Appeals court in TennCare again

Knox News/AP ^ | 5/6/5 | MATT GOURAS

[SmithL]

NASHVILLE - A federal appeals court has paved the way for the state to start cutting TennCare rolls, once again ruling in favor of Gov. Phil Bredesen's reform plans.

The 6th U.S. Circuit Court of Appeals in Cincinnati decided Friday to intervene in the state's fight with a federal judge over plans to overhaul the TennCare program and cut enrollment.

"We're gratified the appeals court acted swiftly in approving our request," Bredesen said in a statement. "This ruling allows us to continue on a fiscally responsible course to gain control of the TennCare program and pass a balanced budget."

A ruling issued late in the afternoon granted an expedited review of a federal judge's most recent decision to slow Bredesen's plans for TennCare.

Bredesen's legal opponents conceded that little stands in the way of the governor's plans to cut enrollees from the expanded Medicaid program.

"It means if the governor decides to proceed with cutting, the court won't stop him," Tennessee Justice Center attorney Michelle Johnson said. "What the governor considers a victory today is in fact a disaster for the state of Tennessee."

The appeals court promised a final decision before June 1.

It is the second time this year that the state has asked the appeals court to reverse orders from U.S. District Court Judge William J. Haynes.

Johnson said the appeals court decision to intervene means the state can start the preliminary steps leading to disenrollment right away.

"Once they start the process it will be very difficult to undo," Johnson said. "There is no hope the court can say you have to keep these people on."

The pressing legal battle over TennCare stretches across three courtrooms and two federal cases. The other case, scheduled for early June, could affect proposed benefit limits but not the planned cuts, Johnson said.

State officials have been waiting for clearance to move ahead with Bredesen's plans to cut between 225,000 to 323,000 people from the TennCare rolls. The move is needed, Bredesen says, to save the state $500 million to $600 million in the coming year.

Even with the cuts, spiraling TennCare costs would force the state to put roughly $60 million more into the $8 billion program.

The governor recently released a plan to keep the cuts at about 225,000 people by trimming benefits and pumping another $100 million in state money into the expanded Medicaid program. Only some of the attorneys representing TennCare enrollees signed on to the plan.

Part of that plan depends on Bredesen's ability to reduce benefits for other enrollees, the state has said.

"Barring additional legal complications, I'm hopeful that we'll be able to continue with our plan to preserve coverage for the sickest and neediest Tennesseans on the program," Bredesen said.

State lawmakers are closely watching the court battle as they try to figure out next year's state budget. At the same time, federal regulators are reviewing Bredesen's proposed cuts and benefit reductions.

Haynes first stopped the cuts entirely earlier this year and subjected the state to an exhaustive review of its plans. But before Haynes could issue that ruling, the 6th U.S. Circuit Court of Appeals intervened and said he was overstepping his authority.

Haynes then issued a new ruling late last month on the disenrollment procedures.

[SmithL]

Haynes must be feeling masochistic.

[GailA]

Oily Phil wants to replace the endless money pit of Tenncare with the endless money pit of universal pre-K. It's passed the House..it must be stopped in the Senate. If passed it will balloon to 250 M in just 5 years. With local taxes having to be raised to boot to fund this new boondoggle.

[donozark]

Missouri's new Governor, Matt Blunt (a Republican)has been excoriated, disemboweled, vilified, and cursed by the liberal media for cutting a mere 100K people off the welfare rolls. Meanwhile, the Gov. of Tennessee (a state with approx. same pop. as MO) a Democrat, can cut 325K off and I've not seen any articles portraying him as a "Nazi."

Go figure...

An amusing aside, in Missouri about 15K people on welfare had not submitted income statements for up to several years. Wonder why...nothing like a "second income."

[Recall]

So you like the cut on Tenn care but you don't trust Gov Phil? Have I got it right?

[GailA]

Tenncare is an endless money pit badly managed, badly implemented. There is NO oversight, NO audits, illegals, out of staters, and legal foreigners flock to Tennessee to get on Tenncare. High risk newborns are automatically put on Tenncare even if one of the parents has private health insurance. Some local doctors here in Memphis send vans into the poor neighborhoods weekly to pick up people for 'routine' exams...the same people, ditto for dental and vision. Their targets are usually children. Thus scamming the system. The list of troubles is endless...over 8 managers in the few years it's been in effect. Nearly bankrupting the state.

Then you have state senator john ford dipping his fingers into the till via 'consutling' work.

No, I don't like Oily Phil, he is a snake oil salesman. He and the media sold him(self) as a moderate Dem..baloney he's as liberal tax and spender as they make them.

[Recall]

Thanks for the info on Gov Phil. I'm trying to learn all I can from you Tenn freepers before we get there.