Tennessee’s one-of-a-kind TennCare Medicaid waiver program crossed over $1 billion in savings, TennCare Director Stephen Smith told state officials during the agency’s budget hearing Thursday.
The program, referred to as “shared-savings,” is a Medicaid waiver that allows the state to access about half of the money it saves from its federal allocation to pay for insurance coverage for the state’s poorest residents.
Tennessee is the only state to receive such a waiver. The state applied for the program in 2021, despite concerns that the only way to save money was to remove people from TennCare or reduce services.
About 1.4 million Tennesseans, or 20%, are enrolled in TennCare, of which over 800,000 are children. As recently as 2023, over 1.7 million were enrolled in TennCare, but the agency purged about 300,000 after the expiration of the rules that had prevented it from doing so during the COVID-19 pandemic.
Tennessee is still one of the handful of states that haven’t expanded Medicaid eligibility under the Affordable Care Act, which could have helped hundreds of thousands of Tennesseans access more affordable insurance.