"TennCare is a noble and worthwhile initiative that has made significant contributions to public health in Tennessee," Bredesen said. "Over the past year, we've made every possible effort to preserve the program. But persistent lawsuits have tied our hands. The sad reality is, we can't afford TennCare in its current form. It pains me to set this process in motion, but I won't let TennCare bankrupt our State. This is the option of last resort."
Bredesen's preferred plan was to cut costs by limiting benefits. But that's been stymied by requirements in three court decrees and a reduction of about $120 million in federal funds, the governor said.
How will this affect Macon County?
According to Michelle Mowery Johnson, Director of Communications, TN Department of Human Services, 5,850 people are enrolled in the TennCare program in Macon County. Four hundred fifty-three families are involved in the Families First program which includes 320 children and 133 adults for the entire county. Families First is Tennessee's welfare reform plan which replaced the Aid to Families with Dependent Children (AFDC) program. The temporary cash assistance program emphasizes work, training, and personal responsibility.
Macon County General Hospital Administrator Dennis Wolford stated that if TennCare went down it would really impact Macon County. For example, if a person who had no insurance because of loss of TennCare came into the emergency room the person would be treated and that the cost would be written off. Then if the person had to be admitted, that cost would also be written off. This would cause the hospital to lose money.
TennCare began in January 1994 as an innovative experiment to expand Tennessee's Medicaid program by using managed care principles to deliver health care to a larger number of people for the same amount of money. In a recent poll, Tennessee showed 23.2% of population was covered by the Health Plan. The total population for the state of Tennessee is 5,841,748. A total of 1,356,519 is currently enrolled in the TennCare program.
If the state loses the TennCare program the changes will not take effect immediately. The process of notifying TennCare enrollees of changes will begin in early January.
How much money will the State save by returning to Medicaid? At the very least, returning to traditional Medicaid will eliminate the projected $650 million TennCare shortfall the State is facing in the 2005-2006 fiscal year. The conversion could yield additional cost savings in the future, depending upon how it's structured and whether consent decrees can be modified.
The loss of TennCare would also cause a problem for the UCHRA. According to UCHRA Director Tracy Powell, the program received a total of $18,000 last month with $15,000 used to provide transportation to and from doctors appointments or to pick up medicine from pharmacy for TennCare patients. This was a total of 83% of UCHRA's funds in the month of October.
To cope with TennCare's cost, the Governor has outlined a broad strategy, including controls on pharmacy spending, cost sharing with enrollees and benefit limits, in a 'last chance' effort to salvage the program. The strategy, which would have a preserved full enrollment, was widely viewed as a sensible approach by stockholders.
The Governor said, "All great enterprises are powered by the heart, but steered by the head, it's time to do some steering."
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