November 10, 2004
NASHVILLE (AP and WATE) -- Gov. Phil Bredesen announced plans to scrap Tennessee's expanded Medicaid program Wednesday. The move will cut more than 430,000 people from the state's financially troubled public health care program.
Those likely to be cut fall into three groups: the uninsured who joined TennCare because they didn't or couldn't gain access to insurance, the uninsurables who have preexisting health conditions and the medically needy who've already used all they have on medical bills.
The only way to head off ending TennCare, Bredesen said, is discussions with legal advocates who've won court battles about the level of health care the state must provide. The governor says he'll try for seven more days to work out an agreement with the attorneys.
"TennCare is a noble and worthwhile initiative that has made significant contributions to public health in Tennessee," Bredesen said in a press release posted on his web site. "Over the past year, we've made every possible effort to preserve the program. But persistent lawsuits have tied our hands. The sad reality is, we can't afford TennCare in its current form. It pains me to set this process in motion, but I won't let TennCare bankrupt our State. This is the option of last resort."
Bredesen says he has instructed the Bureau of TennCare and the Department of Human Services, which provides customer service to enrollees, to prepare a plan for orderly transition to Medicaid.
"No enrollee will lose coverage overnight," Bredesen said. "We will give as much advance notice as possible."
TennCare enrollees will begin receiving notice of changes in early January.
The conversion to Medicaid is expected to finish by mid-2005. As many as 430,000 enrollees, out of a total of 1.3 million enrolled, could lose health coverage.
Even though the process to dissolve TennCare is underway, Bredesen said the decision could be reversed if the Tennessee Justice Center, a nonprofit public-interest law firm based in Nashville, provides the state with immediate relief from longstanding "consent decrees" that are blocking reform efforts.
According to the governor's web site, the consent decrees, agreed on by the state in the 1990s, now prevent the state from implementing Bredesen's TennCare reform strategy and obligate TennCare to provide extraordinary benefits well beyond federal requirements.
The justice center's executive director, sent Bredesen a letter Tuesday asking for an additional seven days to consider the state's request for wholesale modification of the decrees. However, if modification agreement isn't reached in a week, Bredesen says the transition to Medicaid will proceed.
TennCare started in January 1994 as an experiment to expand Tennessee's Medicaid program by using managed care principles to deliver health care to a larger number of people for the same amount of money. But the governor's press release says that from its inception, TennCare was beset by problems and cost overruns.
Bredesen called TennCare's decade-long contribution to public health in Tennessee, "a wonderful dream." But he added that unchecked growth must be brought under control or the state risks jeopardizing all its other priorities.
"All great enterprises are powered by the heart, but steered by the head," Bredesen said on his web site. "It's time to do some steering."
Some portions of this report, copyright 2004 by The Associated Press. All Rights Reserved.