Cost Pressures Threaten Tennessee's Ambitious Health Insurance Program

By Peter T. Kilborn N. Y. Times News Service | THE JOURNAL RECORD, May 26, 1999 | Go to article overview

Cost Pressures Threaten Tennessee's Ambitious Health Insurance Program


Peter T. Kilborn N. Y. Times News Service, THE JOURNAL RECORD


NASHVILLE, Tenn. -- In one bold stroke, Tennessee converted its Medicaid health benefits to managed care five years ago and used the savings to cover hundreds of thousands of people who could not afford health insurance of their own or were too sick to qualify. With 3 million people enrolled, its program, called TennCare, became the most ambitious and generous government health plan in the nation.

But with TennCare's costs rising and Tennessee facing a budget deficit, the program is under fire and facing probable retrenchment under pressure from Gov. Don Sundquist. And the people most at risk are those who benefit most from the state's effort at providing nearly universal health insurance: those with chronic or even terminal diseases who have been rejected by private insurance. To arrest a projected 12 percent increase in TennCare spending for the year beginning in July, Sundquist, a Republican elected to a second four-year term in November, has proposed a moratorium on new enrollments of the uninsurable for six months or a year while the state explores cutting benefits, raising premiums and tightening eligibility.

Meanwhile, TennCare Director Brian Lapps is suggesting that some beneficiaries of the program are exploiting it. The poorest recipients, Lapps said, could help pay for their care if they would only curb their use of cell phones and cigarettes. "We have a spoiled population that wants everything for nothing," he said in an interview. …

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