31,000 lost TennCare coverage in redetermination process

Published 3:17 pm Monday, July 17, 2023

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Tennessee saw more than 31,000 members lose TennCare coverage in the first month of redetermination, according to a recent unwinding report.

Of the 80,000 renewals in the month of April, there were 43,666 who remained eligible for coverage.

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Redetermination of TennCare eligibility was blocked during the COVID-19 health emergency rules between March 2020 to March 31. That meant anyone who qualified once for the programs continued to be eligible until this year.

Normally, states are required to check Medicaid eligibility once every year.

Despite the start of redetermination, TennCare still reached a high of 1.8 million enrolled in the program in May. Those who were determined to no longer be eligible for coverage were referred to the federal health care marketplace.

TennCare went into the state of emergency with 1.3 million members and expected membership to peak at 1.8 million before the completed redetermination process is expected to bring that number back down to 1.3 million.

The extra members from the COVID-19 emergency pause is expected to cost Tennessee $500 million this year.

Overall, 1.3 million in the U.S. have lost Medicaid eligibility since redetermination began March 31 with Florida disenrolling 303,000 and Arizona next at 149,000, according to numbers from the Kaiser Family Foundation.

The U.S. Department of Health and Human Services recently announced new rules to prevent those who still qualify for Medicaid from losing services, including allowing managed care plans to help complete portions of renewal forms and allowing pharmacies and community organizations to help with reinstatement for those recently disenrolled.

“Nobody who is eligible for Medicaid or the Children’s Health Insurance Program should lose coverage simply because they changed addresses, didn’t receive a form, or didn’t have enough information about the renewal process,” said U.S. Department of Health and Human Services Secretary Xavier Becerra.