Would a Tennessee bill exempting insured adult motorcyclists from the helmet law (but keeping uninsured and TennCare-covered riders required to wear one) violate equal protection?

Plain-English summary

Senator Jim Tracy asked whether Senate Bill 925/House Bill 700, which would have created an exception to Tennessee's universal motorcycle helmet law for adults age 21 or older who had medical or health insurance other than TennCare, would violate either the federal or state equal protection guarantees. The exception would have left the helmet requirement in place for uninsured riders and those covered by TennCare.

The AG concluded it would not. Standard equal protection doctrine applies rational basis review to classifications that neither burden a fundamental right nor target a suspect class. Federal and state courts had repeatedly upheld helmet laws under rational basis review (Simon v. Sargent; Picou v. Gillum; Arutanoff). The classification here, by insurance coverage rather than by membership in a suspect class, did not raise the level of scrutiny. The uninsured and the poor are not suspect classes (Harris v. McRae), and no fundamental right was implicated.

Once rational basis was the governing standard, the bill survived easily. The state has a "valid interest in preserving the fiscal integrity of its programs" and may legitimately try to limit expenditures (Graham v. Richardson). A motorcyclist riding without a helmet who is seriously injured generates medical costs. For privately insured riders, those costs largely fall on private insurance. For uninsured riders, and for riders on TennCare (the state-funded Medicaid program), those costs land on the state or the broader public. The legislative line between the two groups was rationally tied to that asymmetry, so it would clear rational basis review.

Currency note

This opinion was issued in 2015. Subsequent statutory amendments, court decisions, or later AG opinions may have changed the analysis. Treat this page as historical context, not current legal advice. Verify current law before relying on any specific rule, deadline, or remedy mentioned here.

Common questions

Q: Why didn't the bill get strict scrutiny?
A: Because the classification was insurance-based and did not implicate a suspect class or fundamental right. Federal Sixth Circuit and U.S. Supreme Court cases hold that wealth and insurance status are not suspect classes (Harris v. McRae; Molina-Crespo), and there is no fundamental right to refuse to be insured or to refuse medical care (U.S. Citizens Ass'n v. Sebelius). With no suspect class or fundamental right, rational basis review applied.

Q: Did the AG decide whether the policy was a good idea?
A: No. Rational basis review asks only whether some legitimate state interest could rationally support the line drawn. Whether the policy is wise is a separate political question. The AG's job in this opinion was to address constitutionality, not policy merit.

Q: Could the legislature have used a different metric, like requiring proof of insurance instead of helmet wearing?
A: Yes. Rational basis review is famously deferential, and lawmakers had multiple constitutionally defensible options. The AG's opinion does not require the chosen line, it merely confirmed that this particular line had a rational basis.

Q: How would enforcement have worked under the bill?
A: The bill's text required helmetless riders age 21+ to "maintain medical or health insurance" outside TennCare. The opinion does not address the enforcement mechanism (proof at traffic stops, post-accident inquiry, etc.); that would have been a matter of implementing regulations or further legislation.

Background and statutory framework

Tennessee Code Ann. § 55-9-302(a) had long required all motorcycle riders and passengers to wear a helmet, with a Class C misdemeanor for noncompliance (§ 55-9-306). SB 925/HB 700 would have amended subsection (a) to add an exception for adults 21+ with insurance other than TennCare.

The constitutional analysis applied the standard federal equal protection framework, also used to evaluate state equal protection claims under Tenn. Small Sch. Sys. v. McWherter: identify the classification, identify the applicable level of scrutiny, then apply it.

The state's fiscal-protection rationale traces back to Graham v. Richardson, where the Supreme Court recognized the state's "valid interest in preserving the fiscal integrity of its programs." The medical-cost externalization rationale was supported by NHTSA literature (cited in the opinion) showing that uninsured or publicly insured patients impose larger societal costs from motorcycle injuries than privately insured patients.

Citations and references

Statutes:

• Tenn. Code Ann. § 55-9-302(a) (universal helmet requirement)
• Tenn. Code Ann. § 55-9-306 (Class C misdemeanor for noncompliance)
• U.S. Const. amend. XIV (federal Equal Protection Clause)
• Tenn. Const. art. I, § 8, art. XI, § 8 (state equal protection)

Cases (level of scrutiny):

• Tenn. Small Sch. Sys. v. McWherter, 851 S.W.2d 139 (Tenn. 1993) (state and federal EP analysis aligned)
• City of Cleburne v. Cleburne Living Ctr., 473 U.S. 432 (1985) (rational basis framework)

Cases (helmet laws under rational basis):

• Simon v. Sargent, 409 U.S. 1020 (1972) (mem.) (affirming MA helmet law)
• Picou v. Gillum, 874 F.2d 1519 (11th Cir. 1989) (FL helmet law)
• Arutanoff v. Metro. Gov't of Nashville and Davidson Cnty., 448 S.W.2d 408 (Tenn. 1969) (TN helmet law)

Cases (suspect class / fundamental right):

• Harris v. McRae, 448 U.S. 297 (1980) (poverty not a suspect classification)
• Molina-Crespo v. U.S. Merit Sys. Protection Bd., 547 F.3d 651 (6th Cir. 2008)
• U.S. Citizens Ass'n v. Sebelius, 705 F.3d 588 (6th Cir. 2013) (no right to remain uninsured)
• Clark v. Prichard, 812 F.2d 991 (5th Cir. 1987)

Cases (rational basis applied):

• FCC v. Beach Comm'ns, Inc., 508 U.S. 307 (1993)
• Heller v. Doe, 509 U.S. 312 (1993)
• Graham v. Richardson, 403 U.S. 365 (1971) (fiscal-integrity interest)
• Neinast v. Bd. of Trs. of Columbus Metro. Library, 346 F.3d 585 (6th Cir. 2003) (broader societal costs)

Source

• Landing page: https://www.tn.gov/attorneygeneral/opinions.html
• Original PDF: https://www.tn.gov/content/dam/tn/attorneygeneral/documents/ops/2015/op15-70.pdf

Original opinion text

Opinion No. 15-70 (October 12, 2015)

Constitutionality of Senate Bill 925/House Bill 700, 109th Gen. Assem. (2015-16), Exception to Motorcyclist Helmet Requirement for Adults with Medical or Health Insurance Other than Insurance Provided Through TennCare

Question

Does Senate Bill 925/House Bill 700 violate the equal protection guarantee of the United States Constitution or the Tennessee Constitution by creating an exception to the motorcyclist helmet requirement for adults covered by medical or health insurance other than insurance provided through TennCare?

Opinion

No. The State's interests in preserving the fiscal integrity of its publicly funded health care programs and preventing broader societal costs provide a reasonable basis for the legislative distinction between (i) motorcyclists with medical or health insurance other than insurance provided through TennCare and (ii) motorcyclists with insurance provided through TennCare or with no insurance.

ANALYSIS

Subject to certain exceptions, Tenn. Code Ann. § 55-9-302(a) requires "[t]he driver of a motorcycle, motorized bicycle, or motor-driven cycle, and any passenger on any of these" to wear a helmet. Failure to do so is a Class C misdemeanor. Id. § 55-9-306.

Senate Bill 925/House Bill 700, 109th Gen. Assem. (2015-16) would amend Tenn. Code Ann. § 55-9-302(a) to create an exception to the helmet requirement for drivers and passengers who are twenty-one or older and who have medical or health insurance other than insurance provided through TennCare. The helmet requirement would remain in effect for drivers or passengers who are uninsured or who are insured through TennCare. Thus, the bill distinguishes between adult motorcyclists who have medical or health insurance other than insurance provided through TennCare and those who do not.

The relevant text of the bill is as follows:

(2) The driver of a motorcycle, motorized bicycle, or motor-driven cycle, and any passengers on these vehicles shall not be required to wear a crash helmet if the driver and passengers are twenty-one (21) years of age or older and maintain medical or health insurance that is not provided pursuant to title 71, chapter 5, or otherwise provided through the bureau of TennCare. A driver or passenger who does not maintain insurance as required by this subdivision (a)(2) shall be required to wear a crash helmet in accordance with subdivision (a)(1).

The question is whether this distinction violates either the federal or state constitutional right to equal treatment under the law. The Fourteenth Amendment to the United States Constitution provides that no state shall "deny to any person within its jurisdiction the equal protection of the laws." Article I, section 8, and article XI, section 8, of the Tennessee Constitution guarantee "essentially the same protection" as the federal Equal Protection Clause. Tenn. Small Sch. Sys. v. McWherter, 851 S.W.2d 139, 152 (Tenn. 1993). Equal protection claims under the Tennessee Constitution are subject to the same legal analysis as is applied to equal protection claims brought under the federal Constitution. Id. at 153.

The level of judicial scrutiny applied to a legislative classification that is challenged on equal protection grounds depends on the nature of the classification. See City of Cleburne, Tex. v. Cleburne Living Ctr., 473 U.S. 432, 439-41 (1985). As relevant here, classifications that neither interfere with a fundamental right nor discriminate against a suspect class receive rational basis review and will be upheld as long as they are "rationally related to a legitimate state interest." Id. at 440.

It is well established that laws imposing a helmet requirement on all motorcyclists are subject only to rational basis review because they neither interfere with a fundamental right nor discriminate against a suspect class. See, e.g., Simon v. Sargent, 409 U.S. 1020 (1972) (mem.) (summarily affirming decision of three-judge district court in Simon v. Sargent, 346 F. Supp. 277, 279 (D. Mass. 1972), which upheld Massachusetts helmet requirement under rational basis review); Picou v. Gillum, 874 F.2d 1519, 1522 (11th Cir. 1989) (upholding Florida helmet requirement under rational basis review); Arutanoff v. Metro. Gov't of Nashville and Davidson Cnty., 448 S.W.2d 408, 412-13 (Tenn. 1969) (upholding prior version of Tenn. Code Ann. § 55-9-302(a) under rational basis review).

Senate Bill 925/House Bill 700 differs from those laws in that it would further classify individuals based on whether they have medical or health insurance other than insurance provided through TennCare. That difference, however, provides no reason to apply a higher level of scrutiny. Neither uninsured individuals nor individuals insured through TennCare are a suspect class for purposes of equal protection analysis. Cf. Harris v. McRae, 448 U.S. 297, 323 (1980) ("[T]his Court has held repeatedly that poverty, standing alone is not a suspect classification."); Molina-Crespo v. U.S. Merit Sys. Protection Bd., 547 F.3d 651, 660 (6th Cir. 2008) ("[A] class of less wealthy individuals is not a suspect class warranting strict scrutiny review."). And classifying individuals based on whether they have medical or health insurance other than insurance provided through TennCare would not implicate any fundamental right. See, e.g., U.S. Citizens Ass'n v. Sebelius, 705 F.3d 588, 601 (6th Cir. 2013) (rejecting argument that there is a fundamental right "to remain uninsured or . . . to refuse to pay for unwanted medical care"); Clark v. Prichard, 812 F.2d 991, 995 (5th Cir. 1987) (rejecting argument that "the right to public assistance is a fundamental right for purposes of equal protection review").

Under rational basis review, a statutory classification bears "a strong presumption of validity" and "those attacking [its] rationality . . . have the burden to negative every conceivable basis which might support it." FCC v. Beach Comm'ns, Inc., 508 U.S. 307, 314-15 (1993) (internal quotation marks omitted). The classification will be upheld as long as there is "a rational relationship between the disparity of treatment and some legitimate governmental purpose." Heller v. Doe, 509 U.S. 312, 320 (1993). "[I]t is entirely irrelevant for constitutional purposes whether the conceived reason for the challenged distinction actually motivated the legislature." Beach Comm'ns, 508 U.S. at 315.

Senate Bill 925/House Bill 700 therefore would survive rational basis review if there is a reasonable basis for treating differently individuals who fail to "maintain medical or health insurance that is not provided pursuant to title 71, chapter 5, or otherwise provided through the bureau of TennCare."

The insurance-based classification in Senate Bill 925/House Bill 700 would easily satisfy that standard. The State has a "valid interest in preserving the fiscal integrity of its programs" and "may legitimately attempt to limit its expenditures." Graham v. Richardson, 403 U.S. 365, 374 (1971) (internal quotation marks omitted). It also has a valid interest in reducing or preventing costs to the public. See, e.g., Neinast v. Bd. of Trs. of Columbus Metro. Library, 346 F.3d 585, 594 (6th Cir. 2003) (holding that legitimate interest supported library's policy requiring patrons to wear shoes because "[i]njuries suffered by . . . barefoot patrons . . . impose broader societal costs").

Those legitimate interests provide a reasonable basis for the distinction in Senate Bill 925/House Bill 700 between motorcyclists with medical or health insurance other than insurance provided through TennCare and those who are uninsured or insured through TennCare. A motorcyclist without a helmet is more likely to suffer serious injury than one wearing a helmet, and those serious injuries, in turn, impose increased medical costs. See Picou, 874 F.2d at 1522. For persons with private insurance, the increased medical costs due to riding a motorcycle without a helmet would be borne by their private insurance companies. See Bruce A. Lawrence et al., U.S. Dep't of Transp., Nat'l Highway Traffic Safety Admin., Costs of Injuries Resulting from Motorcycle Crashes: A Literature Review (2002), available at http://nhtsa.gov/people/injury/pedbimot/motorcycle/Motorcycle_HTML/overview.html ("Only patients with adequate private health insurance coverage represent no medical cost burden to the government."). In contrast, for persons who have no insurance and for those who have medical or health insurance provided by the State under title 71, chapter 5, or otherwise provided through TennCare, the increased medical costs due to riding a motorcycle without a helmet would be borne directly by the State or the Tennessee public.

In sum, Senate Bill 925/House Bill 700 does not violate the equal protection guarantee of the United States Constitution or the Tennessee Constitution because the State's interests in preserving the fiscal integrity of its publicly funded health care programs and preventing broader societal costs provide a reasonable basis for the legislative distinction between adult motorcyclists with medical or health insurance other than insurance provided through TennCare and adult motorcyclists who are uninsured or who are insured through TennCare.

HERBERT H. SLATERY III
Attorney General and Reporter

ANDRÉE SOPHIA BLUMSTEIN
Solicitor General

SARAH K. CAMPBELL
Special Assistant to the Solicitor General and the Attorney General

Requested by:
The Honorable Jim Tracy
State Senator
2 Legislative Plaza
Nashville, TN 37243