NASHVILLE (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.

The federal government funds the majority of the state's Medicaid program, which provides health insurance to approximately 1.7 million low-income Tennesseans, including pregnant women, children, caretaker relatives of dependent children and older adults, and disabled adults.

No one from TennCare testified during Tuesday's hearing or provided information about the bill's potential impact. A spokesperson did not immediately respond to emailed questions.

On Tuesday an official with the Human Rights Campaign cited bills targeting public funds as one way opponents of gender-affirming care for minors are trying to ban the practice.

"We're seeing these bills take lots of different forms across the country," Cathryn Oakley, the group's state legislative director and legal counsel, said on a call with reporters.

"We're also seeing lots of bills that would prevent any kinds of public funds like Medicaid or public facilities including doctors and hospitals from being able to be used to provide gender affirming care," she said.

Last year Georgia agreed to change the rules of its Medicaid program to settle a lawsuit by two Medicaid beneficiaries after they were denied access to gender-affirming care.

Also in 2022, Florida health officials banned state Medicaid insurance coverage for gender dysphoria treatments and issued a report saying they have not been proven safe or effective.

Other efforts have included bills like a measure in Arkansas that would make it easier to file malpractice lawsuits against doctors who provide gender-affirming care to minors. Arkansas has a ban on such care for minors that has been temporarily blocked by a federal judge.

Tennessee Republicans are advancing a similar bill. Civil rights groups promise an immediate lawsuit if it becomes law.

LGBTQ advocates rallied outside the Capitol on Tuesday and criticized Republicans for advancing bills targeting their community, including a proposed ban on certain drag performances on public property or in places where children could be present.

Inclusion Tennessee founder Phil Cobucci referenced Republican Gov. Bill Lee, who often speaks about his Christian belief.

"Are these bills part of the tenets of your faith?" Cobucci said. "Are they compassionate? Do they love your neighbor? Do they help others? I assert here that they do not. What would your Jesus do? And it's not this."

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Associated Press writers Andrew DeMillo in Little Rock, Arkansas, and Jonathan Mattise in Nashville contributed.