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MYTH # 7: REALITY TennCare officials continue to use old enrollment figures from before the cuts when making comparisons to other states. As a result of the cuts, Tennessee has one of the most restrictive Medicaid programs in the country. Coverage for adults is now more limited than the old Tennessee Medicaid program that existed before TennCare. Most other states have Medically Needy, or “spend-down” programs, which Tennessee has sharply limited for all adults except pregnant women.1 Only a handful of states have prescription drug limits that are as low as TennCare’s monthly limit of two branded and three generic drugs.2 Tennessee is 50th in the country in providing home and community-based services for frail adults who need long term care.3 Once a leader in coverage of children, Tennessee now trails the nation. TennCare enrollment figures for children appear larger than other state Medicaid programs’, because Tennessee includes in its Medicaid count children who in other states are covered by a State Children’s Health Insurance Program (SCHIP), which Tennessee does not have.4 Tennessee now is the only state that does not routinely provide health coverage, either through Medicaid or SCHIP, to school age children with incomes above poverty.5 In February 2006, the Governor announced that the state would create an SCHIP plan that would take Tennessee from last place to the top tier of states by insuring all 150,000 uninsured children in the state.6 When the plan, to be known as “Cover Kids”, was released the next month, it proposed to cover only half that number, and to take three years to do so.7 1 Kaiser Family Foundation, State Health Facts, “Medicaid Medically Needy Program Enrollment, 2000”, available at http://statehealthfacts.org/cgi-bin/healthfacts.cgi?action=compare&category=Medicaid+%26+SCHIP&subcategory=Medicaid+Medically+Needy&topic=Total+Enrollment&gsaview=1. See McKinsey, Part 1, p. 7, regarding the costs to the state of cutting the Medically Needy program, as the Bredesen Administration is now doing. In the early 1980s, Tennessee dropped the medically needy category, but the impact on hospitals and local government was so damaging that the group was added back to the program within two years. 2 See Kaiser Commission on Medicaid and the Uninsured and the National Council of State Legislatures, “Medicaid Benefits: Services Covered, Limits, Copayments and Reimbursement Methodologies For 50 States, District of Columbia and the Territories (as of January 2003)”, available at http://207.22.102.105/medicaidbenefits/prescriptiondrugs.html. 3 See n. 6, Myth #4. 4 Kaiser Commission on Medicaid and the Uninsured, “SCHIP Program Type, by State (December 2004)” http://www.statehealthfacts.org/cgi-bin/healthfacts.cgi?action=compare&category=Medicaid+%26+SCHIP&subcategory=SCHIP&topic=SCHIP+Program+Type. 5 Kaiser Commission on Medicaid and the Uninsured, “Income Eligibility Levels for Children's Regular Medicaid by Annual Incomes and as a Percent of Federal Poverty Level (FPL), 2005” http://www.statehealthfacts.org/cgi-bin/healthfacts.cgi?action=compare&category=Medicaid+%26+SCHIP&subcategory=Children%27s+Medicaid+and+SCHIP+Eligibility&topic=Income+Eligibility%2d%2d+Medicaid and ” Income Eligibility Levels for Children's Separate SCHIP Programs by Annual Incomes and as a Percent of Federal Poverty Level, 2005”, http://www.statehealthfacts.org/cgi-bin/healthfacts.cgi?action=compare&category=Medicaid+%26+SCHIP&subcategory=Children%27s+Medicaid+and+SCHIP+Eligibility&topic=Income+Eligibility+%2d%2dSeparate+SCHIP+Program 6 Governor Phil Bredesen, “Remarks: 2006 State of the State Address” (Feb. 7, 2006), 7 Governor’s Press Office Fact Sheet: “Covering Tennessee’s Uninsured: Cover Kids” (March 27, 2006), http://www.tenncare.org/GovernorsPlan/cover_kids.pdf.
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