Chattanooga Times & Free Press, TennCare Deputy Commissioner John Tighe Comment on TennCare Waiver

Earlier this month, CMS approved Tennessee's waiver application to alter TennCare, the state's Medicaid managed care program. The waiver allows the state to split the program into three parts. Medicaid-eligible individuals will be enrolled in TennCare Medicaid. TennCare Standard will cover adults with no access to group insurance and annual incomes below the poverty level, or $8,860 for an individual; children in families with annual incomes below 200% of the poverty level, $36,200 for a family of four, and no access to group insurance; and medically eligible people with illnesses that make them uninsurable. TennCare Assist will provide low-income workers assistance in purchasing private health insurance (Kaiser Daily Health Policy Report, 6/3). The following is a summary of recent commentary on the changes:

• John Tighe, Tennessee's deputy finance commissioner: The federal government's decision to approve the waiver is "an endorsement" of TennCare and will allow the program to provide services "more efficiently, more effectively and with better controls in place," Tighe, who oversees the program, writes in a Chattanooga Times & Free Press opinion piece. The waiver allows TennCare to be structured "more like a commercial insurance product," which Tighe says will "reduce costs and control enrollment" and "encourage and promote ... individual responsibility" in health care decisions. In addition, the waiver allows state officials to implement a so-called stabilization plan -- which would temporarily shift medical risk from participating managed care organizations to the state -- a move Tighe maintains will ensure that patients have access to a "healthy provider network." Tighe concludes that the waiver makes TennCare "more stable than it has ever been," while allowing "the neediest citizens" to retain their TennCare coverage (Tighe, Chattanooga Times & Free Press, 6/9).
• Chattanooga Times & Free Press: Through the waiver, state officials "at least [are] making an effort to ease an ongoing cost and care problem" in TennCare, the editorial states. Noting that the waiver allows for "tighter enrollment checks" and copayments for certain services, the editorial notes that the waiver offers a "flexible approach" to altering the program while still ensuring that Medicaid-eligible individuals receive care. The editorial cautions, however, that Gov. Don Sundquist (R) has said the state "will be back in the old Medicaid cost briarpatch" if lawmakers fail to adequately fund the program (Chattanooga Times & Free Press, 6/7).