SB 1010 - HB 1220
FISCAL NOTE
Fiscal Review Committee
Tennessee General Assembly
March 6, 2025
Fiscal Analyst: Chris Higgins | Email: chris.higgins@capitol.tn.gov | Phone: 615-741-2564
SB 1010 - HB 1220
SUMMARY OF BILL: Enacts the Tennessee Contraceptive Freedom Act. Establishes
that every individual has a fundamental right to make decisions about the individual's reproductive
health care, including the fundamental right to use or refuse contraceptives or contraceptive
supplies.
Requires healthcare providers, including the Department of Health (DOH), to provide
contraceptives, contraception, and information related to contraception and family planning to
consenting patients; or, refer consenting patients to a healthcare provider that can provide
contraceptives, contraception, and information related to contraception and family planning.
Requires health insurance carriers and public health agencies, on or after July 1, 2025, to ensure
affordable access to a wide range of contraceptive methods for all consenting individuals. Requires
health insurance carriers that issue or renew a health insurance policy, plan, or contract of accident
or health insurance providing benefits for medical or hospital expenses, to provide full coverage for
the expenses of the contraceptive method of choice for an individual covered by the health
insurance carrier. Requires a public health agency that serves the people of a municipality to provide
full coverage for the expenses of the contraceptive method of choice for an uninsured individual
residing in the state. Prohibits access to contraceptives from being limited by an individual's sex,
race, age, gender, income, ability to pay, number of children, marital status, citizenship, or motive.
Prohibits the state, and any political subdivision of the state, from administering, implementing, or
enforcing any law, rule, or other provision having the force and effect of law that:
(1) Prohibits or restricts the sale, provision, or use of any contraceptives that have been
approved by the federal Food and Drug Administration (FDA) for contraceptive purposes;
(2) Prohibits or restricts an individual from aiding another individual in obtaining any
contraceptives approved by the FDA or other contraceptive methods; or
(3) Exempts any contraceptives approved by the FDA from any other generally applicable
law in a way that would make it more difficult to sell, provide, obtain, or use those
contraceptives or contraceptive methods.
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FISCAL IMPACT:
STATE GOVERNMENT
EXPENDITURES General Fund
FY25-26 & Subsequent Years $50,300
FEDERAL GOVERNMENT
EXPENDITURES
FY25-26 & Subsequent Years $5,500
LOCAL GOVERNMENT
EXPENDITURES Mandatory
FY25-26 & Subsequent Years $34,100
Article II, Section 24 of the Tennessee Constitution provides that: no law of general application shall impose increased expenditure
requirements on cities or counties unless the General Assembly shall provide that the state share in the cost.
OTHER FISCAL IMPACT
To the extent that the Department of Health and local health departments cannot accommodate
the proposed legislation, state and local expenditures will increase. Such increases are dependent on
a number of unknown factors, including how many new uninsured individuals will seek free
contraception, and their contraceptive method of choice, and cannot be reasonably determined.
Assumptions:
• All programs under the Division of TennCare provide coverage for contraceptive methods
of choice approved by the FDA.
• The State Group Insurance Program (SGIP) currently provides full coverage for over-the-
counter contraceptives and tubal ligations, but requires co-payments for male sterilization
procedures.
• Based on information provided by the Division of Benefits Administration, the average
amount of co-payments made for male sterilization procedures is $99,389 per year. The
SGIP will be responsible for paying this cost in FY25-26 and subsequent years.
• It is estimated that 48 percent of members are on the State Employee Plan, 43 percent are
on the Local Education Plan and 9 percent are on the Local Government Plan.
• The state contributes 80 percent of member premiums resulting in a recurring increase in
state expenditures of $38,165 ($99,389 x 48% x 80%).
• Some state plan members' insurance premiums are funded through federal dollars. It is
estimated 14.41 percent of the state share of the state plan is funded with federal dollars,
resulting in an increase in federal expenditures of $5,500 ($38,165 x 14.41%).
• The state contributes 45 percent of instructional member premiums (75 percent of Local
Education Plan members) and 30 percent of support staff member premiums (25 percent
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of Local Education Plan members) resulting in state expenditures of $17,629 [($99,389 x
43% x 75% x 45%) + ($99,389 x 43% x 25% x 30%)].
• The mandatory increase in expenditures for the local government share of the Local
Education Plan is estimated to be $25,108 [($99,389 x 43%) - $17,629)].
• The state does not contribute to the Local Government Plan. It is estimated the Local
Government Plan would be responsible for a mandatory increase in local expenditures
estimated to be $8,945 ($99,389 x 9%).
• The total increase in state expenditures is estimated to be $50,295 ($38,165 - $5,500 +
$17,629) in FY25-26 and subsequent years.
• The total increase in federal expenditures is estimated to be $5,500 in FY25-26 and
subsequent years.
• The total mandatory increase in local expenditures is estimated to be $34,053 ($25,108 +
$8,945) in FY25-26 and subsequent years.
• The proposed legislation will require public health agencies that serves the people of a
municipality to provide full coverage for the expenses of the contraceptive method of
choice for an uninsured person residing in the state.
• Local health departments currently provide family planning services, including birth control
information and supplies, in all 95 counties. The costs of contraceptives are based on
household income on a sliding fee scale, and free services may be provided to individuals
who are unable to pay.
• Six metropolitan counties operate independent health departments with family planning
services.
• Based on information published by the DOH, the Department served approximately 40,412
individuals through family planning services in FY23-24.
• To the extent the current family planning budgets of DOH and the local health
departments cannot accommodate the proposed legislation, state and local expenditures will
increase. Such increases are dependent on a number of unknown factors, including how
many new uninsured individuals will seek free contraception, and their contraceptive
method of choice, and cannot be reasonably determined.
• The Department of Commerce and Insurance can monitor compliance with the proposed
legislation utilizing existing personnel and resources.
IMPACT TO COMMERCE:
NOT SIGNIFICANT
Assumptions:
• The proposed legislation will not change the amount of expenditures for contraception for
SGIP enrollees, only shift the individual share of the cost for certain procedures.
• The impact on private insurance companies will be dependent on the contractual
agreements comprising each individual policy of healthcare; however, the overall impact to
commerce in the state is estimated to be not significant.
• Any impact on jobs in Tennessee is estimated to be not significant.
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CERTIFICATION:
The information contained herein is true and correct to the best of my knowledge.
Bojan Savic, Executive Director