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| Articles TennCare cutoffs begin Tuesday | State reducing rolls by 288,000 in all July 8, 2005 | By Richard Locker
NASHVILLE -- After months of debate, negotiations and legal wrangling, the first group of up to 288,000 people facing removal from the TennCare program will lose health coverage Tuesday.
Three weeks later, on Aug. 1, reduced benefits -- including caps on prescription drugs, hospital stays and doctor's office visits -- go into effect for most of the remaining adult TennCare enrollees not in nursing homes, mental health institutions or community-based programs. Until now, TennCare's downsizing has consisted of warnings, planning, deadlines and court battles over the government's ability to pay for health care vs. education and other needs. It starts getting real next week, when the 20-day notice expires for the first couple of thousand notified of disenrollment last month, and coverage actually ends.
"This is a very sad day for the people of Tennessee. These cuts are not necessary and will inflict harm on hundreds of thousands of individuals and families," Tony Garr, executive director of the Tennessee Health Care Campaign, said Thursday.
Garr and other advocates contend the state could avoid cuts by alternative reforms, appealing to the federal government for a bailout and raising tobacco taxes. But Gov. Phil Bredesen says those measures wouldn't save nearly as much as needed and would not solve TennCare's underlying problems of limitless benefits and escalating costs.
Tennessee's experiment with near-universal health insurance has operated as an expanded version of the national Medicaid program since Jan. 1, 1994, with just over 1.3 million enrollees.
Federal taxpayers pay about two-thirds of its $8.7 billion tab this year; the state pays the rest.
Nearly a year after taking office, Bredesen first proposed benefit cuts for most adult enrollees but maintaining enrollment levels. Legal roadblocks, a steep upturn in drug costs and a reduced federal share of funding prompted him to propose enrollment cuts in January -- up to 323,000 people, a quarter of TennCare's total.
That number has since been scaled back to about 288,000, and could be as low as 191,000 if a plan to retain coverage for up to a year at a time for about 97,000 people with huge medical bills is ultimately approved. It has not been approved yet, however, and those 97,000 "medically needy" people are among those facing termination over the next year -- about 8,000 a month.
Wednesday was the deadline for 191,000 enrollees believed ineligible for continued coverage, including 17,378 in Shelby County, to return information forms sent to them last month.
About 127,000 people returned the forms, including 10,539 from Shelby, leaving about 64,000 facing automatic termination in 20 days. The state is reviewing the forms turned in. Those determined ineligible will receive 20-day termination notices.
TennCare spokesman Marilyn Elam said Thursday the first people who returned their forms quickly and were determined ineligible for continued coverage begin losing their coverage next Tuesday.
Contact Nashville bureau chief Richard Locker at (615) 255-4923 TennCare Timeline
June: requests for information to determine continued eligibility sent to 191,000 enrollees.
July 6: deadline for returning the forms.
July 12: first enrollees begin losing coverage.
Aug. 1: New limits on benefits and medical services go into effect for most remaining adult enrollees not institutionalized. Copyright 2005, commercialappeal.com - Memphis, TN. All Rights Reserved. Vermont Initiative for Universal Health Access EMAIL: wsavt@wsavt.com All rights reserved |
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