and many parents have no idea until it’s too late

April, 8th 2019 / Authors: Alex Kent and Anna Walton

Children are losing their health insurance

Years of gains in covering children have been erased, and the number of uninsured children continues to rise. The number of children without health insurance has risen in the past two years in large part due to the state’s dramatic reductions in public coverage of children. Since November of 2016 (when the TennCare eligibility redetermination process started), children’s enrollment in TennCare has dropped by 100,342. The coverage losses may be even higher once TennCare posts the enrollment data for February 2019. TennCare initially posted data showing 50,000 children lost coverage in February alone. They deleted that data after reporters raised questions.

Additionally, nearly 30,000 children have been disenrolled in CoverKids in the last year. If children were losing TennCare coverage because of increased parental income, they would be more likely to transition to CoverKids, which has a higher income threshold. The drop in CoverKids enrollment indicates that this is not the case.

There is now data showing that state officials’ optimistic interpretation of declining TennCare enrollment was mistaken. Many of the children losing TennCare are not moving to private insurance but are left without any coverage at all. This is evident from the fact that Tennessee saw a 20% percent increase in the number of uninsured children in 2017, and this trend is expected to continue when data from 2018 becomes available. Tennessee has seen a greater loss of health coverage among children than almost any other state.

TennCare’s Redetermination Process

These increases in uninsured children coincide with TennCare’s manual redetermination process. It appears that a major cause of the loss of health coverage for children is TennCare’s troubled process for redetermining enrollees’ eligibility. TennCare suspended the process in 2014 due to its lack of a working computer system. Despite continuing computer problems, TennCare resumed the redetermination process in 2016, with disastrous results. In many cases, TennCare mailed renewal packets to wrong addresses and failed to process documentation submitted by families proving their eligibility. In late 2017, the Tennessee Comptroller reported on the many problems with TennCare’s redetermination process. Those problems include a 98-page packet, the call center’s inability to update enrollees’ addresses, and systemic failures to link eligibility information to all members within a family.

Most children should still have received coverage under special categories of TennCare and CoverKids, even if their household income increased. Of the 100,000 children who lost coverage, TennCare does not know how many children were actually ineligible and how many lost their coverage due to administrative issues, because TennCare does not track that data.

Health care is vitally important for children. We know when kids are covered, they are more likely to succeed in school and in life. If you know a family who has lost TennCare or CoverKids coverage for their child, they can call the Tennessee Justice Center at 1-844-479-KIDS (5437) for free assistance.