State Still Unsure About Medically Needy Population

Governor Phil Bredesen expects to decide by early next week if the 97-thousand medically needy on TennCare will get to keep their health care coverage.

This is an optional Medicaid category for those with medical bills so high, that their net income is reduced to 241-dollars per month. Bredesen says the state got most of the changes to the Grier consent decree it asked for, but says lawyers are still deciphering the latest ruling from U-S district Judge John Nixon, issued yesterday.

TennCare advocates with the Tennessee Justice Center have charged that none of the current medically needy enrollees will be eligible since TennCare will have covered all recent bills.

But Bredesen says the 97-thousand will be able to apply for the new program once their current eligibility period ends.

“If someone ceases to be on and then in the next month has bills significant enough to qualify for the program with a no interruption whatsoever. So we’re trying really hard. The way it worked before you could get on the program if you showed a medical bill from anytime in history, you could walk in with a medical bill that was ten years old paid or not paid, if it was large enough, get on the program. Well that’s not fair to people who’ve got current medical bills so what we’re saying is they gotta be current.”

The state will continue enrollment for the 97-thousand medically needy, only if it’s allowed to change the eligibility requirements established by federal law. The state wants to limit enrollment to those with a significant bill incurred in the last 90-days, and for that it needs a waiver from the Centers for Medicaid and Medicare.

Judge John Nixon in his ruling yesterday said he wouldn’t condone any actions taken by the state that haven’t yet been approved by CMS.

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