All Roll Calls
Yes: 153 • No: 4
TennesseeHB 1956114th General Assembly (2025-2026)HouseWALLET
AN ACT to amend Tennessee Code Annotated, Title 8; Title 56; Title 63; Title 68 and Title 71, relative to step therapy.
Sponsored By: Rebecca K. Alexander, Rebecca K. (Republican)
Became Law
Insurance Companies, Agents, Brokers, Policies
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Bill Overview
Analyzed Economic Effects
2 provisions identified: 1 benefits, 0 costs, 1 mixed.
Cancer patients can skip step therapy
Beginning January 1, 2027, if your plan covers cancer care and you have a cancer diagnosis, the plan cannot make you try other drugs first before covering an approved cancer drug. This ends step‑therapy requirements for cancer, with an exception in subdivision (h)(3) of the law. The law also removes stage‑based limits, so these rules apply to all cancers, not only late‑stage disease. These protections apply to policies entered into, renewed, or changed on or after January 1, 2027.
Cancer step therapy rules start 2027
The new cancer step‑therapy protections start January 1, 2027. They apply to health policies entered into, renewed, or changed on or after that date. The state insurance and health commissioners can issue rules to carry out the law under the state rulemaking process. The law also deletes one defined term in the step‑therapy statute.
Sponsors & Cosponsors
Sponsor
Rebecca K. Alexander, Rebecca K.
Republican • House
Cosponsors
Clark Boyd, Clark
Republican • House
Rush Bricken, Rush
Republican • House
Karen D. Camper, Karen D.
Democrat • House
Kip Capley, Kip
Republican • House
Michele Carringer, Michele
Republican • House
Jesse Chism, Jesse
Democrat • House
John Ray Clemmons, John Ray
Democrat • House
Mark Cochran, Mark
Republican • House
John Crawford, John
Republican • House
Tandy Darby, Tandy
Republican • House
Elaine Davis, Elaine
Republican • House
Vincent Dixie, Vincent
Democrat • House
Clay Doggett, Clay
Republican • House
Jeremy Faison, Jeremy
Republican • House
Andrew Farmer, Andrew
Republican • House
Bob Freeman, Bob
Democrat • House
Ron M. Gant, Ron M.
Republican • House
John Gillespie, John
Republican • House
Ronnie Glynn, Ronnie
Democrat • House
Rusty Grills, Rusty
Republican • House
Yusuf Hakeem, Yusuf
Democrat • House
Michael Hale, Michael
Republican • House
Torrey C. Harris, Torrey C.
Democrat • House
David B. Hawk, David B.
Republican • House
Esther Helton-Haynes, Esther
Republican • House
Caleb Hemmer, Caleb
Democrat • House
Gary Hicks, Gary
Republican • House
Gary Hicks, Gary
Republican • House
Dan Howell, Dan
Republican • House
Justin Jones, Justin
Democrat • House
William Lamberth, William
Republican • House
Mary Littleton, Mary
Republican • House
Jr., Harold Love, Jr., Harold
Democrat • House
Susan M. Lynn, Susan M.
Republican • House
Aron Maberry, Aron
Republican • House
Pat Marsh, Pat
Republican • House
Brock Martin, Brock
Republican • House
Jake McCalmon, Jake
Republican • House
Bo Mitchell, Bo
Democrat • House
Debra Moody, Debra
Republican • House
Jerome Moon, Jerome
Republican • House
Antonio Parkinson, Antonio
Democrat • House
Justin J. Pearson, Justin J.
Democrat • House
Jason Powell, Jason
Democrat • House
Bill Powers, Bill
Republican • Senate
Kevin D. Raper, Kevin D.
Republican • House
Iris Rudder, Iris
Republican • House
Lowell Russell, Lowell
Republican • House
Rick Scarbrough, Rick
Republican • House
Paul Sherrell, Paul
Republican • House
William Slater, William
Republican • House
Bryan Terry, Bryan
Republican • House
Ron Travis, Ron
Republican • House
Greg Vital, Greg
Republican • House
Dawn White, Dawn
Republican • Senate
Ryan Williams, Ryan
Republican • House
Dave Wright, Dave
Republican • House
Jason Zachary, Jason
Republican • House
Roll Call Votes
Senate vote • 4/20/2026
FLOOR VOTE: Third Consideration 4/20/2026
Yes: 30 • No: 3
House vote • 4/6/2026
FLOOR VOTE: REGULAR CALENDAR PASSAGE ON THIRD CONSIDERATION 4/6/2026
Yes: 90 • No: 1
House vote • 4/2/2026
HOUSE CALENDAR & RULES COMMITTEE
Yes: 0 • No: 0
House vote • 3/30/2026
HOUSE GOVERNMENT OPERATIONS COMMITTEE
Yes: 11 • No: 0
House vote • 3/24/2026
HOUSE INSURANCE COMMITTEE
Yes: 17 • No: 0
House vote • 3/11/2026
INSURANCE SUBCOMMITTEE
Yes: 5 • No: 0
Actions Timeline
Pub. Ch. 995
5/26/2026Effective date(s) 01/01/2027
5/26/2026Signed by Governor.
5/19/2026Transmitted to Governor for his action.
5/7/2026HouseSigned by Senate Speaker
5/5/2026SenateSigned by H. Speaker
4/30/2026HouseEnrolled; ready for sig. of H. Speaker.
4/23/2026HouseSenate substituted House Bill for companion Senate Bill.
4/20/2026SenatePassed Senate, Ayes 30, Nays 3
4/20/2026SenateReceived from House, Passed on First Consideration
4/9/2026SenatePassed H., Ayes 90, Nays 1, PNV 4
4/6/2026HouseSponsor(s) Added.
4/6/2026HouseEngrossed; ready for transmission to Sen.
4/6/2026HouseH. Placed on Regular Calendar for 4/6/2026
4/2/2026HousePlaced on cal. Calendar & Rules Committee for 4/2/2026
4/1/2026HouseRec. for pass; ref to Calendar & Rules Committee
3/30/2026HousePlaced on cal. Government Operations Committee for 3/30/2026
3/25/2026HouseRec. for pass; ref to Government Operations Committee
3/24/2026HouseSponsor(s) Added.
3/23/2026HousePlaced on cal. Insurance Committee for 3/24/2026
3/18/2026HouseAction def. in Insurance Committee to 3/24/2026
3/17/2026HouseSponsor(s) Added.
3/16/2026HouseRec. for pass by s/c ref. to Insurance Committee
3/11/2026HousePlaced on cal. Insurance Committee for 3/17/2026
3/11/2026HouseSponsor(s) Added.
3/11/2026House
Bill Text
Enrolled / Public Chapter
Fiscal Note
Introduced
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