Nearly 250,000 more Tennesseans are expected to qualify for health care coverage through the TennCare program in the next five years under the health reform plan signed into law this week.
Most of the expanded Medicaid benefits will be picked up by the federal government, which is expected to pump more than $30 billion into Tennessee's Medicaid program over the next seven years.
But Gov. Phil Bredesen predicts the state still will have to spend an extra $1.1 billion during the same period on expanded TennCare benefits, which he said threatens to hurt an already recession-ravaged state budget.
"Even in good times, that is a lot of money and it's going to be a heavy toll," Gov. Bredesen said. "But that is the way it is now."
The Bredesen administration cut the state's TennCare rolls by about 170,000 through a series of program changes and verification requirements to trim health care spending. The new health plan President Barack Obama signed Tuesday will reverse that trend by extending TennCare benefits beyond the 1.2 million Tennesseans who now qualify as low-income children, parents or adults with certain diseases.
By 2014, low-income people who earn up to 133 percent of the federal poverty level -- about $14,400 for a single person -- will be eligible for Medicaid coverage regardless of their health condition.
Two gubernatorial candidates who will have to deal with the changes if elected say they don't like the new Medicaid changes.
"Politicians in Washington may have temporarily lost their minds, but we still have our sanity out here in the states and we need to take action to roll this law back," said Lt. Gov. Ron Ramsey, R-Blountville.
U.S. Rep. Zach Wamp, R-Tenn., said the expansion of TennCare "is a multi-billion-dollar mandate on Tennessee, and we do not have the money to pay for it."
One legislator who's also a doctor said more people on TennCare could overload the state's health care system.
LOOKING AHEADThe Times Free Press will examine the impact of health care reform in coming days.* Friday: Doctors and hospitals* Saturday: The cost to employers* Sunday: Pre-existing conditions* Monday: Coverage for young adultsRELATED COVERAGEA House subcommittee delayed final action on a Tennessee Health Freedom Act. Metro.Obama pledges that federal funds won't be used to pay for abortions. A4WHAT'S CHANGING?By 2014, Medicaid will be expanded to cover low-income people who earn up to 133 percent of the federal poverty level, up to $14,400 for a single person and up to $28,300 for a family of four. Low-income, childless adults will be eligible for Medicaid coverage for the first time.BY THE NUMBERS* $7.6 billion -- 2009-10 budget for TennCare, including $5.3 billion in federal funds and $2.2 billion of state money* 1.2 million -- Number of Tennesseans now enrolled in TennCare* 250,000 -- Projected increase in TennCare enrollment by 2014Source: Tennessee Bureau of TennCare
State Rep. Joey Hensley, R-Hohenwald, a doctor who is chairman of the General Assembly's TennCare Oversight Committee, said more Tennesseans should get access to health care coverage through TennCare. But the expanded TennCare population could overwhelm health care providers unless more physicians and hospitals agree to participate in TennCare, he said.
"We're already having problems with physicians and hospitals not being paid enough, and this could put another 250,000 people into the program," he said.
Advocates for the health care changes said Tennessee will have to pay a relatively small matching share to improve both the state's health care and pump more money into the economy.
"There's a misconception among many people, including many legislators, that poor people automatically qualify for TennCare, but many don't," said Tony Garr, president of the Tennessee Health Care Campaign, which backed the reforms. "Why it took so long for these changes is the real question."
Even without any changes, the cost of TennCare was projected to double in the next decade, according to a 2008 actuarial study by the Centers for Medicare & Medicaid Services.
"Health care costs continued to rise without these changes, and I really think it's too soon to know what the total fiscal impact will be from health care reform on our state," said Gordon Bonnyman, executive director of Nashville's Tennessee Justice Center, a nonprofit advocacy group for the poor. "But we do know there will be greater access to needed health care programs with more people covered."
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