TennCare to begin accepting medically needy ahead of schedule
The governor has cut 191,000 people from the TennCare rolls and reduced benefits for thousands of others to control costs in the $8.7 billion program.
He earlier said he would keep 97,000 “medically needy” adults on the program if the state got relief from a 1999 agreement with legal advocates for TennCare patients. A federal judge has granted most of that relief.
On Tuesday, Bredesen said the TennCare reforms mean the medically needy category could open as early as February rather than July and will provide applicants a full 12 months of coverage without proof of medical bill expenses every three months as outlined in an original legal agreement.
The plan must meet federal approval, but the governor said “we’re going to work to make this a reality.”
“It is an enormous pleasure to stand before you and bring you this good news on TennCare,” Bredesen said at a news conference. “Sound management of TennCare is beginning to show positive results.”
The medically needy are those with high unpaid medical bills that reduce their income enough to qualify for TennCare, the state’s expanded Medicaid program.
Bredesen was joined by House Speaker Jimmy Naifeh, who said he and his colleagues worked with the governor to create a “more generous option for covering these medically needy TennCare enrollees.”
“People are concerned and they want us to continue to look for ways to help them,” said Naifeh, D-Covington.
Last month, TennCare Director J.D. Hickey told the governor during a budget hearing that the reforms will allow TennCare to close the 2005 fiscal year by using less money from the reserve fund than expected. He said the program will also be able to work within next year’s fiscal budget without a supplemental appropriation or reserves.
However, legal advocates have said cuts wouldn’t have been necessary if the state had relied on those reserves and budget surplus money.
“You have to ask yourself what are the TennCare reserves for if not to protect people when they are in a deep medical crisis,” Gordon Bonnyman, executive director of the Tennessee Justice Center, said Tuesday.
Bredesen reiterated Tuesday that cutting people from TennCare has been tough but said he continues to look for ways to help those who have been removed from the rolls.
Part of his initiative includes expanding a so-called “safety net” program that provides transitional assistance for disenrollees, as well as seeking additional legal relief to adopt a “soft limit” on prescription drugs.
Currently, there’s a hard limit of five prescriptions. But the change would allow doctors to prescribe over that amount if medically necessary.
“I want you to know I’m going to continue to fight for TennCare,” Bredesen said.