In Tennessee, 1.4 million of the most vulnerable depend on TennCare, the state’s Medicaid program. Unfortunately, the state has requested a special waiver that would completely change the funding structure of the TennCare program to a block grant – an experimental move that would jeopardize thousands of beneficiaries’ access to care.
Instead of expanding Medicaid, the block grant proposal incentivizes states to make cuts to enrollment and benefits for TennCare consumers. Here are some of the ways the proposal would harm Tennesseans on TennCare:
Limiting Coverage: Under the proposal, the structure of the block grant would result in Tennessee limiting enrollment and cutting coverage by imposing additional barriers to important services. Enacting this unprecedented waiver would make it more difficult for patients to access the care they need. The proposal would also result in cutting payments to both hospitals and providers to reduce spending under the block grant, which would cause Tennessee to increase the costs patients will have to cover out of pocket over time.
Restricting Treatment Options and Prescription Drug Access: The waiver would limit Tennesseans’ access to treatment options by creating a closed drug formulary, restricting coverage to only certain medicines. This would significantly hinder the ability of doctors to prescribe treatment courses and medications that best suit their patients’ medical needs and based on factors including efficacy, side effects, interactions with other medications and other health conditions.
Removing Federal Quality Standards: The proposal is unprecedented in scope and would allow Tennessee to be exempt from federal Medicaid standards and requirements. This includes important safeguards that set standards for things like adequate networks, which ensure patients can actually see the right doctors and receive the care they need. Tennessee is also asking for the ability to change the amount, duration and scope of benefits, which would allow the state to put caps on services that TennCare beneficiaries desperately depend on.
This proposal is bad for the people of Tennessee and, if enacted, would set a dangerous precedent for states across the country to limit the quality, accessibility and affordability of coverage for those who need it most. Consumers for Quality Care is fighting to prevent these changes and we need your help. Please take a moment to send a letter voicing your concerns to the Centers for Medicare and Medicaid Services and help protect the most vulnerable Tennesseans.