initiate this [expansion] conversation in light of the work requirement," Yarbro added.

Bill sponsor Sen. Kerry Roberts, R-Springfield, questioned whether Yarbro's amendment legally fit the scope of his bill. Senate Clerk Russell Humphrey ruled the amendment did not fit the bill's caption.

Yarbro also sought to amend the bill with another provision ensuring the state doesn't spend more to implement the work requirement than it would save by its implementation.

Roberts and fellow Republicans voted to table it.

The state would use federal money from a reserve in Tennessee's Families First welfare program to fund the program if it's approved by federal officials.

Michele Johnson, executive director of the advocacy group Tennessee Justice Center, later called it "unfortunate that the legislature has passed a politically inspired bill that will waste $40 million of taxpayer funds on unnecessary bureaucracy, just to punish mothers with the loss of health insurance when they lose their jobs."

Johnson charged in her statement that the bill "recklessly puts thousands of vulnerable children, seniors and people with disabilities at risk that the state system will cost them their health coverage."

She accused lawmakers of continuing "to ignore the real health concerns of Tennesseans. They still block the Governor's use of our federal tax dollars to cover uninsured low-wage workers, sustain rural hospitals, create jobs and broaden access to treatment for addiction and other serious illness."

The political arm of the libertarian Nashville-based Beacon Center, which lobbied for the bill, praised its passage.

"We are glad to see that the legislature has passed common sense work requirements for able-bodied welfare recipients," said Beacon Impact Executive Vice President Stephanie Whitt. "While the opposition will continue to spread misinformation and exaggerate the effects of this bill, the fact is that this is a major step in the right direction for Tennessee families and taxpayers."

While the Trump administration has approved Medicaid work requirements in a number of states, those states had expanded Medicaid under the Affordable Care Act to low-income working adult men and women.


House Speaker Beth Harwell, R-Nashville, who is running for governor, and Rep. Dan Howell, R-Georgetown, sponsored the House bill.

In other legislative action Thursday:

» Following testy debate, the House voted 65-15 for legislation that directs the state to design and erect a "Tennessee Monument to Unborn Children" in the state Capitol complex.

"This is for children who never make it to birth, who actually died while in the womb," said bill sponsor Rep. Jerry Sexton, R-Bean Station, adding the list includes "abortion, assault, miscarriage, anything that was inside the womb."

Rep. Sherry Jones, D-Nashville, objected, saying that "having something there to remind women of it constantly is not a good thing."

She said Nashville already has a monument to children who have died, located in the city's Centennial Park. Sexton, who made headlines in 2016 with a bill seeking to make the "Holy Bible" the official book of state government only to see Gov. Bill Haslam veto it, told Jones the Centennial Park monument is for children who have died after birth.

Another member, Rep. John Ray Clemmons, D-Nashville, asked, "what is the real reason you want to put that memorial on the Capitol grounds? It's either to stigmatize women who've made the most difficult decision in their life or who didn't have a decision or it's to make a political statement for all the above. So tell me what this is about."

Sexton, who earlier said he believes life begins at conception, said "if your philosophy is correct, then it would not be against the law to take the life of a 1-year-old or a 2-year-old. However, children in the womb in your assertion aren't human. So it's lawful to take their lives. That is the people I'm directing this monument to — those that never had the chance at life."

The Senate has scheduled the bill to be heard Monday night.

» The Republican-run House approved all of Haslam's proposed nine nominees to the new University of Tennessee board of trustees, even approving in a symbolic gesture four nominations that Senate Education Committee Republicans torpedoed last week, effectively deep-sixing their appointments.

House Republicans railed at their GOP counterparts, saying that denying new appointments to current UT trustees Sharon Pryse, Bill Evans and Brad Lampley effectively robbed the new board of anyone with any experience.

The House confirmed all three of them in the House resolution, which has no effect on the Senate's action, as well as that of attorney and lobbyist Melvin Malone, a Chattanooga native and former Tennessee Regulatory Authority member who once served as the first black chairman of the Chattanooga-based Miller and Martin law firm.

Rep. Gerald McCormick, R-Chattanooga, noted he went to UT-Knoxville with Malone, praising the attorney and Brainerd High School graduate for experience in a number of areas.

Senators rejected Malone, saying they didn't want any lobbyists serving on the new board.

One GOP member recently confirmed to the Times Free Press that a House colleague pointedly noted to senators they had no problem when former state Senate speaker-turned lobbyist Ron Ramsey was named to a newly created trustee board for East Tennessee State University a few years ago.

A Republican senator retorted that Ramsey wasn't a lobbyist at the time.

The House also confirmed the five Haslam nominees approved by the Senate. The list includes Kim White, president of the River City Company, a nonprofit group involved in downtown projects. Those five, along with the state agriculture commissioner, will result in an operating quorum for the 10-member UT system board, which in addition has a non-voting student member.

Contact staff writer Andy Sher at or 615-255-0550. Follow him on Twitter @AndySher1.