TennCare Oversight Committee Approves Sundquist’s Waiver Plan, Requests More Details On Enrollment Restrictions

Meeting for the first time since Tennessee Gov. Don Sundquist (R) announced a proposal to change TennCare, the state's Medicaid managed care program, the Legislature's TennCare Oversight Committee on Oct. 9 approved a three-year extension of the program, the Nashville Tennessean reports. However, the lawmakers said they needed "more details" about the proposed changes (de la Cruz, Nashville Tennessean, 10/10). Under Sundquist's Medicaid waiver proposal, TennCare would be split into three insurance pools. Beneficiaries who are categorically eligible for Medicaid would be placed into TennCare Medicaid, Medicaid-ineligible beneficiaries with no access to employer-sponsored health coverage would be placed in TennCare Standard and people who have access to employer-sponsored insurance but cannot afford the premiums would be put into TennCare Assist, which would subsidize premiums. The proposal also would cut from TennCare about 180,000 beneficiaries who are Medicaid-ineligible, a move that would save the state $150 million (Kaiser Daily Health Policy Report, 10/4). At the Oversight Committee meeting, state Sen. Roy Herron (D) said he was "concerned" that many "working poor" would no longer qualify for coverage under the changes and might quit their jobs to become eligible. Herron also said the TennCare Bureau would be unable to "handle the bureaucracy" of the program if it is divided into three pools. TennCare Director Mark Reynolds, however, said that a "streamlined eligibility process" would improve the program's management and that the "stricter limits" are needed to ensure the "neediest" are covered (Nashville Tennessean, 10/10).

Tax Reform
Critics of the proposal, who rallied against the plan at the Legislature on Oct. 8, said that Sundquist is "slashing" the program to "ease opposition" to a state income tax, but Sundquist has denied that claim (Cheek, Nashville Tennessean, 10/9). The Memphis Commercial Appeal reports that many legislators have said they will not consider any tax reforms or increases until TennCare is "fixed" (Wade, Memphis Commercial Appeal, 10/9).

New Dental Plan
Meanwhile, since the number of dentists willing to treat TennCare patients has "sharply dwindled," state officials hope to "carv[e]" children's dentistry services out of the program and into a new plan. Currently, dental care is managed by "regular" TennCare managed care organizations, but dentists have complained of "hassles" and late reimbursements. As a result, the number of dentists in the program has fallen from 1,700 to under 200 in the past few years. Under the new proposal, one MCO will run the dental plan, which will cover patients up to 21 years old who qualify for TennCare coverage. Dentists worked with TennCare officials to draft the proposal, which also aims to "restaff" public dental clinics that have been closed or are "seriously understaffed." These clinics will "target" schools that have a significant number of children enrolled in the school lunch program. State officials hope to have the new plan running by March 1 (Cheek, Nashville Tennessean, 10/10). For further information on state health policy in Tennessee, visit State Health Facts Online.