Tennessee lawmakers in the state capital of Nashville are warning they might give up on TennCare and leave 260,000 people without healthcare coverage if a lawsuit succeeds in blocking Gov. Phil Bredesen's cost-saving plan.
Advocates for enrollees of TennCare -- the state's expanded Medicaid program for about 1.3 million poor, disabled or otherwise uninsured citizens -- last month asked a federal judge to order the state to improve care for children on the program. That prospect spurred some lawmakers Wednesday to say they would rather return to a traditional Medicaid program covering only the poorest residents rather than continue costly battles in court.
TennCare is expected to cost $7.8 billion next year, about a third of Tennessee's budget, and its accelerated growth has loomed as a threat to the state's ability to fund other programs.
"I would hate it for those 260,000 folks, but that's a real strong possibility," said state Sen. Jerry Cooper, a Democrat from Morrison, Tenn., and chairman of the legislative Fiscal Review Committee. "I think the majority of legislators will say, 'OK, we're tired.' I think advocates need to be careful."
Sen. David Fowler, a Republican from Signal Mountain, Tenn., complained that advocates did not even wait for the changes to take place in January before bringing the state back to court.
Enrollee advocates say they filed a request for a contempt hearing because the state failed to form a plan to improve healthcare for children, and the planned changes could worsen conditions for enrollees.
"We've seen no focus on a real reform plan for children so that they're actually getting checkups and proper treatment," said Michele Johnson, an attorney with the Tennessee Justice Center, a not-for-profit law firm.
The Justice Center last month filed the request in U.S. District Court because TennCare failed to live up to an existing court order requiring a children's healthcare plan, Johnson said. The hearing could occur this summer.
Bredesen called the new court action a "destructive force" that could ultimately destroy TennCare.
"I am hoping that the advocates will come around. We're trying to do the same thing and save TennCare," he said.
Bredesen said he would like to continue providing healthcare for as many people as possible with full benefits, such as prescription drugs, which the state is not required to provide.
Pending federal approval, Bredesen plans in January to remake TennCare by limiting benefits and imposing copayments. Children, pregnant women and people with disabilities will be exempt from most reductions.
Who will be defined as disabled and what services and drugs will no longer be covered under a tighter definition of what is "medically necessary" still has not been decided, advocates claim.