TN HB2005

Creates the "TennCare Buy-In Act" allowing Tennessee residents ages 18-64 to purchase coverage through the state's Medicaid program if they are not eligible for Medicare, other TennCare categories, or incarcerated

Establishes a sliding-scale premium structure based on household income as a percentage of the federal poverty level, with monthly payments due the first of each month and a 30-day grace period

Enrollees receive full TennCare medical assistance benefits through managed care organizations, excluding non-emergency medical transportation

Coverage terminates for nonpayment after the grace period, with a potential 3-month lockout before re-enrollment and requirement to pay outstanding premiums

Requires the Department of Finance and Administration to seek federal approval through a state plan amendment or Section 1115 waiver, and mandates comprehensive fiscal analysis within 2 years of implementation and every 3 years thereafter