NCLEJ Submits Public Comment Opposing Tennessee’s Proposal to Turn TennCare into a Block Grant Program

On November 20, 2019, Tennessee submitted an application to the federal Center for Medicaid Services (CMS) and the Department of Health and Human Services (HHS). With its application, Tennessee is requesting that the Secretary of HHS waive certain federal Medicaid requirements that would allow the state to convert its Medicaid managed care program, called TennCare, into a “block grant” program. If approved by HHS, the waiver application gives Tennessee more federal dollars and less oversight and accountability requirements. Tennessee’s waiver also includes incentives for the state to reduce the health care services it provides through TennCare in order to reap the “savings” that result from the “block grant” structure of the waiver.

Tennessee’s cruel proposal to reduce its Medicaid costs and increase its “savings” under this proposal will strip away or significantly reduce the health coverage of individuals who currently rely on Medicaid benefits to access critical health care services. The state’s request jeopardizes access to health care for 1.4 million vulnerable Tennesseans, including children, low-income parents, and people with disabilities. Particularly vulnerable to the waiver’s negative impacts are Medicaid enrollees with disabilities and chronic illnesses because the waiver proposes to eliminate federal Medicaid rules that prohibit discrimination based on a patient’s medical condition. If DHS approves Tennessee’s waiver application, it would authorize the state to effectively “target benefits to certain populations” and provide fewer treatment options or inadequate services to patients with mental illness or substance use disorders. Furthermore, the waiver seeks to make unprecedented cuts to prescription drug coverage, which would enable the state to deny access to the most effective drugs for serious and costly illnesses like cancer and hepatitis.

NCLEJ unequivocally condemns Tennessee’s request to be paid more federal money to do less for its Medicaid beneficiaries. The proposal could disproportionately harm low-income people with high health care costs and strip away or limit health coverage for people who need Medicaid the most.

Today, we submitted public comments opposing HHS approval of Tennessee’s waiver application. Read our full comment letter here.