However, Biden’s administration is expected to oppose the ten-year approval. While incoming officials may reverse the decision, the state may request a trial to challenge the determination. The overthrow of approvals has rarely, if ever, occurred.
Funding for Medicaid, which covers more than one in five Americans, is now open, with the federal government paying more than 60% of the total Medicaid costs, and states having to pay about 40% of the bill.
Conservatives complain that the formula encourages states to spend more so they can get more federal funding, while a block grant will encourage them to better control costs. Consumer advocates, on the other hand, say that block grants will cause states to shrink their Medicaid programs to stay below the spending limit, which harms vulnerable residents.
What Tennessee Can Do Now
Tennessee’s waiver shifts federal funding for its TennCare program to a lump sum, which will increase annually based on Medicaid’s expected growth rates in the president’s budget. If the entry increases or decreases by more than 1%, the block allowance is adjusted accordingly. TennCare currently covers approximately 1.5 million low-income residents.
If the program comes under budget and meets certain quality criteria, the state can share in the savings. According to officials, the top priorities for the extra funds to address maternal health are individuals with mental and developmental disabilities who are currently on a waiting list to receive, serve and address other state-specific public health crises.
“Our approved plan will create an unprecedented opportunity for Tennessee to be rewarded for its successful administration of TennCare and further improve the health of TennCare members and Tennessee communities with the reward,” said Republican Bill Lee, a Republican. .
The state may only supplement, not reduce, the current coverage and benefits of beneficiaries, CMS administrator Seema Verma said.
The waiver also gives the state more flexibility to administer its program, including limiting the number of prescribed drugs covered and amending the optional benefits, such as prescribed medication and physical therapy.
Tennessee is one of a dozen states that Medicaid has not expanded to low-income adults under the Affordable Care Act.
Opponents of the Block grant, however, say the arrangement could lead to Tennessee reducing enrollment or benefits to increase potential savings and stay below the limit. They point out that the approval of waiver does not prohibit the state from taking such steps.
“It just creates a major incentive for Tennessee to cut its program,” said Hannah Katch, senior policy analyst at the Left Center for Budget and Policy Priorities.