Les Jones

East Tennessee > TennCare Reform

Phil Bredesen is preserving TennCare by cutting some 323,000 adults from the plan. All children will still be on the plan, as will all adults who are also on Medicare. As it was, TennCare was absorbing all of the state's revenue cuts and then some. The cuts will save $575 million during the next fiscal year.

Arbyte has an excellent TennCare roundup and notes that, despite the savings, TennCare's budget will still grow:

New fiscal projections indicate TennCare "as is" would require $647 million in additional state revenue in order to sustain it in the 2005-2006 fiscal year — approximately $322 million more than the State anticipates collecting in total new revenue. Under the revised plan, TennCare will require no more than $75 million in new revenue.

These were hard cuts, but Tennessee's budget couldn't keep TennCare alive as it was originally formulated, and major changes were needed. Among other things, TennCare was providing free healthcare for 1 in 4 Tennesseans. That ratio was just too high.

For most recipients, TennCare originally had no limits on the number of doctor's visits or hospital days, no co-pays, and no limits on the number of presciptions, which was the biggest growth area. The result was free healthcare for the needy that was better than the private insurance provided by many employers. It was the equivalent of building housing for the poor with jacuzzis, cathedral ceilings, and swimming pools, and then giving that housing to 1 in 4 Tennesseeans. It wasn't going to work, and there was no way to pay for it. If it hadn't been set up that way to begin with, these radical cuts might not have been necessary.

A humane society should provide a basic safety net for the disadvantaged, but the safety net isn't obligated to provide much more than the basics. The new plan for TennCare is much closer to a sustainable ideal than the old one. Hopefully, the plan can recover enough to provide care to more people, rather than having to cut more people from the rolls.