Tenncare: No hearing raises concerns
County with the most enrollees gets skipped
Major Tenncare changes proposed by Gov. Bill Lee’s administration will be subject to three public hearings across Tennessee this week — one in Nashville, one in Knoxville and one in Jackson.
Memphis is not scheduled to have a public hearing on the matter, despite Shelby County being home to more Tenncare enrollees than any other county, per August enrollee data.
On Monday, Memphis Mayor Jim Strickland said in a statement that his office is “confident that a public meeting will be held in Memphis” after being in contact with Lee’s office about the issue. A
Tenncare public hearings schedule
Nashville: Tuesday, 2 p.m. CDT, in Training Room B of the Honey Alexander Center at 2400 Clifton Ave.
Knoxville: Wednesday, 2:30 p.m. EDT, in the community meeting room of the Knox County Library Burlington
Branch at 4614 Asheville Highway
Jackson: Thursday, 2:30 p.m. CDT, in the Jackson-madison County Library at 433 E. Lafayette St.
Those who would like to comment on the proposal can also email public.notice.tenncare@tn.gov or send mail to Tenncare Director Gabe Roberts at 310 Great Circle Road, Nashville, 37243.
spokesperson for Lee has not responded to a request for comment.
A Memphis hearing is being considered, but nothing has been finalized yet, said Tenncare spokeswoman Sarah Tanksley.
The proposed changes focus on how Tenncare, the state’s Medicaid program, is funded. This could affect coverage for more than 1.4 million people in the state. The hearings are part of a 30day public comment period on the proposal before it is sent to the federal government.
If implemented, the proposal would convert the billions the federal government provides for Tenncare funding annually into a $7.9 billion block grant. Proponents believe this block grant, which would pay for Tenncare’s core functions, would lead to a more efficient, cost-conscious Tenncare since the state has more control over how that money is spent.
Others are concerned the hard spending cap typical of block grants would mean the state could run out of Tenncare funding. Under a traditional block grant, an enrollment spike could make that a reality. But the state says the “modified” block grant has mechanisms in place to cover such scenarios.
‘I think it is an oversight’
Some Tenncare stakeholders may want to get more information from officials about the proposal before taking a position. That’s what Church Health, the Memphis nonprofit providing health care to those with little or no access to it, is looking for and believes a public hearing could help with.
“Truthfully, I don’t think there’s been enough detail,” said Jennie Robbins, Church Health’s chief financial officer, of the block grant proposal.
Robbins said she hopes the Division of Tenncare will find time to have a meeting in Memphis, noting many lowincome Memphians rely on Tenncare.
“I think it is an oversight to not have it in Memphis because of the population that’s on Tenncare,” Robbins said. “I can’t imagine it was intentional. I just think it was an oversight or about scheduling.”
Jackson, roughly a 90-minute drive from Downtown Memphis, was chosen as the site of a public hearing because of its central location for the West Tennessee area, said Tanksley.
“We felt like Jackson was a good location for anyone in West Tennessee to travel to,” she said.
Shelby County has 250,292 Tenncare enrollees, enrollment data says. Nashville’s Davidson County has 133,601, Knoxville’s Knox County has 76,973 and Jackson’s Madison County has 24,528 enrollees.
Cato Johnson, a vice president at Methodist Le Bonheur Healthcare who is also chairman of Tenncare’s advisory committee, said he was generally supportive of the governor’s proposal, but it was an obvious mistake not to hold a public hearing in Memphis. Johnson said the governor’s administration spoke to some hospital officials in Memphis, but he would have “greatly preferred” a hearing in the city.
“We have a tremendous number of kids on Medicaid,” Johnson said. “Memphis is going to be a majority player in this, regardless of what (the federal government) approves or doesn’t approve.”
A meeting in Memphis would be a good opportunity for Lee’s administration to connect with a city that has many Tenncare stakeholders, said Kiki Hall, CEO of the Memphis-based health improvement collaborative Common Table Health Alliance, a nonprofit.
Memphis continues to be one of the least healthy communities in the country, with poverty being “a common denominator,” Hall said.
“I think that coming here and addressing our large population would show the governor is wanting to give Memphis, Shelby County and West Tennessee the attention we need,” said Hall, who added she is “not judging” Lee’s proposal yet.
State representative calls for Shelby County hearing
State Rep. Karen Camper, whose district is part of Shelby County, has requested the Division of Tenncare hold a public hearing in Shelby County. She said in a letter she’s concerned many stakeholders, including residents and health care professionals, won’t have the chance to hear proposal details unless they travel to one of the public hearing sites.
“The majority of West Tennessee’s population lives near Shelby County and many of these residents will be affected if the proposal is approved by CMS,” Camper wrote.
According to Camper, 17.3% of Memphis residents ages 65 or younger don’t have health insurance and “will be directly affected by any changes made to the current Tenncare program.”
Robbins said a public hearing in Memphis would help Tenncare officials get additional information on what they need to consider before submitting a proposal. Church Health doesn’t have a public position on the proposal yet, according to Robbins.
The best way to comment on the proposal is in writing, Tanksley said. Tenncare officials present at the public hearings will be focused on facilitating the comment process rather than engaging in back-and-forth discussions or answering questions about the proposal.
“If they’re not going to come to Memphis to listen, Memphis needs to find a way to have feedback sessions or a forum so we can have a voice, so we can have some collective messaging from the Shelby County delegation,” Robbins said.
Tennessean health care reporter Brett Kelman contributed to this report.
Max Garland covers Fedex, logistics and health care for The Commercial Appeal. Reach him at max.garland@commercialappeal.com or 901-529-2651 and on Twitter @Maxgarlandtypes.