The state is proposing big changes to TennCare, which provides health care services to 1.4 million people or roughly one in five Tennesseans.
The proposal would turn a program that receives open-ended funding from the federal government into what the state calls a modified block grant – a set amount of federal funding for many but not all of TennCare’s services. It also would remove many regulations that the federal government has placed on TennCare and other Medicaid programs.
The state argues less regulation will help the state better tailor TennCare – its version of the federal Medicaid program that provides health care to lower-income people – to the needs of the state.
It also argues that the way TennCare is financed, with an open-ended match of funds from the state, rewards the state for spending money and punishes it for saving money.
Members of the public – that’s you – have through Friday, Oct. 18, to send written comments about the draft proposal.
Hearings will be held on the proposal Oct. 1, 2 and 3. The Nashville hearing will take place Tuesday, Oct. 1, 2 p.m., at Family and Children’s Service, Training Room B, 2400 Clifton Ave.
A hearing will be held Wednesday, Oct. 2, in Knoxville at the Burlington Branch of the Knox County Library, 4614 Asheville Highway, in the community meeting room, at 2:30 p.m. EDT.
The hearing for West Tennessee is set for Thursday, Oct. 3, 2:30 p.m., in the program center of the Jackson-Madison County Library, 433 East Lafayette St.
Official notice of the proposed change is online at www.tn.gov/content/dam/tn/tenncare/documents2/Amendment42ComprehensiveNotice.pdf. There are several links in the official notice with details including the proposal itself, how to comment and how to attend a hearing.
Medicaid was established under federal law in 1965. TennCare was born when the state added a managed-care component, which the federal government approved in 1994.
Both state and federal dollars fund TennCare, which covers primarily low-income pregnant women, children and people who are elderly or have a disability. In Tennessee, the state covers about 35% of costs. TennCare’s budget is about $12 billion, with 65%, or about $7.8 billion, coming from the federal government. Under the block grant proposal, TennCare would receive about $7.86 billion.
Once the public comment period is over, the state will submit a proposal to the federal Centers for Medicare and Medicaid Services (CMS) for approval. State officials say CMS normally takes six to nine months to act on the TennCare change requests. This could take longer because Tennessee is the first state to request a modified block grant for part of the federal match.
The state Legislature also must approve any block grant waiver agreement before it can be implemented.