TennCare officials unveil details, timeline behind proposed cuts
NASHVILLE — TennCare officials unveiled the details behind cuts Gov. Phil Bredesen announced last week, and officially started the process of rolling back the troubled expanded Medicaid program.
Bredesen laid out a course that would cut 323,000 adults from the TennCare rolls and cap benefits for others, while retaining full coverage for 112,000 children. The cuts are expected to save the state about $600 million in TennCare costs during the next fiscal year that begins in July.
Right now the program covers about 1.3 million poor, disabled and uninsured Tennesseans, and has a price tag that was expected to climb to nearly $10 billion in combined state and federal money.
TennCare officials Wednesday sent official notice to the TennCare Oversight Committee and legal advocates at the Tennessee Justice Center, which has won a number of court victories over the state’s handling of TennCare.
The notification details the cuts but permission isn’t needed for the governor to move forward, TennCare director J.D. Hickey said.
“We are certainly receptive to input, but we believe substantially this document will remain the same,” he said.
In about 30 days, the state will seek federal approval for the changes. By May, the state expects to start cutting some people and putting the first benefit caps in place. The cuts should be finished no later than early 2006, officials said.
The federal waiver, beyond the enrollment cutbacks, seeks to cap annual benefit limits to 12 doctor visits, 10 lab and X-ray uses, 20 days in a hospital and eight outpatient days at a hospital. It also caps pharmacy benefits at four per month.
The state also is asking for the authority to exclude costly, and popular, gastric acid reducers and antihistamines. Other cuts are being sought in methadone clinic services, adult dental services and private nursing benefits.
Of the 323,000 adults that will be cut, 121,000 are labeled as uninsured, 67,000 as uninsurable, 97,000 medically needy people who earn too much for Medicaid qualifications, and 38,000 people eligible for both Medicaid and Medicare.
The “basic” TennCare plan would serve about 612,000 children and nearly 400,000 adults, Hickey said.
Most of the people being cut — about 60 percent — are female, and most earn less than 150 percent of the federal poverty level, according to details released Wednesday.
Hickey stressed the administration believes it is offering the most responsible plan under the current legal and budget constraints.
He said the administration doesn’t believe it will need any additional legislation to move ahead with the cuts.
———
On The Net:
TennCare: http://www.tennessee.gov/governor/tenncare.htm