An 11th-hour approval for major changes to Medicaid in Tennessee

An 11th-hour approval for major changes to Medicaid in Tennessee

cbaker_admin
Tue, 01/12/2021 – 02:30

The Trump administration has approved a new structure for Medicaid funding in Tennessee, where dollars would be awarded as a spending-capped block grant. The 10-year experiment has been a pet project of CMS Administrator Seema Verma and a long-time goal of conservatives. However, patient advocates intend to mount a legal challenge against the plan, which they worry will strip the poor of access to health care in the state—one of dozen that did not adopt Medicaid expansion under the Affordable Care Act. The plan gives Tennessee more flexibility in terms of prescription drug prices and what services its program covers, but caps annual funding based on a formula. If spending falls short of the block grant amount, the state is entitled to 55% of the savings to spend on other health services. If it overspends, though, it will have to use state funds to cover the difference. The incoming Biden administration is expected to overturn the structure, although Verma has inserted language in the new contracts to prevent waivers from being dissolved with fewer than 9 months of notice. “We want to make sure that people don’t come into office and on a political whim terminate waivers,” she explained.