Gov. Bill Lee on Thursday downplayed recent pushback on his administration’s effort to change Tennessee’s Medicaid program into a block grant system, countering that the opposition is likely due to misinformation.
“I do think that a lot of the folks who are concerned about this have been either misinformed or have not taken the time to really understand it. And there’s legitimate concern about that. We want people to understand this,” Lee, a Republican, told reporters.
Lee’s administration unveiled the $7.9 billion Medicaid block grant plan last month as part of their effort to make Tennessee the first state in the nation to receive its Medicaid funding in a lump sum. If approved, the plan would drastically overhaul the program that provides health care services to low-income and disabled residents.
However, since the proposal was released earlier this year, health care activists and provider groups have raised concerns that the proposal would result in severe cuts to the state’s Medicaid program _ also known as TennCare.
Most recently, large crowds flocked to public hearings this week in Nashville and Knoxville to provide overwhelmingly negative feedback on Lee’s proposal. Some contended that the plan would be illegal, while many others called for Tennessee to expand Medicaid instead _ an option provided under the Affordable Care Act that has been opposed by Lee and the Republican-dominated Statehouse.
Overall, the likelihood of the plan ever being implemented is largely unknown. To date, no state has been given permission to rely solely on block grants to cover Medicaid expenses. The idea has been floated by Republicans for decades but never implemented, because of possible legal challenges and concerns that doing so would result in large spending cuts to the states' most vulnerable populations.
Lee said he’s not worried about the proposal’s legality, pointing out that President Donald Trump’s administration is supportive of states issuing block grant proposals. Lee has also promised that current TennCare beneficiaries won’t be at risk of losing benefits nor face being taken off eligibility rolls should the federal government sign off on the plan.
“It’s a complicated block grant proposal. There’s a lot to comprehend,” Lee said. “Certainly anyone can understand it if they take the time to read it. It’s a great deal for Tennessee.”
Tennessee is set to have three more hearings in Jackson, Memphis and Chattanooga. For those who can’t make the hearings, the public also can submit comments online until Oct. 18. Another federal public comment period will follow.
The block grant would cover core medical services for the disabled and blind, children, adults and elderly _ or about 1.2 million Tennesseans. This means administrative costs, prescription drugs, uncompensated hospital payments and individuals dually eligible for Medicaid and Medicare would not be part of the block grant plan, which would cover a much smaller segment of TennCare.
The federal government would increase Tennessee's block grant funding if enrollment grows beyond the original calculation.
TennCare Director Gabe Roberts has described the plan as a "hybrid" approach to block grants because the state has designed its proposal to allow Tennessee to keep 50% of any unspent block grant funds.
For example, TennCare cost $2 billion less than projected in 2018. Under the block grant, Tennessee would have been able to pocket $1 billion, depending on what is ultimately negotiated with the federal government.
