TENNCARE REVAMP: THREE YEARS IN, EXPANSION REMAINS THE SOLUTION

In the three years since federal officials approved Tennessee’s waiver to revamp the state’s Medicaid program, the lives of thousands Tennesseans have improved.

Through the restructured program, TennCare began covering dental services for 600,000 adults in 2023. States are required to provide dental services for people covered by Medicaid who are under 21 years of age, but the coverage is optional for adults.

Before expanding covered services to include dental care, Tennessee was one of three states without any dental coverage for all TennCare-eligible adults.

In addition to the adult dental benefit, TennCare has used money saved over the past few years in the restructured program to extend postpartum coverage for new mothers from six weeks to 12 months and to increase TennCare’s eligibility threshold for pregnant women to 250% of the federal poverty level, according to a Sunday Times Free Press report. The program also increases the eligibility threshold for parents and caretakers of children to 100% of the federal poverty level and offers lactation consulting as a benefit.

Gov. Bill Lee and the rest of the GOP believe that they achieved something positive for the state, and they did — to a point.

Yes, some benefits have been added or expanded. Great. But the reality is Tennessee still has a large population of uninsured residents. The benefit additions and extensions that state officials tout are common in other states.

If we expanded Medicaid and accepted more federal funds, the state would be able to cover more residents and drive down Tennessee’s uninsured rate.

Tennessee is among 10 GOP-led states that haven’t expanded Medicaid. There have been many good opportunities for the state to expand the program for low-income and disabled individuals.

Study after study shows that expansion would make health care more accessible. The latest research estimates that 151,000 Tennesseans would gain health insurance coverage and reduce the state’s uninsured population by 27%. All it would take is the GOP-controlled legislature agreeing to accept the $1.4 billion annually from the federal government to allow expansion of the $14 billion-a-year health care program.

Despite studies that document the positive results of expanding health care coverage to Tennesseans who need it most, the GOP remains committed to denying the move.

GETTING IN THE WAY OF HEALTH CARE

The TennCare waiver that has allowed the state to add services to the TennCare population does not prevent the Lee administration and legislature from expanding Medicaid.

According to the TFP report, TennCare Director Stephen Smith said there’s nothing about the waiver that precludes Medicaid expansion, and no reason why full Medicaid expansion should negatively affect the shared federal-state savings.

“Some people think, ‘Oh well, because they did this, that means Tennessee can never expand.’ It’s two completely independent conversations,” Smith told reporter Elizabeth Fite.

The conversation around a possible Medicaid expansion is one-sided. An expansion would recognize that health care requires a holistic perspective and needs to be as broadly available as possible.

TennCare III, as the restructured program is known, is now focused on connecting its enrollees to resources that are important to their overall health and functionality, services that are not necessarily associated directly with “health care” but are interconnected: transportation, housing, nutritious food and education.

The more people who can benefit from this kind of system, the better. The COVID-19 pandemic opened our eyes to the struggles that many members of our community face, whether it is the lack of transportation, living in a food desert or being without a home, and how those challenges negatively affected their health outcomes.

Our health depends on much more than just trips to doctors. Struggling, low-income Tennesseans need access to a strong safety net.

GOP STUCK IN THE PAST?

Health care is a right; it is not some partisan tool to be used as a weapon for political gain.

Lee and his administration got their way with the TennCare waiver. Savings were squeezed from the program and benefits were added. Now it’s time to move forward.

Too many Republicans still try to hang the “Obamacare” label on an expansion of Medicaid. It’s time to drop that nonsense. They should open their eyes to the reality of 2024’s landscape and know Tennesseans are in need of access to quality, reliable health care services, and they need it now.

Public health is an issue that crosses race, socioeconomic class and age.

Expansion is the answer for Tennessee.