Task force proposal emphasizes motivation and achievement for coverage expansion.
Insure Tennessee Alternative Awaits Federal Approval
At the end of June, the 3-Star Healthy Task Force, created by House Speaker Beth Harwell, announced its proposal to make TennCare, the state’s Medicaid program, more accessible, efficient, and cost-effective.
The task force has been at work since April, meeting with healthcare providers, community leaders, and businesses across the state in their effort to close the coverage gap for uninsured, low-income Tennesseans. Insure Tennessee, Gov. Bill Haslam’s plan for Medicaid expansion, failed in 2015. Task force members presented their plan to federal officials from the Centers for Medicare and Medicaid Services, but negotiations with CMS could take several months. Pending federal approval, the task force expects a vote on the proposal in the next legislative session.
Under the proposal, The Tennessean reports, TennCare would be expanded with a two-step phase-in program that emphasizes motivation and achievement. The first phase would focus on veterans and those with mental health or substance abuse disorders. Coverage would be contingent upon a qualifying diagnosis of a mental illness or proof of honorable discharge from the U.S. military, and enrollees can earn up to 138 percent of the federal poverty level (about $16,000 for an individual or $27,000 for a family of three). Up to 115,000 Tennesseans are estimated to be eligible to enroll in TennCare with this first phase.
The second phase, pending success of the first phase, would be open to all Tennesseans earning up to 138 percent of the federal poverty level. Success could be judged by cost-per-member analysis, number of enrollees, health outcomes, and utilization of emergency rooms and primary care doctors.
Federal funds would account for 65 percent of the costs of the task force’s plan, while Tennessee would be responsible for the remaining 35 percent.
Small business owners like Ken Gough, NFIB member and president/general manager of Accurate Machine Products Corporation in Johnson City, want to know how much this is going to cost and how the state is going to pay for it. Following the task force’s meeting in Johnson City, during which Gough presented the small business perspective, he contributed a letter to the Johnson City Press. Gough, whose healthcare costs at his own business have risen 90 percent, wrote:
“It doesn’t matter what the opinion polls say if the numbers don’t add up; going broke in a noble cause is still going broke. There is no point in talking about federal dollars and state dollars when the individual taxpayer is ultimately responsible for both. … It is indefensibly immoral to insist that the people of Tennessee commit to another entitlement without certainty that we can afford it.”
