TennCare Oversight Committee Expected To Hold Nonbinding Vote This Week on Reform Proposals

The TennCare Oversight Committee has been meeting this week to discuss a proposal by Tennessee Gov. Don Sundquist (R) that would alter the structure of TennCare, the state's Medicaid managed care program, the Chattanooga Times & Free Press reports (Park, Chattanooga Times & Free Press, 12/4). 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. Sundquist's plan also calls for the creation of TennCare Standard, which would offer benefits similar to those under a commercial managed care plan to 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. The proposal also would create TennCare Assist, which would offer "premium assistance" to low-income workers to purchase private health insurance (Kaiser Daily Health Policy Report, 11/19). Although the proposal does not require the committee's approval, the panel is expected to take a nonbinding vote this week on the plan (Park, Chattanooga Times & Free Press, 12/4). Rep. Gene Caldwell (D), chair of the oversight committee, said the vote could be delayed until next week if members need more time to review the proposal (Park, Chattanooga Times & Free Press, 12/5). Legislators could prevent or delay the Sundquist administration from submitting the waiver proposal to CMS through state Comptroller John Morgan, a legislative appointee who must sign off on the plan. On Dec. 4, Morgan said he would make his decision after hearing from the oversight committee and the House Finance Committee, which is meeting next week to discuss the plan. "If the committees are not comfortable with [the plan], if they have serious objections, then I will refuse to sign it," Morgan said (Wade, Memphis Commercial Appeal, 12/5). TennCare Director Mark Reynolds said that while there is no deadline for submitting the proposal to CMS, Sundquist has made a "political commitment" to file the plan by Dec. 15 (Chattanooga Times & Free Press, 12/5).