A Republican-backed bill aimed at protecting access to fertility treatment and contraceptives narrowly passed the House floor on Thursday after overcoming intense debate from fellow Republicans.

Sponsored by Sen. Becky Massey (R-Knoxville) and Rep. Iris Rudder (R-Winchester), SB449/HB533 would codify protections for Tennesseans to utilize certain pregnancy prevention methods like intrauterine devices or emergency contraceptives, as well as ensure access to fertility treatments like artificial insemination and in vitro fertilization (IVF).

Although the measure easily (and unanimously) cleared the Senate nearly a month ago, it dodged multiple unfriendly amendments in the lower chamber as it made its way through the legislative process, including a committee amendment that would have effectively gutted the bill’s IVF protections, and a floor amendment that would have defined “personhood” as beginning at fertilization. Both amendments were opposed by TMA.

In a relatively rare move in a supermajority-controlled Republican legislature, the bill sparked heated infighting. Oppositional arguments ranged from insufficient language governing how fertilized embryos must be discarded, to concerns with certain “non-conservative” advocacy groups supporting the legislation. Many Republicans simply argued the bill was not needed because access to contraceptives and IVF are already permitted under state law, though some comments underscored just why the measure was indeed needed.

Both physician legislators in the House, Rep. Bryan Terry, MD (R-Murfreesboro) and Rep. Sabi Kumar, MD (R-Springfield) spoke in support of the measure, dispelling misconceptions about certain contraceptives protected under the bill, and the usage and preservation of fertilized embryos.

Notably, many of the same lawmakers who voted in favor of the legislation as it traveled through its respective committees voted against it on the floor. Concerns raised over supposed deficiencies in the bill’s language were compelling enough for many to switch their votes in the eleventh hour.

Despite the controversy, backing from top Republican leadership (including the Speaker of the House as a co-sponsor) proved to be an effective barometer for the bill’s fate. The measure successfully cleared the necessary constitutional majority to become law, securing a vote of 54-37-8.

Due to the adoption of a minor clarifying amendment that ensures the definition of contraceptives does not change year over year, the bill must now go back to the Senate to conform so that identical versions pass. Once approved, the law will take effect immediately.

ABORTION-INDUCING DRUGS

A proposal seeking to strengthen civil penalties for mailing or delivering abortion-inducing drugs into Tennessee advanced out of the House Judiciary Committee on Wednesday, paving the way for competing versions to be debated on the floor of both chambers.

As amended, HB5 by Rep. Gino Bulso (R-Brentwood), would make companies that mail or deliver abortion-inducing drugs to a patient strictly liable for $5 million in damages for wrongful death injury claims should the drug lead to the death of an unborn child. Although mailing such drugs to persons in this state is already illegal under the Abortion-Inducing Drug Risk Protocol Act passed in 2022, the sponsor contended that the law is being violated regularly, and thus harsher penalties were needed.

A similar proposal advanced out of the Senate last week, but without the strict liability language. While physicians are explicitly amended out of both versions of the bill, TMA’s primary objection with the House version is that it undermines the state’s caps on damages that have been in effect for well over a decade. Should the measure pass as written, it could set a precedent that would embolden trial lawyers to expand the caps on non-economic damages for medical malpractice claims.

The dual versions of the bill means that either the Senate or the House sponsor will have to substitute and conform in order for the bill to pass, a scenario that could leave the measure in legislative limbo until an agreement can be struck between both parties. As seen in previous years, legislation in this position can die solely based on unwillingness to negotiate, but it is too early to make an assessment at this point.

For now, the House version has been dual-referred to the House Health Committee, where it has yet to be put on notice. This procedural move is typically reserved for bills covering multiple subjects—in this case, both law and health. As the legislature looks to conclude its business and adjourn within the coming weeks, its unclear whether the legislation will progress quickly enough to cross the finish line in 2025.