Sundquist Makes Changes to TennCare Waiver Proposal, Sends to State Lawmakers

Tennessee Gov. Don Sundquist (R) made a few "relatively minor" changes to his proposals for TennCare, the state's Medicaid managed care program, before sending it to state lawmakers Nov. 16, the Memphis Commercial Appeal reports. Sundquist's "controversial" proposal, to be sent to federal officials as a modification of the existing TennCare waiver, would scale back the program to a managed care plan -- called TennCare Medicaid -- for Medicaid-eligible residents. That proposal would eliminate coverage for approximately 500,000 Medicaid-ineligible people in TennCare by July 1, 2002. Sundquist's plan also calls for the creation of TennCare Standard, which would offer benefits similar to those under a commercial managed care plan. The following people would be covered under TennCare Standard: adults with no access to group insurance and with incomes below the poverty level; children in families with incomes below 200% of the poverty level and no access to group insurance; and "[m]edically eligible" people with illnesses that make them uninsurable. Sundquist also has proposed the creation of TennCare Assist, which would offer "premium assistance" to low-income workers for the purchase of private health insurance. TennCare Assist would go into effect only after TennCare Standard was "in place and only if funded by the Legislature," the Commercial Appeal reports. Sundquist's "slight modifications" to the proposal include:

• Covering uninsured women who are diagnosed with breast or cervical cancer through a CDC screening program under TennCare Medicaid (Wade, Memphis Commercial Appeal, 11/17). Under the Breast and Cervical Cancer Prevention and Treatment Act, signed into law in October 2000, states can expand their Medicaid programs to include uninsured women under age 65 who have breast or cervical cancer (Kaiser Daily Health Policy Report, 1/5).
• Adding mental health benefits under TennCare Standard. Assistant Finance Commissioner John Tighe said that the benefits, offered under a plan called TennCare Partners, would ensure that "most of Tennessee's seriously mentally ill" would continue to have mental health coverage.
• Giving prescription drug benefits to Medicare beneficiaries who do not qualify for Medigap plans (Memphis Commercial Appeal, 11/17).

Real Reform?
"[T]here certainly is no blessing or reason for Thanksgiving in the governor's gratuitously costly and destructive proposal," a Chattanooga Times Free Press editorial says. The editorial says that Sundquist's labeling of the proposal as "reform" is "mere camouflage for political expediency." Sundquist is using the proposal to spur tax reform and "satisf[y] myopic Republican legislators" by attempting to save money in TennCare, the Times Free Press states. But the editorial says that TennCare "already costs half as much per participant than private-market care," and Sundquist's plan would not bring any savings, "only additional costs and burdens." The editorial concludes, "Indeed, it is truly bizarre to propose to pay for less, and to leave 200,000 Tennesseans again without insurance to boot. But in Tennessee ... such tricks these days are passed off as leadership" (Chattanooga Times Free Press, 11/19).