Tennessee Officials Say New TennCare Applicants Could Lose Coverage When Waiver Takes Effect

To comply with a judge's order, officials in TennCare, Tennessee's Medicaid managed care program, have spent $136,000 since June 13 to sign up new applicants even though those applicants would lose coverage if state lawmakers conducting budget negotiations this week elect not to fully fund the program, the Nashville Tennessean reports. U.S. District Judge William Haynes in March 2001 ordered the state to open TennCare enrollment when slots became available; accordingly, the state has mailed information packets to 220,000 individuals who had previously been rejected for TennCare benefits, inviting them to apply for about 5,000 slots vacated by individuals found ineligible. But TennCare lawyers in court documents called the process a "futile exercise," saying that the new beneficiaries might lose their coverage when the state's recently approved Medicaid waiver takes effect July 1 (Lewis, Nashville Tennessean, 6/26). The waiver will restructure eligibility and benefits offered under the program, allowing the state to create TennCare Medicaid, which would cover Medicaid-eligible individuals, and TennCare Assist, which would provide low-income workers assistance in purchasing private health insurance. Further, the waiver permits the creation of TennCare Standard for 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 (Kaiser Daily Health Policy Report, 6/3). State Deputy Finance Commissioner John Tighe, who oversees TennCare, said if lawmakers decide not to fully fund TennCare -- an option that has been discussed in state budget negotiations -- up to 420,000 beneficiaries could lose coverage. Joint TennCare Oversight Committee Chair Rep. Gene Caldwell (D) said Haynes' order "makes very little sense," adding "The people who come in will be removed July 1." But according to court documents, Haynes disagreed with state officials, saying the process offers some individuals a "last chance" to receive benefits before the waiver takes effect (Nashville Tennessean, 6/26).