Fewer Tennesseans have health insurance than a year ago, but most are satisfied with TennCare plans

Staff file photo by Doug StricklandOrthopedist Dr. Jad Dorizas gives a patient a viscosupplementation injection in this June photo in the offices of UT Erlanger OrthoSouth at Erlanger hospital in Chattanooga. TennCare, the state's Medicaid program, is switching vendors in hopes of getting its dysfunctional telephone help line working properly at last.
Staff file photo by Doug StricklandOrthopedist Dr. Jad Dorizas gives a patient a viscosupplementation injection in this June photo in the offices of UT Erlanger OrthoSouth at Erlanger hospital in Chattanooga. TennCare, the state's Medicaid program, is switching vendors in hopes of getting its dysfunctional telephone help line working properly at last.

Uninsured in Tennessee

The share of adults and children in Tennessee without health insurance rose this year to the highest level since 2014. But the number of uninsured persons in the state this year is still down 27 percent from the start of the decade before the Affordable Care Act, or ObamaCare, was adopted.2018 - 6.7 percent, 451,627 persons2017 - 6.0 percent, 408,083 persons2016 - 5.6 percent, 368,792 persons2015 - 5.7 percent, 370,115 persons2014 - 7.2 percent, 472,008 persons2013 - 9.6 percent, 611,368 persons2012 — 9.2 percent, 577,813 persons2011 - 9.5 percent, 604,222 persons2010 - 9.9 percent, 618,445 persons2009 - 10 percent, 616,967 personsSource: Boyd Center for Business and Economic Research, University of Tennessee

Dividing the TennCare pie

* 36 percent on Volunteer State Health Plan administered by BlueCross BlueShield of Tennessee* 33 percent on UnitedHealthcare (formerly AmeriChoice)* 22 percent on Amerigroup plans* 6 percent on TennCare selectSource: Boyd Center for Business and Economic Research, University of Tennessee* 36 percent on Volunteer State Health Plan administered by BlueCross BlueShield of Tennessee* 33 percent on UnitedHealthcare (formerly AmeriChoice)* 22 percent on Amerigroup plans* 6 percent on TennCare selectSource: Boyd Center for Business and Economic Research, University of Tennessee

Tennesseans on TennCare overwhelmingly say they are satisfied with their health care coverage, but a new survey finds the number of uninsured Tennesseans rose this year to the highest level in four years as a growing share of Tennesseans say they can't afford to buy any health insurance even with the subsidies offered for low-income households under the Affordable Care Act.

In a survey of 5,000 Tennesseans released Monday, University of Tennessee researchers found the share of adults in Tennessee without health insurance grew this year to 8.0 percent, up from 7.5 percent the previous year, while the share of uninsured children in the state increased from 1.5 percent in 2017 to 2.3 percent this year.

"Affordability continues to be the major reason cited for not having insurance, cited by approximately 80 percent of respondents across all income categories," said LeAnn Luna, the University of Tennessee accounting professor who authored the study on the Impact of TennCare in 2018. "Overall, TennCare continues to receive positive feedback from its recipients with 95 percent reporting satisfaction with the program. This positive feedback is a strong indication that TennCare is providing satisfactory medical care and meeting the expectations of those it serves."

UT researchers survey Tennesseans about health care every year to help measure the effectiveness of the state's Medicaid program, known as TennCare. Despite record high employment in the state, the share of Tennesseans overall with health insurance from either their employer or government programs declined this year from last year, leaving 42,544 more Tennesseans without health care coverage in 2018 compared with the previous year.

Dr. Luna said the drop could be caused by several factors, although most respondents said that affordability was a major problem after health insurance rates under the individual coverage plans of Obamacare have more than doubled, on average, in the past five years. Rates are heading lower in 2019, which eligible persons will be able to start signing up for next month. But the Trump administration struck down the individual mandate that required everyone to buy health insurance or pay a penalty to the IRS.

With no mandate and less support for programs to sign up persons for Obamacare plans, it is not surprising that there was a decline in enrollment, especially as premiums rose for higher income persons not covered by subsidies, Luna said. The increase in Tennesseans without health insurance also is consistent with nationwide trends.

Overall, the survey found 77 percent of all heads of household and 71 percent of TennCare heads of households rated the quality of care as "good" or "excellent." Among those on Tenncare, 95 percent said they were either "very satisfied" or "somewhat satisfied" with the the quality of care they received.

Three fourths of the respondents on TennCare said they were able to get a doctor's appointment within a week, and 47 percent obtained an appointment within one day this year - the highest since UT has been tracking such results. Only 11 percent reported waiting more than three weeks for an appointment, a record low.

"I am pleased that TennCare continues to be recognized for providing access to high quality care for our members," TennCare director Wendy Long said in a statement about the new report. "We collaborate with our health plans to promote the delivery of the right care in the right place at the right time, and those efforts are paying off."

Contact Dave Flessner at dflessner@timesfreepress.com or at 757-6340

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