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Suit alleges Tennessee put Medicaid applicants in limbo by steering them to HealthCare.gov


By Beth Kutscher
Posted: July 23, 2014 - 3:30 pm ET
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Tennessee residents who faced lengthy delays when they applied for Medicaid are now suing the state for failing to process their applications in a timely manner.

The lawsuit, filed Wednesday in U.S. District Court in Nashville, claims that the backlog developed when the state began requiring residents to apply for the TennCare program through the federal health insurance marketplace HealthCare.gov, which was not designed to process Medicaid applications.

The class-action suit is backed by the Southern Poverty Law Center, the National Health Law Program and the Tennessee Justice Center. The organizations filed the class-action suit on behalf of residents they say have been left without coverage because of the processing lag.

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Applicants have had to wait on coverage longer than the 45-day turnaround period allowed by law, the lawsuit says (PDF).

“It is clear that Tennessee is a national outlier,” Jane Perkins, legal director of the National Health Law Program, said during a call with reporters. “It is among the worst, if not the worst, in the country (for processing Medicaid applications). The delays are atrocious. It's unacceptable to sit by while people are suffering.”

A spokeswoman for the TennCare program said the agency did not see the suit until it was released to the media and could not comment.

The problems began Jan. 1, when local health department offices stopped accepting Medicaid applications and began directing patients to the federal exchange instead, said Sam Brooke, staff attorney at the Southern Poverty Law Center. Although he stopped short of saying the state made the move to oppose Obamacare's implementation, he said many Southern states have put up significant resistance to the Patient Protection and Affordable Care Act.

“Tennessee is frankly playing politics with the lives of their citizens,” he said on the call.

Melissa Wilson, a plaintiff in the suit, said she has been waiting 163 days for a decision to be made on her Medicaid application. She once took as many of 17 medications for conditions including high blood pressure, atherosclerosis and kidney disease, but can afford only three. One of those medications alone would eat into more than half of her monthly paycheck.

“I'm constantly worried about my health and what's going to happen to me,” said Reynolds, who is the primary caretaker for her three grandsons.

April Reynolds, another plaintiff, racked up $20,000 in debt when she was hospitalized in March with severe high blood pressure. She had applied for Medicaid the previous month, but 154 days later is still waiting for a coverage decision.

She has not seen a doctor since March out of fear of incurring more medical bills. “Every day we receive letters and phone calls from bill collectors,” her husband, Rick Reynolds, said. “April and I wake up with anxiety each day. If April can enroll in TennCare, it would be a huge weight off my shoulders.”

Follow Beth Kutscher on Twitter: @MHbkutscher


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