Lower the price of prescriptions for every Tennessean by buying in bulk for seven million people, starting with insulin and naloxone.
Tennesseans pay some of the highest prescription drug prices in the country. The pharmacy benefit manager system takes a cut at every step while hiding the real costs. Oregon and Washington built a better model: the Northwest Prescription Drug Consortium now covers over a million people, passes 100% of manufacturer rebates through to consumers, and has saved over $130 million for residents.
Tennessee has 7 million people, more than enough bargaining power to negotiate real prices. We'll establish a state purchasing cooperative, starting with insulin and naloxone, that buys in bulk and passes the savings directly to Tennesseans.
Affordable homes that stay affordable — for you and for the family that buys them next.
In the Nashville metro area, home prices have increased roughly 137% in the past decade. Knoxville and Chattanooga, and even rural towns have followed similar trajectories. Young families are being priced out of the communities they grew up in.
We'll change zoning rules so duplexes, triplexes, and small apartment buildings can be built by right on residential lots, increasing housing supply without anyone having to build a skyscraper. And we'll invest in community land trusts, where a nonprofit owns the land, sells homes to income-qualified families at below-market price, and caps resale so affordability is permanent. The Lincoln Institute tracked over 4,000 properties across three decades and found 95% remained affordable through boom, crash, and recovery. Nashville and Memphis already have trusts on the ground. We'll capitalize and expand them statewide.
State-owned solar and battery storage cuts state government's own power bills, guarantees host counties a payment on every megawatt-hour, and gives Tennessee generation assets no federal policy shift can take away.
Tennessee can build its own renewable generation today, inside the rules that already exist. Federal law does require TVA to buy power from qualifying state-owned generators, but only at TVA's self-calculated avoided cost of roughly 4 to 5 cents per kilowatt-hour. We won't build a state generation program on selling cheap power to TVA.
Instead, we'll create the Tennessee Renewable Power Authority that puts generation where it earns full value. First, on state facilities like campuses and office complexes, where every kilowatt-hour generated avoids 12 to 15 cents of retail cost. As state facilities are saturated, the Authority will expand through partnership projects with local power companies (LPCs), funded by revenue-backed bonds from the electricity and savings the Authority generates, not from the state's General Fund.
For community solar installations, every megawatt-hour will write a check to the county that hosts it. The Authority's enabling law guarantees host communities a per-megawatt-hour payment, delivering an estimated $1.5 to $2.5 million a year to rural host counties within four years, growing to $10 to $15 million a year within a decade. This revenue can fund education improvements, infrastructure improvements, or other projects that host communities decide to invest in.
Cover the ~95,000 Tennesseans stuck earning too much for TennCare and too little for private insurance, using the federal money Tennessee taxpayers already paid in.
Tennessee is one of ten states that still hasn't closed the Medicaid coverage gap. Every year we don't act, federal dollars that Tennessee taxpayers already paid flow to other states instead.
We'll extend TennCare to every adult earning up to 138% of the federal poverty line. The federal government covers 90% of the cost. For every dollar Tennessee spends, nine federal dollars come home, roughly $420 to $510 million a year flowing to Tennessee hospitals, clinics, and providers.
The expansion includes dental, vision, mental health, and addiction treatment coverage. Because untreated dental disease and vision problems are significant barriers to employment, Tennesseans won't just be more healthy, they'll be more capable of taking care of themselves and each other.
Give builders ready-made home designs and quick permits, so new homes get built faster near the jobs, schools, and bus routes Tennesseans already use.
Tennessee home prices have risen faster than wages for a decade. The state controls two levers that directly affect what gets built and where: permitting speed and investment criteria.
We'll publish a library of pre-engineered, code-compliant residential plans through the Tennessee Housing Development Agency, available for free to any builder. Projects using a library plan get automatic fee waivers and a guaranteed 5-business-day permit decision. Oregon's pre-approved plans cut permitting from months to days. In Tennessee we'll apply the same logic across a wider range of housing types.
We'll also change where affordable housing gets built. Tennessee invests $60 million a year in housing tax credits, but scoring doesn't reward proximity to transit or jobs. Families end up in locations where $10,000 to $14,000 in annual transportation costs erase the affordability. We'll fix the scoring to spend the same amount of money in better locations.
Drop Tennessee's 4% state grocery tax to zero over three years, saving the average family about $400 a year, paid for by closing corporate tax loopholes.
Tennessee is one of eight states that still taxes groceries at a meaningful rate. Working families pay 4% on every trip to the store, the same structure that makes Tennessee's tax system the third most regressive in the country. In 2026, 89% of Tennessee voters supported a cut. Yet the legislature passed a $58 billion budget without a single dollar of grocery tax relief.
We'll drop the state grocery tax from 4% to 2% in Year 1 and to 0% by Year 3, following the same timeline Kansas used with bipartisan support. The $775 million revenue loss is fully offset by closing corporate tax loopholes. Schools lose nothing: the $111 million K-12 earmark shifts from the grocery tax to the Future Families Fund, a more stable source. This will save the average family about $400 a year.
Lend Tennessee households and small businesses the upfront capital for rooftop solar, batteries, heat pumps, and weatherization, with repayment built into their utility bills or scaled to their income.
A $20,000 rooftop solar system or a $3,000 to $5,000 whole-home weatherization is out of reach for most Tennessee families without accessible capital. Heat pump water heaters alone save up to $550 per year for a family of four. The savings are real, but the upfront cost is the barrier.
We'll create the Tennessee Green Bank, a state-chartered financing institution capitalized with $100 million in state funds. Modeled on the Connecticut Green Bank, which has drawn nearly seven dollars of private investment for every public dollar, the Tennessee version will finance residential solar, batteries, heat pumps, and weatherization. On-bill or income-based repayment ensures monthly loan payments stay below the energy savings each project delivers so households save money from day one. Manufactured housing will be prioritized since Tennessee has one of the highest manufactured housing shares in the country, the population with the highest energy burden and the highest return on weatherization investment.
Open new clinics and hospitals in the 93 of 95 counties without enough care, by repealing the rule that requires state permission to build them.
Ninety-three of Tennessee's 95 counties are federally designated healthcare shortage areas. A quarter of rural counties have no hospital at all. Between 2010 and 2021, Tennessee lost 22 hospitals, and 75% of remaining rural hospitals are at risk of closure.
Tennessee currently blocks new hospitals and clinics from opening unless the state approves them through a Certificate of Need. In practice, the rule protects existing hospital monopolies and keeps new providers out of the counties that need them most.
We'll repeal Certificate of Need just like South Carolina did in 2023. Healthcare access in every county starts with letting providers open.
Cover childcare costs for working Tennessee families earning up to $99,000, with parents free to choose center-based, home-based, or faith-based providers.
Tennessee already subsidizes childcare for families up to roughly $87,000 through Smart Steps. But families earning more get nothing despite being unable to afford quality care on their own.
The Future Families Fund closes that gap with a sliding-scale subsidy. Parents choose the provider: center-based, home-based, faith-based, whatever works for the family. Reimbursement rates tied to actual cost-of-care data ensure providers are paid fairly. If federal childcare funding is cut, the Fund backstops the full population so no Tennessee family loses coverage because of decisions made in Washington.
Together with CoverKids, this creates one threshold: if your family earns under $99,000, your kids are covered. Healthcare and childcare, no gaps.
Fund Tennessee's Medicaid expansion through a hospital tax, like 43 other states already do. Hospitals come out ahead because expanded coverage means fewer unpaid emergency room visits.
Forty-three states already use a hospital provider tax to generate their state share of Medicaid expansion costs. Hospitals pay into the system and come out ahead because expanded coverage means fewer patients showing up to the emergency room without insurance.
We'll bundle this into the Medicaid expansion omnibus bill for the 2027 legislative session. A provider assessment on hospital net patient revenue serves as Tennessee's match share. Combined with reduced uncompensated care, the net result is approximately $75 million a year in state-level savings, with hospitals coming out ahead on every dollar they put in.
Lower healthcare premiums for Tennessee families by taking over Tennessee's marketplace from the federal government and keeping the fees Tennessee already pays.
About 643,000 Tennesseans buy health insurance through the federal healthcare.gov platform. Tennessee has no say in how that market operates, and the fees those Tennesseans pay on their premiums, roughly $120 million a year, leave the state entirely. However, twenty states already run their own marketplaces.
We'll create a Tennessee Marketplace Authority to run our own platform, keep the fees, and use the surplus to lower premiums. A state reinsurance program targets a 10 to 15% premium reduction for every marketplace enrollee, with 60 to 70% of the cost covered by federal pass-through savings. For Tennesseans earning $30,000 to $45,000, we'll also cap premiums at 5% of household income through a state subsidy.
The marketplace and reinsurance pay for themselves. The premium subsidy is the only new cost: $50 to $75 million a year from the General Fund.
Every Tennessee kid deserves full medical, dental, vision, and mental health coverage, no matter what their family earns.
CoverKids already insures Tennessee children up to 250% of the federal poverty level. We'll expand it to 300%, the threshold where the federal Children's Health Insurance Program match covers roughly 90% of the cost. For every dollar Tennessee spends, nine federal dollars flow back to Tennessee providers.
Children's healthcare costs a fraction of adult coverage. For businesses currently covering dependents, this takes a real expense off their books. For families earning just above today's eligibility cutoff, it means their kids see a doctor, a dentist, and a counselor without anyone choosing between care and rent. The cost to the Future Families Fund is roughly $3 million a year after the federal match.
Cut rooftop solar payback roughly in half for Tennessee homeowners, require new data centers to generate their own clean power, and create competitive Renewable Energy Zones open to every Tennessee community.
Tennessee's renewable energy economy is partially constrained by federal statute, but customer-side generation can grow right now.
We'll require any new industrial site receiving state tax incentives to generate at least 10% of its power on-site from renewables in year one, growing to 50% by year five, capturing the fastest-growing electricity load before it becomes TVA gas demand. For homeowners, TVA's standard buyback pays about 4 cents per kilowatt-hour for exported solar, making payback take 20 years or more which is a non-starter for financing renewable energy growth. We'll top that up to a fair 11-cent rate through a state-funded production adder, add an upfront rebate of up to 30%, and launch statewide automated permitting, bringing payback to roughly 10 to 12 years. For renters who can't put panels on their roof, we'll also expand community solar.
Lastly, we'll designate 3 to 5 competitive Renewable Energy Zones, open to every Tennessee local power company (LPC), with state matching grants for solar-plus-storage. And we'll press TVA for a fair buyback rate, and the day TVA adopts one, the state adder will sunset automatically.
Spend $10 million to buy and forgive over $1 billion in medical debt and lift bankruptcy off the families carrying it.
Medical debt is the leading cause of personal bankruptcy in Tennessee. Undue Medical Debt already operates here and has abolished $142 million in debt for roughly 73,000 Tennesseans in prior rounds. The organization purchases debt portfolios at pennies on the dollar and forgives them entirely, with no tax consequence to the recipient.
Medical debt acquisition costs range from 21:1 to 110:1, and Tennessee's prior rounds have landed near the high end. We'll scale this statewide with $10 million state investment to purchase over $1 billion in medical debt relief.
