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TennCare’s convenient self-congratulations

More Tennesseans are insured! …For now.

To get a job done right, it’s often better to take care of it yourself. But that’s not necessarily the case for many states when it comes to health insurance coverage for the most vulnerable.

In states like Tennessee, the government contracts with a private health insurance company to manage the care for citizens who meet the need threshold. These “managed care” providers aren’t without their share of challenges – when private insurance companies take control of healthcare, it doesn’t always work out in the patient’s favor.

And new numbers from TennCare, Tennessee’s Medicare program, mirrors the same trends we’ve seen elsewhere.

The state’s Department of Finance and Administration, which oversees TennCare, contracted with The Boyd Center for Business and Economic Research at the University of Tennessee to develop a report and get an accurate read on insurance status in the state.

The good news? According to the report, the uninsured rate for children in Tennessee declined for the second straight year to just 2.3% for 2022. Overall, the percentage of uninsured Tennesseans is also trending downward – representing more than 42,000 people who have gained heath care coverage since 2021.

More coverage means more care, so this is cause for celebration, right?

Not quite.

The boost in insured Tennesseans was largely the result of the Families First Coronavirus Response Act, requiring state Medicaid agencies to forgo disenrolling people as long as the federal public health emergency remains in place, and ensuring more federal funds flow to states to manage the uptick in coverage.

But the public health emergency is set to expire in April – and with it, many of those coverage gains.

It sure seems like when the federal dollars are flowing, TennCare is happy to draw attention to its critical role in Tennesseans’ ability to access care. But what happens when the funds dry up?

We might look to Memphis for a possible answer. Methodist Le Bonheur Healthcare System is officially out of network for patients with TennCare health plans managed by Blue Cross Blue Shield of Tennessee (BCBST), after the insurer failed to reach a deal with the health system.

All we can say is it’s certainly striking that BCBST wants Tennessee’s dollars to manage care for patients in need, yet those in Memphis will have to find somewhere else to get it.

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