Capitol Correspondence - 11.26.19

Tennessee Takes Next Steps in Block Grant Proposal

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With many of the Administration’s health policy priorities stalled in the courts, the state of Tennessee has attracted national attention with its efforts to move forward on a proposal to administer the Medicaid program through block grants. This proposal could set a dangerous precedent with several implications for disability entitlements in Medicaid. The comment period for the proposal closed on October 18, and as Politico Pro reported:


“Tennessee has submitted to the Trump administration its sweeping plan to cap federal Medicaid funds in exchange for new flexibility.


State officials sent the overhaul about a week after CMS Administrator Seema Verma vowed to soon release federal guidance allowing states to pursue Medicaid spending caps. The state’s plan would apply to people traditionally covered by the program, including children, pregnant women, poor seniors in nursing homes and people with disabilities.


Tennessee officials tweaked certain components of the proposal since unveiling it in September, but the broad structure of the novel plan remains the same. For example, the state says it would only use new flexibility on Medicaid benefits to add coverage and it wouldn’t have the authority to make reductions without CMS approval. Tennessee also clarified that no changes will be made to EPSDT benefits, which provide a range of preventive services and treatment for people under 21 years old.


In response to concerns about medications in light of the state’s request to limit which drugs are covered, Tennessee clarified it would maintain an exceptions process to cover drugs that are not on the formulary when medically necessary.


Roughly 1.4 million people are enrolled in Tennessee’s Medicaid program, known as TennCare. The state is one of 14 that has not joined Obamacare’s Medicaid expansion for low-income adults.


State officials in the waiver request clarified that ‘covering additional needy individuals is one way in which block grant funds could be used.’”