TennCare wants to hear what people think about a new work requirement, now that the agency has submitted a draft plan to the federal government. But Tennessee is still at least two years away from implementation.
With encouragement from the Trump Administration, the Tennessee legislature voted to start making TennCare benefits contingent on employment, with some exceptions. While some state leaders questioned the need for the proposal, supporters say it could motivate recipients to look for work and inspire confidence in the Medicaid system.
"A well-designed process to connect individuals to employment in a way that promotes positive health outcomes will serve to advance the goals of the TennCare demonstration," the agency writes in its waiver amendment which will be submitted to the Centers for Medicare and Medicaid Services. "This is true whether the individual obtaining employment remains enrolled in TennCare or is able to transition to private insurance."
Now the agency is going through the process of turning that idea into practice. That requires a month of feedback from the public, including three hearings this month. The first is at the Bordeaux Library on October 8 at 11 a.m.
Once the plan is approved, there are major operational questions. TennCare will have to build a computer system that can monitor employment status continually. According to legislative estimates, compliance is expected to cost $38 million — far more than it saves.
"We just don't have the technology solution developed right now," TennCare spokesperson Sarah Tanksley says. "We're focused on rolling out the new eligibility determination system, and so that's the first priority."
The new computer system for initial eligibility checks is years behind schedule but should be completed next year, Tanksley says.
TennCare did not advocate for work requirements. Most people on the government insurance are mothers and children, which makes them exempt. Out of the 1.4 million Tennesseans that are on TennCare, fewer than 4,000 are predicted to lose eligibility. Most of the states that are farther along with work requirements expanded Medicaid, which was meant to cover more of the working poor.
TennCare also has a plan to pay for enforcement that will require special permission. State lawmakers proposed to pay for the idea by diverting excess funds from the welfare cash assistance program. That will need sign-off from the Administration for Children and Families, which has jurisdiction over Temporary Assistance for Needy Families, known by the acronym TANF.