TennCare would cover more pregnancies and diapers under proposal from Gov. Bill Lee

Tennessee Gov. Bill Lee is proposing a significant expansion of the state’s Medicaid program, known as TennCare, using money from a new deal negotiated with the Trump Administration described as a “block grant.”

Basically, the state now gets to keep some of the money it’s been saving the federal government by offering fewer benefits and operating more efficiently. With this $300 million, the governor wants to cover more pregnant Tennesseans by raising the income cap to 250% of the federal poverty limit — roughly $34,000 for a single person household. And he wants TennCare to pay for diapers for the first two years of life, which would be a first for the nation if approved by federal regulators, the governor says.

“Despite enormous criticism from those who said we couldn’t or wouldn’t, we are going to do exactly what we said we would do when we pursued this shared savings waiver — expand services for the most vulnerable and provide those services to even more Tennesseans,” Lee said in his State of the State address Monday.

The expansion would add roughly 25,000 people to the TennCare rolls, which have ballooned to 1.7 million during the pandemic. The expanded benefits also include lactation services for new mothers and higher income limits for parents or caretakers of children.

The critics called out by the governor argued that Tennessee should have started by expanding Medicaid, as envisioned under the Affordable Care Act. The state would receive a more favorable match for an estimated 250,000 people who currently make too much to qualify for TennCare, often dubbed “the working poor.”

“Most Tennesseans care about mothers and babies getting what they need. And the truth is, if he’s interested in that, the most important thing is that women before they get pregnant have access to healthcare,” said Michele Johnson, executive director of the Tennessee Justice Center, which fought against the block grant now in place. “Right now, waitresses and home health aides, they don’t have access to healthcare until they get pregnant, and that’s too late.”

The legislature will still have to sign off, and so far, top Republican leaders have not endorsed the specifics of the plan. When asked for comment, Senate Speaker Randy McNally released a statement praising the new funding model and that it has “yielded shared savings that enables TennCare to offer expanded coverage.”