Advocates for Families in Need


211 7th Avenue N, Ste. 100

Nashville, TN 37219

Phone: (615)255-0331 Fax: (615)255-0354

e-mail: website:


For Release: August 6, 2019


Kinika Young

Director of Children’s Health,,

(615) 846-4709

How Tennessee Became an Outlier in the Rising Number of Uninsured Children and What Must Happen to Reverse the Trend


Nashville, Tenn.

Tennessee saw a 20% increase in the number of uninsured children in 2017, making us one of only nine states to see a statistically significant increase in the percentage of uninsured children. On an issue as important as ensuring that all children have health coverage, why is Tennessee an outlier? The Tennessee Justice Center’s recent policy brief examines how state policies and administrative problems contribute to the rise in the number of uninsured children and what steps the state can take to address the problem.

In conjunction with the rise in the number of uninsured children, Tennessee saw a 10.1% decline in enrollment – the country’s largest – in our state’s public health insurance programs: TennCare, the state’s Medicaid program, and CoverKids, the state’s Children’s Health Insurance Program (CHIP), which together have traditionally covered over half of Tennessee’s children.

State officials’ assertion that declining enrollment in TennCare and CoverKids is a result of less children being financially eligible due to the state’s improving economy does not stand up to scrutiny. According to state data supplied to the Tennessee Justice Center in response to a public records request, between 2016 and 2018, TennCare terminated coverage for at least 220,000 children because of alleged problems with paperwork, not because the state determined that the children were no longer eligible. The state has no way of knowing how many of those children remain financially eligible for TennCare or CoverKids. Given Tennessee’s eligibility rules that broadly cover children, most children undergoing the redetermination of eligibility should have remained eligible, had the state correctly assessed their eligibility and not simply cut them off for administrative reasons.

Specifically, the brief suggests that TennCare’s five-year delay in implementing its new computerized TennCare eligibility determination system (TEDS) has forced the state to rely on an unreliable, ad hoc, and highly manual process for redetermining the eligibility of TennCare and CoverKids enrollees, which has caused many children to lose coverage despite remaining eligible for these programs.

TennCare should reinstate all children who have had their health coverage terminated until it has accurately determined whether they meet eligibility requirements for any of the several pathways to coverage. TennCare should also promptly investigate why so many children lost coverage on administrative grounds. Only then can the state determine whether it is taking all reasonable steps to ensure that every child who is eligible for TennCare and CoverKids is enrolled and receiving the important health benefits of coverage.


The Tennessee Justice Center (TJC) is a non-profit public interest law and advocacy firm serving families in Tennessee since 1996. It gives priority to policy issues and civil cases in which the most basic necessities of life are at stake and where advocacy can benefit families in need statewide. TJC works to empower its clients by holding government accountable for its policies and actions.

TJC is located at 211 Seventh Avenue, North, Nashville, TN. For additional information about the Tennessee Justice Center and its services, call 615-255-0331.