More Tennesseans got health insurance during pandemic, but some may soon lose coverage

The rate of Tennessee children without health insurance is at its lowest since 2018 -- a year that saw uninsured child rates spike due in part to a drop in TennCare enrollment -- while the rate of all Tennesseans without health insurance is at its lowest level since before the COVID-19 pandemic.

Since the pandemic, an unprecedented number of people have enrolled in Medicaid, which in Tennessee is called TennCare, according to a recent report from the Urban Institute and Robert Wood Johnson Foundation. A lower unemployment rate has also contributed to an increase in residents with health insurance coverage.

A new report from the University of Tennessee's Boyd Center for Business and Economic Research found that in 2022 the number of uninsured Tennesseans decreased from 8.3% to 7.5% of the population, which represents roughly 42,000 residents.

Increased Medicaid enrollment is largely attributed to a provision in 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. In turn, the federal government has increased its contribution to states for the duration of the emergency.

But an anticipated end to that emergency in April has advocates concerned that enrollees could be unexpectedly left without coverage as states work to redetermine Medicaid eligibility.

Michele Johnson, executive director of the Tennessee Justice Center, said in a phone interview that staff members are working to recruit volunteers across the state to help people with the redetermination process and encourage TennCare enrollees to prepare.

"We're really working hard to spread the word across the state for church groups or book clubs or anyone who's looking to help people through this process," Johnson said. "I'm particularly worried, given the massive increase in mental health issues in teenagers, if kids lose their coverage and find out they've lost their coverage at the pharmacy, they can lose their medications and it will be really dangerous."

In the past, Johnson said a 95-page packet of paper had to be filled out for each TennCare enrollee, but at this time it's unclear what people will have to do to prove eligibility.

"If we don't have families knowing it's coming and people working to make it less overwhelming, we're really concerned," Johnson said, noting that enrollees need to be proactive about making sure TennCare has their correct address before April.

TennCare is the state and federally funded health insurance program that covers more than $1.7 million low-income Tennesseans -- mostly women, children and people with disabilities.

For enrollees who make too much money now to qualify, Johnson said there are options on the Affordable Care Act marketplace and other health insurers.

A recent change to the ACA now deems dependents of those with employer-sponsored health insurance eligible for subsidies on ACA plans if the family premium under the employer coverage is more than 9.5% of the family's income.

"There definitely will be people who aren't eligible anymore," Johnson said, "but the important thing is that they find their pathway to coverage."

Contact Elizabeth Fite at or 423-757-6673. Follow her on Twitter @ecfite.

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