NASHVILLE, Tenn. (AP) — The private companies that manage care for most of Tennessee’s Medicaid program could no longer contract with the state if they cover gender-transitioning medical care, according to a bill Republican lawmakers advanced Tuesday.

The legislation is the latest proposal targeting transgender people that Tennessee lawmakers have introduced this year. It's similar to bills seeking to limit or ban gender-affirming care being considered in statehouses across the country.

According to the legislation, Tennessee's Medicaid program — known as TennCare — could no longer contract with managed care organizations if they provide coverage for gender-transition treatment, be it in Tennessee or in any other state. The rule would apply to patients of all ages.

Republican Rep. Tim Rudd told the House Insurance Subcommittee that insurance companies should not use Tennessee dollars to cover such medical treatments in other states.

Kentucky Republicans introduced legislation last week that seeks to keep drag shows at least 1,000 feet — approximately the length of three football fields — from "locations that cater to minors," including schools, churches, parks, homes and walking trails.

While the bill, SB 115, broadly takes aim at "adult-oriented businesses" — which it also defines to include adult cabarets, strip clubs and adult movie theaters — one of the bill's five co-sponsors said the idea for the bill originated, in part, from concerns over a “family-friendly” drag show in the state.

“They’re adult-oriented performances; there’s no reason children need to be exposed to that,” Kentucky state Sen. Lindsey Tichenor told NBC affiliate WLEX of Lexington on Wednesday.

Uma Jewels, a drag queen based in Lexington, the state's second largest city, disagreed with Tichenor.

“Drag is just about the most unsexy thing I can think of doing and if you are wanting to sexualize drag, I think that is on you and not on the performer,” Jewels told WLEX.

Missouri has been the site of some of the most vicious battles over transgender rights in recent years. In 2022, a trans healthcare ban and trans sports ban came just short of passing after time ran out over a fight about redistricting. In those debates, transgender people were openly compared to “an infection” by sitting legislators. This year, the pace of anti-trans bills has increased, with sometimes as many as 8 anti-trans bills being heard in a single day. Now, one of the gender affirming care bans for trans youth that passed out of committee was amended with a new provision: the forced medical detransition of incarcerated transgender people.

The new amendment contained carveouts to HB419, which bans gender affirming care for transgender youth. Legislators removed language that involved continuing hormones if withdrawing them meant a threat to the life of the child - explicitly voting through an amendment that removed protections for the life of the kid. Republicans also added a new line that has never been before seen in anti-trans legislation: that any correctional facility would no longer provide gender affirming care to those incarcerated.

The withdrawal of gender affirming care for incarcerated people is especially alarming, considering that Missouri is also considering several bills that target drag artists and transgender performers. In the hearing over those bills, Representative Mazzie Boyd (R), one of the anti-drag bill sponsors, stated that she knew it targeted transgender people and any gender nonconforming person performing regardless of explicit sexualization and seemed to agree with that end goal. When asked later if she considered drag in and of itself sexually explicit, she stated yes. It is conceivable that, should both bills pass, Missouri could legalize arresting transgender people for doing anything considered “performance” and forcing their medical detransition.