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Just the facts: What led to the single largest decrease in the nation's uninsured population?

The Administration claims that the State never wanted to strip hundreds of thousands of sick families of their medical care. The Administration fully intended to conduct mass terminations from the TennCare program. This decision was independent of any action, legal or otherwise, by any advocacy organization.

Such drastic action could not be accomplished without a scapegoat. So, the Administration found one. The mass disenrollments of vulnerable people are blamed on supposed legal action taken by Tennessee Justice Center.

In reality, no such legal action occurred. The Center has had long-standing court orders that apply to the TennCare program—in fact, Governor Bredesen himself agreed in 2003 to the entry of these orders as they affect TennCare. TJC never threatened legal action prior to the disenrollments. In November 2004, TJC offered to stand down from litigation for two years so that the Administration could achieve reform as long as the Administration would agree not to conduct mass disenrollments. The Administration refused this offer.

The Administration’s most important goal is re-election. In order for this goal to be achieved, political accountability for the devastation that is unfolding across the state as 191,000 try to survive without health care must be avoided.

Here are the true facts and a timeline that led to the single largest increase in the nation’s uninsured population.  

Timeline

October 2003
The Bredesen Administration settles all four class action lawsuits with the Justice Center resulting in hundreds of millions of dollars worth of savings for the state. <Learn More>

February 2004
The governor announces draconian cuts to the benefits of the 1.3 million TennCare enrollees. The governor repeatedly assures the public that he will not be cutting eligibility but only benefits.

February 2004 until September 2004
State employees worked to flesh out the governor’s reform plan. Advocates meet and provide suggestions to the Administration about cost-saving options that will protect the health and lives of enrollees.

September and October 2004
The State submits the amended TennCare waiver proposal to the federal government. According to federal court testimony by State officials, within weeks of this waiver submission, state officials knew that the state could not implement the waiver. State officials knew not only that their systems were not capable of operationalizing the benefit changes but also that the changes would not save enough money in Fiscal Year 2006. Saving money in FY06 was of paramount importance to state officials because the Administration did not want to have to deal with issues related to TennCare finances in FY07—the re-election cycle. <Goetz Testimony [pdf]> <PX 149 [pdf]> <PX 228 [pdf] >

The Administration decided to abandon the September 2004 waiver not based on the Tennessee Justice Center or any other external factor. The State’s own documents show that the State would have abandoned its September 2004 plan even if the Justice Center and any suits against the TennCare program did not exist. <PX 226 [pdf]> . Although this truth is revealed in State documents, no state official has ever or will now admit this truth.

November 2004
During the November election legislators from across the state ran on the governor’s coattails and the fact that they had “fixed TennCare.” Just days after the election, the governor announces what he knew for weeks beforehand--that he had decided to take the radical steps of disenrolling hundreds of thousands from TennCare. The governor blamed this decision on the Tennessee Justice Center. Internal documents and court testimony show that pointing the finger at TJC was all part of the State’s well-planned and detailed strategy to “surface the issue” for the public after the November 2004 election.

• November 15, 2004 — Immediately upon learning of this threat of disenrollment for our clients, the Justice Center asked the court to put all of the Center’s TennCare cases on hold for a period of two years. <Motion to Hold John B in abbeyance [pdf]> <Motion to Hold Rosen in abbeyance [pdf]> <Motion to hold Newberry in abbeyance [pdf]> <Motion to hold Grier in abbeyance [pdf]>
  
  The Center agreed to allow the State to implement any waiver approved by the federal government—as long as the State would not conduct mass disenrollment. 48 hours later, the State rejected TJC’s offer out of hand, without analyzing the cost savings of these proposals.

January 2005
The governor announced his plan to cut all the adult waiver and optional TennCare enrollees. The decision to allow waiver and option children to remain on the program was based on a calculation that the State would gain $140 million by covering these children because the State would continue to receive a favorable federal match rate and children’s health care is so inexpensive. The governor also announced that he would spare 97,000 people if he received complete federal court relief. This promise to the 97,000 remains unfulfilled as the proposed program will serve only a small subset of this group. <Learn More>

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