Congressman Cohen Urges Biden Administration Not to Re-Approve Trump’s TennCare Waiver

September 8, 2021
Press Release
A “devastating blow to Tennesseans who rely on Medicaid”

MEMPHIS – Congressman Steve Cohen (TN-09) today filed formal comments with the Centers for Medicare and Medicaid Services opposing the block grant-style waiver for Tennessee’s Medicaid program, known as the TennCare III waiver. The unhealthy waiver, granted by the Trump administration as it was leaving office without public comment, would be a “a devastating blow to Tennesseans who rely on Medicaid to meet their basic health needs.” TennCare is Tennessee’s Medicaid program. The deadline for submitting comments on the plan is Thursday.

Please see Congressman Cohen’s entire comments here.

In his statement, Congressman Cohen said in part:

Dear Administrator Brooks-LaSure, 

I write to express my opposition to the TennCare III waiver. The waiver, which was approved in the final days of the Trump Administration without public comment, prioritizes frugality of managed care over the health and well-being of Tennesseans. Proceeding with the waiver would be a devastating blow to Tennesseans who rely on Medicaid to meet their most basic health needs.

Tennessee already has a long record of cutting Medicaid spending and services. It spent less on each full Medicaid benefit enrollee than every other state except for three (Georgia, Nevada and South Carolina). With a life expectancy of 75.5 years, Tennessee is ranked 47th out of the 50 states plus Washington, DC. It is also one of only a dozen states that has not expanded its Medicaid program under the Affordable Care Act; enrollment in TennCare is restricted to only the poorest and sickest citizens. Tennessee also requires most residents to enroll in managed care plans that use regulatory red tape to deny care to enrollees. Tennesseans who need timely care scarcely have the resources to fight with managed care organizations (MCOs), which take the position that a doctor’s order does not meet their standards of “medical necessity.”

The TennCare III waiver would motivate MCOs to restrict treatment even more, since it would enact an aggregate cap on federal funding and allow Tennessee to direct unused federal Medicaid funds toward other “policy priorities.” This block grant funding structure creates a perverse incentive for the state to deny or delay care so that savings from cutting care could be diverted to lawmakers’ preferred projects. The funding cap could also erode TennCare over time as federal support fails to keep up with rising costs.