TennCare illegally cut health care for thousands of Tennesseans, judge rules

This article was originally published in The Tennessean. Read it here.

Tennessee’s Medicaid program TennCare unlawfully terminated health care coverage for thousands of Tennesseans, a federal judge ruled Monday, marking the conclusion of a four-year-long class-action lawsuit.

“Poor, disabled, and otherwise disadvantaged Tennesseans should not require luck, perseverance, or zealous lawyering to receive healthcare benefits they are entitled to under the law,” U.S. District Judge Waverly D. Crenshaw writes at the beginning of his 116-page ruling.

“After years of litigation, Plaintiffs have proven TennCare violated their rights under the Medicaid Act, the Due Process Clause of the Fourteenth Amendment, and the Americans with Disabilities Act,” Crenshaw said.

The plaintiffs in the case were represented by the Tennessee Justice Center, the National Health Law Program, the National Center for Law and Economic Justice and New York-based law firm Selendy Gay.

“This is a tremendous win for the plaintiffs and all TennCare members who have lost their vital health coverage due to TennCare’s unlawful policies and practices,” Tennessee Justice Center Executive Director Michele Johnson said in a news release. “We are proud to have stood with the courageous families that brought the case in order to protect the health coverage of many thousands of their neighbors across the state. We will continue to fight as this case moves forward.” 

TennCare Director Stephen Smith was appointed by Gov. Bill Lee in March 2020. Lee spokesperson Elizabeth Johnson told The Tennessean in an email that the governor “continues to have the utmost confidence in his selection of Director Smith for his important role at TennCare.”

Crenshaw found that TennCare failed to properly evaluate the eligibility of thousands of Tennessee families and withheld information they needed to try to retain their coverage, according to the Tennessee Justice Center’s news release.

In 2020, 35 children and adults sued over a “defective process” in TennCare’s eligibility verification system implemented in March 2019 that caused thousands of children and disabled adults to be disenrolled from the program. The lawsuit alleged thousands lost their insurance without any notice. 

Tennessee had long acknowledged that it had ramped up its efforts to confirm eligibility and later disenrolled some participants, but it denied that anyone had been improperly disenrolled. 

The lawsuit alleged TennCare disenrolled nearly 250,000 children not due to ineligibility factors, but because their parents or guardians failed to return or fully complete cumbersome TennCare paperwork requirements. 

The plaintiffs argued the TennCare bureaucratic red tape was not only flawed but illegal under the Medicaid Act and the Americans with Disabilities Act, noting that the eligibility system screened out and placed an unequal burden on people with disabilities.

Crenshaw wrote that those who have been removed from TennCare coverage since the new eligibility verification system was put in place “more likely than not faced both financial hardships and adverse health outcomes on account of TennCare’s unlawful actions.”

“Now, the Court must ensure they receive their deserved relief,” the judge wrote.

TennCare provides health care for about 1.5 million Tennesseans. A spokesperson for TennCare did not respond to a request for comment.