Tennessee Specific Information

(as of 01/29/2016) Tennessee has chosen not to expand Medicaid


Please see below for an excerpt from the January 19, 2016 Article from www.HealthInsurance.org

Tennessee health insurance exchange / marketplace

239k enrolled in private plans by Jan 9, exceeding last year’s total with 3 weeks to go

During this third open enrollment period, the mayors of Tennessee’s four largest cities have reached out to their constituents to urge them to visit Healthcare.gov or GetCoveredTenn.org to seek assistance with the enrollment process. Chattanooga Mayor Andy Berke, Knoxville Mayor Madeline Rogero, Memphis Mayor AC Wharton, and Nashville/Davidson County Mayor Megan Barry have joined together with Get Covered Tennessee and Enroll America “to make it as easy as possible for every resident of our great cities to get access to the information they need to get covered.

For the full article visit Tennessee health insurance


Please see below for an excerpt from the January 12, 2016 Report from the Kaiser Family Foundation regarding State Health Facts

Characteristics of Poor Uninsured Nonelderly Adults in the ACA Coverage Gap

The 2010 Affordable Care Act expands Medicaid coverage to nearly all adults with incomes at or below 138% of the federal poverty level (about $16,242 for an individual in 2015). However, the Supreme Court ruling issued in 2012 made the decision whether to expand Medicaid optional for states. As of January 12, 2016, 32 states (including DC) were moving forward with the Medicaid expansion while 19 states were not moving forward with the expansion. In states that do not expand Medicaid, poor uninsured adults with incomes above current Medicaid eligibility levels but below poverty may fall into a “coverage gap” of earning too much to qualify for Medicaid but not enough to qualify for Marketplace premium tax credits. These data exclude undocumented immigrants and legal immigrants who have been in the US for <5 years.

Tennessee Numbers:  Number of Adults in Medicaid Coverage Gap (118,000), of these Adults without Dependent Children (98%), of these Female (47%)

For the full report visit Kaiser Family Foundation


Please see below for an excerpt from the January 8, 2015 Article in the Tennessean

Tennessee lawmakers return Tuesday

Lawmakers met in a special session to discuss the fate of Gov. Bill Haslam’s landmark Insure Tennessee proposal, which would have expanded access to health insurance for hundreds of thousands of low-income Tennesseans.

It bombed, quickly, setting a tone for a session dominated not by health care, but in many respects by guns, religion and social issues in general.

For the full article visit Tennessee lawmakers return Tuesday

Please see below for an excerpt from the February 9, 2015 Article in the Tennesean


Insure TN deserves do-over after senator explains vote

Insure Tennessee deserves a do-over because it’s become clear that at least one of the seven senators who voted to kill it relied on inaccurate information as the rationale for his decision.

The facts:

Even though TennCare relies on Medicaid dollars, the programs are separate. TennCare’s fate was never at risk.

The facts:

There is no “going back to TennCare.” TennCare continues to exist. TennCare and Insure Tennessee are separate programs. The people who would have been covered by Insure Tennessee are not the same people covered by traditional TennCare. In addition, there was no written contract with the federal government.

he facts:

One of the other reasons used by lawmakers to oppose Insure Tennessee was the lack of a written guarantee that the program would work as it should. However, Health and Human Services Secretary Sylvia Burwell sent Governor Haslam a letter saying that Tennessee could discontinue Insure Tennessee without penalty.

Finally, to clarify the funding for the program, the federal government was responsible for 100 percent of the cost through 2016. After that the federal government would cover 90 percent and the Tennessee Hospital Association agreed to pick up the remaining 10 percent. Tennessee’s budget was not at risk. That was a main selling point for Haslam.



Please see below for an excerpt from the February 4, 2015 Article from News Channel 11

Sen. Crowe to vote yes in key first vote on Insure TN Wednesday

Governor Haslam’s plan to expand Medicaid in Tennessee faces a key vote Wednesday morning,  and Johnson City State Senator Rusty Crowe said he’ll vote yes when the roll is called.



Please see below for an excerpt from the January 28, 2015 Fact Sheet from the Kaiser Family Foundation

Proposed Medicaid Expansion in Tennessee

If implemented on January 1, 2016, the waiver amendment would:

  • Expand Medicaid coverage to newly eligible adults ages 21-64 primarily through capitated Medicaid managed care organizations (MCOs) already operating in the state.  MCOs would administer health savings accounts in which newly eligible adults would accrue credits by participating in certain designated healthy behaviors.
  • Offer newly eligible adults with access to employer-sponsored insurance (ESI) the option of receiving premium assistance through a defined contribution from the state toward ESI.3 Under the Volunteer Plan, the amount of the state’s contribution is still to be determined but is expected to cover the beneficiary’s share of premiums and may partially cover the ESI plan deductible and copays.
  • Enroll individuals ages 19 and 20 into the regular TennCare Medicaid managed care program and provide them with all TennCare benefits, including Early and Periodic Screening, Diagnosis, and Treatment

KFF Tennessee Plan Medicaid Exp Waiver


Please see below for an excerpt from the January 14, 2015 posting from the Department of Health & Human Services

Open Enrollment Week 8: January 3, 2015 – January 9, 2015

Since Open Enrollment began on November 15, nearly 6.8 million consumers selected a plan or were automatically re-enrolled in the Federally Facilitated Marketplace (FFM).

Federal Marketplace Snapshot Week 8
Jan 3 – Jan 9
Nov 15 – Jan 9
Plan Selections 163,050 6,756,438
Applications Submitted 332,318 8,768,448


HealthCare.gov States Cumulative Plan Selections
Nov 15 – Jan 9
Tennessee 172,530



Please see below for an exerpt from the January 09, 2015 Article from the Tennessean

Bill Frist supports Haslam’s Insure Tennessee plan

Insure Tennessee would be a two-year pilot program that offers coverage solutions for Tennesseans who earn less than 138 percent of the federal poverty level, or $32,913 for a family of four. Currently subsidies are available to Tennesseans earning more than 100 percent of the poverty level, or $23,850 a year for a family of four. But many individuals earning less than 100 percent of the federal poverty level are neither eligible for Medicaid nor subsidies.



Please see below for an excerpt from the News.TN.Gov Posting





Please see below for an exerpt from the January 09, 2015 Article from the Tennessean

Haslam calls special session for Insure Tennessee

Gov. Bill Haslam is calling a special session of the legislature to hear his answer to Medicaid expansion: “Insure Tennessee,” a two-year pilot program that would provide health care to more than 200,000 Tennesseans who lack direct access to coverage.



Please see below for an excerpt from the December 31, 2014 Blog knoxblogs.com

Eighteen TN state senators, one fomer rep sign brief in anti-Obamacare lawsuit

Eighteen Republican Tennessee state senators, including Lt. Gov. Ron Ramsey, and a former Tennessee House member signed a brief filed with the U.S. Supreme Court Monday in support of a lawsuit challenging the tax incentives provided for health insurance plans bought through federal health care exchanges.

An estimated five million Americans in these and other states would lose their subsidies if the Supreme Court rules the IRS acted illegally and the subsidies therefore are invalid. At least 85% of those enrolled in federal exchanges are receiving subsidies for their health insurance, lowering their monthly premiums by an average of 76%.



Please see below for an excerpt from the December 30, 2014 Article in the Tennessean

Tennessee lawmakers voice support for ACA opposition in court case

If the court finds that tax subsidies are available only on state exchanges, then people who bought insurance on the federal exchange will no longer be eligible for the tax subsidy. Tax subsidies discount the monthly premium on a sliding scale depending on factors including income and size of household.

There were 151,352 Tennesseans who bought a plan via the federal exchange in 2014; roughly 121,000, or 80 percent, received a subsidy. For 2015 coverage, 87, 137 Tennesseans had bought coverage as of Dec. 15, according to the Department of Health and Human Services. Of those, 83 percent are eligible for a subsidy.



Please see below for an excerpt from the December 09, 2014 Article from Nashville Public Radio

Doomed From The Start: Tennessee May Just Scrap Computer System For Determining Who Gets Medicaid

Tennessee may just scrap a doomed computer system meant to determine who is eligible for the state’s Medicaid program and find a new contractor. That’s one of three options outlined by TennCare, who hired Northrop Grumman to build the system. It was supposed to be done a year and a half ago and remains nowhere near complete.


Please see below for an excerpt from the December 08, 2014 Article from Nashville Public Radio

TennCare Swells Under First Year Of Health Insurance Mandate

The number of Tennesseans on Medicaid has shot up by 120,000 since the beginning of the year…

The insurance program for low-income residents has grown despite the state’s refusal to expand Medicaid to include more of the working poor. TennCare director Darin Gordon says these are likely people who were already qualified for coverage and just didn’t know it until the Affordable Care Act’s insurance mandate took effect.



Please see below for an excerpt from the December 05, 2014 Article in the Tennessean

Haslam says decision on Medicaid expansion close

Gov. Bill Haslam said Friday that he’s talked with nine Republican governors who have expanded Medicaid for low-income people in their states, and he plans to announce what he will do by the end of the month.



Please see below for an excerpt from the November 12, 2014 Issue Brief from the Kaiser Family Foundation explaining about the “Medicaid Gap”

The Coverage Gap: Uninsured Poor Adults in States that Do Not Expand Medicaid – An Update

One of the major coverage provisions of the 2010 Affordable Care Act (ACA) is the expansion of Medicaid eligibility to nearly all low-income individuals with incomes at or below 138 percent of poverty ($27,310 for a family of three1). This expansion fills in historical gaps in Medicaid eligibility for adults and was envisioned as the vehicle for extending insurance coverage to low-income individuals, with premium tax credits for Marketplace coverage serving as the vehicle for covering people with moderate incomes. While the Medicaid expansion was intended to be national, the June 2012 Supreme Court ruling essentially made it optional for states.

As of October 2014, 23 states were not expanding their programs. Medicaid eligibility for adults in states not expanding their programs is quite limited: the median income limit for parents in 2014 is just 50% of poverty, or an annual income of $9,893 a year for a family of three, and in nearly all states not expanding, childless adults will remain ineligible.2 Further, because the ACA envisioned low-income people receiving coverage through Medicaid, it does not provide financial assistance to people below poverty for other coverage options. As a result, in states that do not expand Medicaid, many adults will fall into a “coverage gap” of having incomes above Medicaid eligibility limits but below the lower limit for Marketplace premium tax credits (Figure 1).

In states that do not expand Medicaid under the ACA, there will be large gaps in coverage available for adults.



Please see below for an excerpt from the August 27, 2014 Article in Times Free Press

TennCare computer system delays detailed

Just days before TennCare leaders head to court over accusations that state failures have created months-long delays in coverage, the agency’s director faced questions from lawmakers about the unfinished computer system that led to those delays.



Please see below for an excerpt from the March 12, 2014 Article in the Tennessean

Republicans defeat bill to expand TennCare with federal funding

House Bill 1723 would have expanded TennCare, the state’s Medicaid program, only for as long as all of its funds came from the federal government through the Affordable Care Act. Tennessee could receive as much as $1.4 billion in federal funds.



Please see below for an excerpt from the February 23, 2014 Article in the Times Free Press

TennCare changes: Three plans to offer statewide coverage in 2015

BlueCare. The TennCare plan operated by the state’s biggest health insurer, the Chattanooga-based BlueCross BlueShield of Tennessee

AmeriGroup. Based in Virginia Beach, Va., the Medicaid provider is a subsidiary of WellPoint, Inc., and serves 2.7 million members in Tennessee, Georgia and 10 other states.

UnitedHealth Group. The Minneapolis-based insurer, the nation’s biggest, serves 70 million Americans.

http://www.timesfreepress.com/news/business/aroundregion/story/2014/feb/23/tenncare-changes-three-plans-offer-statewide/132441/Tennessee Bureau of TennCare