State, federal governments agree to TennCare overhaul
By GARREN SHIPLEY
TennCare is going into the shop for a major overhaul - one that will clamp down on fraud but is likely to cut benefits to nearly 25,000 enrollees.
Gov. Don Sundquist announced Friday that the state has received a five-year federal waiver to institute major changes to the state's health insurance program for the poor and uninsured.
Under the new agreement, TennCare will become three programs.
One is for people eligible for Medicaid, the federal-state health care program for the poor and disabled.
Another is TennCare Standard, a package "comparable to a commercial HMO product" with benefits similar to Medicaid.
The third is TennCare Assist, where the state will help pay premiums for the those who have access to group health insurance but can't afford it.
"I thought TennCare was a great model 10 years ago when it was created, and it's an even better model today," said Tom Scully, administrator of the federal Centers for Medicare and Medicaid Services.
"Tennessee has chosen to keep TennCare fiscally sound and has the most comprehensive health care coverage in the nation," Scully told the Associated Press. "You should be proud of what you've done."
Scully said Tennessee is "the most aggressive state in the nation" in using its Medicaid funds to cover a broader range of people.
Legislators won't have to appropriate any more money for the program, said Sundquist, since the new waiver was designed to be "budget neutral."
But the changes will likely force about 24,500 people on TennCare rolls out of the program since they'll no longer meet the income requirements or not qualify as uninsurable under tighter medical guidelines.
Beyond those enrollees, the governor's office expects about 70,000 more people to lose their coverage due to a new annual recertification process where the state will re-evaluate enrollees' income, access to insurance and other criteria.
The new waiver also allows for tighter controls over who gets into the program.
Applicants will have to show proof of income, residency, citizenship status and access to insurance, among other things. Those who cannot supply such proof will not be enrolled.
Another change officials said they hope will drive down costs is the inclusion of a prescription drug co-pay for both TennCare Standard and TennCare Medicaid.
Advocates for TennCare enrollees were critical about the revamped program.
"We estimate 150,000 people will lose coverage by the end of the year," said Tony Garr, director of the Tennessee Health Care Campaign. "Seniors will lose prescription drug coverage, and children in near poverty will be hurt. It's a terrible design."
TennCare will begin evaluating enrollees for continued coverage on July 1 and should be done by the end of the year.
About 1 million of the state's roughly 1.4 million TennCare enrollees are Medicaid eligible, while the rest either don't have access to health insurance or have "uninsurable" medical conditions.
Friday's announcement comes at an interesting political time - a revenue crisis and a debate over new taxes.
Sundquist said those who have been saying "fix TennCare" before attempting to raise taxes should now have confidence that TennCare is fixed.
"The citizens of Tennessee should have confidence it's a better system," Sundquist said. "Those who have said TennCare is the root of our budget problems have been wrong, and they are wrong. It's a political issue being used inaccurately."
Locally, some legislators said the new waiver is good news, but its impact on the state's revenue troubles will be minimal.
"Money is money, and money is good," said Rep. Ken Givens, D-Rogersville.
But Givens hastened to add that anyone who thinks the new waiver eliminates the need for new revenue is badly mistaken.
Tennessee spends just under $2 billion per year on TennCare, while the federal government picks up the remaining $3.5 billion.
Anybody besides me remember this during the POTUS campaign? I think Tazquist is DC bound early next year.
Georgewbush.com
August 17, 1999
Tennessee Governor Becomes 22nd To Endorse George W. Bush
AUSTIN – Tennessee Governor Don Sundquist today endorsed Governor George W. Bush for President.
"I am pleased to join Governor Bush’s campaign and will work hard in Tennessee to help him win the nomination and the Presidency," said Governor Sundquist at a Nashville news conference. "I have known Governor Bush and his family for many years, and I know how important public service is to them."
"As a colleague of Governor Bush’s, I have watched him become one of the strongest governors in the country. His record in Texas is outstanding, and many of his innovative programs have served as models for the nation. Governor Bush is a proven leader who has the unique ability to unite people and accomplish success. I look forward to working with him and his team, as we gain support from Memphis to Mountain City for this dynamic leader," added Governor Sundquist.
"Governor Sundquist is a valued colleague and a good, close friend, and I am honored to have his support" said Governor Bush. "Don is devoted to welfare reform and better education for the people of Tennessee. His help will be important to my campaign in the Volunteer State. I intend to wage a vigorous, winning effort in Tennessee, not only in the primary, but the general election as well."
Re-elected to a second term last year with a record 69 percent of the vote, Governor Sundquist has initiated unprecedented reforms in Tennessee in the areas of welfare, government and crime, while placing a special emphasis on Tennessee children. Under his watch, the growth of government spending has been cut by more than half; the number of employable adults on welfare has been reduced by 60 percent; and Tennessee became the first state in the nation to connect every public school and library to the Internet and to offer universal health care coverage to all children.