Investigators Blame TennCare’s Dense Paperwork For Bumping Vulnerable Enrollees | Nashville Public Radio

Investigators Blame TennCare’s Dense Paperwork For Bumping Vulnerable Enrollees

Dec 6, 2017

TennCare's 98-page renewal form is making it harder than necessary for low-income Tennesseans to maintain their subsidized government health coverage, according to the Tennessee Comptroller. After conducting an investigation requested by House Speaker Beth Harwell, the state agency has issued a memo suggesting a list of changes.

Enrollees have to provide 17 full pages of personal and financial information, even though the Comptroller says TennCare already knows some of what it's requesting.

"TennCare’s packets make IRS tax forms look like a picnic by comparison," Michele Johnson of the Tennessee Justice Center said in a statement. "We get calls from lawyers and doctors trying to help their clients and patients, and even they can’t understand the forms. They are especially hard on seniors and people with disabilities."

More: Download the Comptroller's report on problems with TennCare redetermination

That issue assumes enrollees even receive the form. Eva Kelly in Clarksville says her so-called "redetermination" form never arrived this year, though she seemed to be getting other mail from TennCare.

"There was no reason they wouldn't have had my address," Kelly said. "And I was not told they needed me to turn in a new address."

The delays have ripple effects on other government benefits like Social Security. Kelly says because of her interruption, her monthly disability check was reduced, and she was forced to pull from a small burial savings account to pay her monthly bills.

By the nature of the program, everyone on TennCare is struggling financially. And the Comptroller says it would help if the state offered self-addressed, postage-paid envelopes to return the bulky forms (download an example here).

For those with questions, an overworked call center has become their primary sore spot. The average wait time at one point this year was 50 minutes, according to the Comptroller. Dorothy Sheler of Nashville regularly spent hours on hold while doing her HR job, trying to sort out a complex coverage situation for her grandchildren. 

"I would just stay on hold for a while, and if I didn't get through, obviously I'd hang up again because I would have to concentrate on my work," Sheler said.

TennCare doesn't know how many people might still be eligible for coverage but were bumped because of paperwork problems. The Tennessee Justice Center points out that enrollment dropped by nearly 63,000 children and close to 5,000 seniors since December 2016. The advocacy group thinks that could be a starting point for how many people may be eligible but no longer enrolled.

However, the decrease could also be thanks to an improving economy, which has stabilized total TennCare enrollment to roughly 1.4 million people.

The annual reviews to maintain eligibility were supposed to get easier under the Affordable Care Act. But that required a new computer system, which still hasn't come online, meaning the process has become even more labor intensive.

A TennCare spokesperson says the agency has already implemented a bit of the Comptroller's advice, and officials had already been trying to offer more assistance. But some problems may not be fully addressed until the long-delayed computer system comes online more than a year from now.