Funding TennCare isn’t state’s only obligation
As far as the federal government is concerned, Gov. Phil Bredesen has amply made his case for reform of TennCare, the beleaguered $8.7 billion health care program for 1.3 million poor, chronically ill and uninsured Tennesseans.
There’s no doubt that the reforms Bredesen seeks will work an economic and emotional hardship on hundreds of thousands of Tennesseans who have come to depend on the health care TennCare provides. But it is also clear that if TennCare is to survive, radical surgery is now required.
The numbers tell the story: Since TennCare began roughly a decade ago, enrollment has grown approximately 20 percent, but program costs have skyrocketed more than 300 percent. Without fundamental reform, TennCare is estimated to consume slightly more than 90 cents in every new dollar of revenue the state takes in by 2008.
In this session of the General Assembly, Gov. Bredesen’s budget depends entirely upon the $575 million in savings his administration says reform would make possible. With reform, Bredesen proposes to add just $75 million to TennCare in this next fiscal year. Without it, the bill would soar to $650 million — a horse-choking amount of money that would likely require both horrendous cuts in other areas of government and a steep tax increase as well.
Although Tennessee’s situation is extreme, the fact is, all 50 states have altered their Medicaid programs in the past two years to try to get a handle on skyrocketing health care costs. The reason is clear: In the last five years, alone, Medicaid spending has mushroomed 63 percent. There simply is no revenue stream that can keep pace with such increases.
Health care is important, but a healthy Tennessee that can’t afford education for its children or adequate infrastructure to maintain jobs or lure new ones isn’t an option. TennCare isn’t the only obligation of government.