Bredesen announces deal to ease TennCare cuts
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“There is no question it is a heavy weight to be thinking about taking away health insurance from people, including some people that really need it,” Bredesen said. “There are people who are frail and there are people who are vulnerable … and we need to find some ways to continue to help these people.”
The governor had said he would end coverage for 323,000 adults to control soaring costs in the $8 billion expanded Medicaid program. More than 1.3 million people, about 23 percent of the state’s residents, get their health coverage from TennCare.
Bredesen was surrounded by the enrollee lawyers who helped craft the compromise, George Barrett and Ted Carey, and top lawmakers, including House Speaker Jimmy Naifeh, D-Covington, and Senate Speaker Pro Tem Mike Williams, R-Maynardville, as he broke the news of the settlement.
The latest twist in the ongoing TennCare saga had one familiar component — complete disagreement between Bredesen and chief legal advocate Gordon Bonnyman of the Tennessee Justice Center.
The Justice Center, which until last year exclusively represented TennCare patients, was noticeably absent from the announcement. Bonnyman said at a separate news conference that the announcement was politically crafted and that the 100,000 enrollees aren’t really promised a thing.
“The governor does not promise protection to a single one of the 323,000 people losing coverage,” he said. “The fine print makes clear that the only sure thing is that the governor is demanding a removal of the constitutional rights of 1.3 million Tennesseans.”
The proposed settlement faces a number of hurdles, requiring the blessing of two federal judges and officials with federal Medicaid, which provides two-thirds of the funding for the health care program for the poor, disabled and uninsured. Lawmakers also need to approve portions of the deal.
Another possible sticking point is the price tag, which is $100 million beyond what the governor proposed for TennCare next year. Going forward, it would only require $25 million a year more than planned because the agreement also calls for such cost-cutting mechanisms as a hard prescription limit of five per enrollee, including two brand-name prescriptions.
“This is the first step in a process, that if we’re successful, I think can substantially mitigate the worst of the negative effects of having to take people off the rolls,” Bredesen said. “I’m trying to be a good governor.”
Tuesday’s deal, which formalizes a proposed change to legal agreements that dictate much of TennCare’s operation, also was supported by the Tennessee Hospital Association, other health care groups and the AARP.
Those groups said Bredesen needs freedom from consent decrees to manage the program responsibly.
While the state waits to hear from one federal judge that it can start the process of disenrolling people from TennCare, it is preparing for a June 6 hearing in another federal court that will dictate much of the plan announced Tuesday.
TennCare director J.D. Hickey said the state will hope to get approval quickly from U.S. Senior Judge John Nixon so that it can clear the changes through the Center for Medicare and Medicaid Services before the July 1 start of the state’s fiscal year.
Without any changes or cuts to TennCare, the state estimates a $650 million cost overrun next year.
As usual, the rhetoric was strong.
Bonnyman, in his pointed criticism, said the governor should instead be doing more to rein in TennCare contractors that have been linked to lucrative insider deals with state Sen. John Ford.
“They are not asking anything of John Ford’s clients, they are not asking anything of Blue Cross-Blue Shield, they’re not asking anything of the political fat cats of this state,” he said. “They’re only demanding constitutional surrender of protections guaranteed to every American, by the weakest, the sickest and the most vulnerable people in our communities.”