LWV Joins Opposition to TN Medicaid waiver

Per request by LWVTN, the League signed onto a letter opposing the approval of the TN Medicaid block grant, which would limit the amount of federal funding provided to the state and authorize limits on prescription drug coverage. The League believes that all Americans should have access to quality and affordable healthcare no matter the state they live.

Dear CMS Director:

Tennessee patient and consumer organizations strongly oppose the prior Administration’s approval of Tennessee’s modified block grant waiver, TennCare III. This is a reckless move that could reduce Tennessee’s ability to provide access to critical healthcare for our State’s most vulnerable patients, especially in the midst of a global pandemic and future economic downturns.

The TennCare III proposal does not meet the principal objectives of the Medicaid Program. In order to increase benefits to one group of stakeholders, benefits, eligibility or payment will have to be decreased to another. This waiver agreement, if implemented, will limit Tennessee’s fiscal ability in responding to recessions, pandemics, new treatments and natural disasters – and as a consequence moves in the opposite direction of the lessons learned from 2020. In addition, the waiver does nothing to expand coverage to the over 300,000 low-income vulnerable Tennesseans who cannot afford health insurance.

Instead, in the words of Congressman Jim Cooper:

“This radical waiver makes Tennessee the first block grant Medicaid state, in other words, treating Tennesseans like guinea pigs.”

Our organizations have clearly and repeatedly voiced our deep concerns with Tennessee’s proposal, as well as our strong opposition to block grants and caps in Medicaid in general. Per capita caps and block grants are designed to limit the amount of federal funding provided to states, forcing them to either make up the difference with their own funds or make cuts to their programs reducing access to care for the patients we represent. Indeed, the approval specifically includes authority to limit prescription drug coverage, a dangerous proposal for patients. In addition, our organizations are deeply concerned at the lack of transparency and oversight.

Since our organizations filed comments opposing Tennessee’s proposal nearly one year ago, our nation has been overwhelmed by the COVID-19 pandemic, and our concerns about how Tennessee’s proposal will harm patients with serious and chronic health conditions have only intensified.

The TennCare III waiver that was approved by CMS on Jan. 8, 2021 contains significant changes to Tennessee’s proposal. It was introduced by Tennessee’s Legislature on Jan. 12 and passed after waiving procedural rules and was signed by the Governor on Jan. 15. Not only did state legislators not have the opportunity to understand what they had passed but the general public had no say regarding these significant changes. It was irresponsible to approve this waiver without further public review during this public health crisis, and especially to do so for an unprecedented 10-year period.

The organizations listed [in attached letter] strongly urge the Biden Administration to halt implementation of the TennCare III waiver.