Gov. Bill Lee, R-Tennessee, said last week he is optimistic a waiver for a Medicaid block grant would be given, making Tennessee the first state in the nation to receive such a grant.
“We’re very hopeful that this happens,” Lee said. “If it does, it will be very good for our state. It will provide us an opportunity to provide greater services to our Medicaid population and the opportunity to potentially add folks to TennCare.”
Lee made the comments during an interview with the Citizen Tribune last week during his visit to the Lakeway Area where he appeared at a grand opening of a welding program at Jefferson County, a forum at Walters State Community College and a fundraiser for state Rep. Rick Eldridge, R-Morristown.
According to the Associated Press, the block grant would cover core medical services for the disabled and blind, children, adults and elderly _ or about 1.2 million Tennesseans. This means administrative costs, prescription drugs, uncompensated hospital payments and individuals dually eligible for Medicaid and Medicare would not be part of the block grant plan, which would cover a much smaller segment of TennCare.
The block grant proposal is currently in a 30-day public comment stage. Lee said the state is currently taking comments from people across the state. Once the 30-day window is up, Lee said the state would submit the proposal to the federal government by Nov. 30.
But, it will still be a long process before the state knows whether the waiver will be granted.
“We don’t expect we’ll know the outcome of this for six, eight, 10 months after we submitted it,” he said.
Currently, there are 1.4 million people enrolled into TennCare statewide. In Hamblen County, more than 16,000 people are on TennCare. Across the Lakeway Area, almost 70,000 people are enrolled in TennCare, according to data from the Tennessee Division of TennCare.
The Associated Press reports some contended that the plan would be illegal, while many others called for Tennessee to expand Medicaid instead - an option provided under the Affordable Care Act that has been opposed by Lee and the Republican-dominated Statehouse.
Overall, the likelihood of the plan ever being implemented is largely unknown. To date, no state has been given permission to rely solely on block grants to cover Medicaid expenses. The idea has been floated by Republicans for decades but never implemented, because of possible legal challenges and concerns that doing so would result in large spending cuts to the states’ most vulnerable populations.
Lee said he’s not worried about the proposal’s legality, pointing out that President Donald Trump’s administration is supportive of states issuing block grant proposals. Lee has also promised that current TennCare beneficiaries won’t be at risk of losing benefits nor face being taken off eligibility rolls should the federal government sign off on the plan.
Lee said he has heard a lot of feedback, so far, from the public since the proposal has been introduced. He said it is a very complicated idea and the more people know “what it is and what it is not” they support the waiver.
One key component the governor has talked about during his campaign and since he took over the governorship in January is finding more money to put into mental healthcare as the state battles an ongoing opioid crisis.
Lee said the block grant will help tremendously with that effort.
He said right now there is a shortage of funds for rural health care, opioid addiction services and mental health services.
“If this block grant works, there will be more money to provide those services,” he said.
Another key proponent of the block grant is the state is also asking for a modified grant, he said. That means the money provided from the federal government will go up the more people are enrolled into TennCare. So, in the case of a recession where more people may need health assistance, the federal government will make up the difference by paying more for each individual enrolled in the program.
The waiver differs in the traditional way that Medicaid is offered to states. Tennessee refused Medicaid expansion when Obamacare was first voted into effect by the U.S. Congress.
Republicans have long since pushed block grants for years because they say states would have much more control of how the money is dispersed, instead of the federal government.
Lee said the block grant will provide more resources to the state if it is completed.
“It is a win for Tennessee if we get it done,” Lee said.