Tennessee Gov. Bill Lee unveils controversial $7.9 billion TennCare Medicaid block grant plan
Republican Gov.
The governor is also making a novel request to share future anticipated savings in TennCare on a 50/50 basis with the federal government. Lee says if the past is any guide and U.S.
Lee proposes to plow the money into health, including rural health initiatives, and also is not ruling out select expansion of TennCare to new population categories.
"We're excited about the prospects, and we think we have crafted a waiver that is going to really mitigate the risk that Tennesseans have [from a block grant] but actually give us an opportunity to benefit from the efficiencies that we have and from the way that we run our program," Lee said during a Monday roundtable with
The governor, who was joined by TennCare Deputy Commissioner
"So this could be a big win for the state," Lee added.
(Read more: Lee vows to pursue Medicaid block grant but not accept one 'that would be bad for
TennCare now covers some 1.42 million low-income children, mothers, seniors and disabled Tennesseans at a total projected cost this year of
According to the waiver, the block grant is projected to impact about 1.3 million people, based on a three-year monthly averaging calculation.
Excluded from the waiver are special federal payments to hospitals providing large amounts of otherwise uncompensated care, critical access and essential hospital payments and similar payments.
Also excluded are people who are enrolled in both Medicare and Medicaid; services that are now carved out of TennCare's current waiver, such as those for individuals with intellectual disabilities; children in state custody; outpatient prescription drugs and administrative expenses that are not treated as medical assistance expenditures.
(Read more:
Lee initiated the process Tuesday morning by providing notice of his plans for the managed care program. A 30-day public comment period is in place before the actual Medicaid Section 1115 waiver for TennCare can be submitted to federal officials.
The Republican-controlled
For his waiver, Lee is proposing to plow the money into health care, including rural health initiatives. He is not ruling out expanding TennCare to new population categories.
Sen.
"Last
The state could make changes in response to questions and criticisms raised during the 30-day comment period. State officials would need to submit the waiver request to the
But Lee's proposals have already come under fire, even before he made the full details public.
"I think the issue is that when they say that they've created all these 'savings' for the federal government, that includes like the 220,000 children that were cut off even though tens of thousands of them were eligible," said
"Here's the bottom line," Johnson said. "The Trump administration has said they're going to cut over a trillion dollars out of the [national] Medicaid program through block grants. The Lee administration says we're going to be able to get all this money, an expansion of health care? The math doesn't work out."
"The state would shoulder some additional long-term financial risk under this plan, but overall the proposed funding changes are weighted heavily in
Noting the proposal also gives TennCare officials "unprecedented control over changes to optional program benefits and provider payments," Berlind added: "This broad power shift from federal to state policymakers could have significant effects on TennCare spending, enrollees, and providers -- either positive, negative, or mixed depending on if and how state officials use that power."
Last spring as the bill was pending before lawmakers, a dozen national patient groups, including the the
But Americans for Prosperity Tennessee Director
"By investing in the health of Tennesseans, not just health insurance, we are finding the solutions to improve access to health care," she added.
The bill was sponsored by Sen.
Bailey issued a statement Tuesday saying the governor and his administration have "done an excellent job in moving forward with a bold and ambitious plan to improve healthcare in our state and to ensure that TennCare members continue to receive high-quality care into the future."
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