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 Tennessee
(St@teside Published April 17, 2007)
Governor Phil Bredesen recently launched Tennessee 's CoverKids program aimed at providing health insurance to tens of thousands of Tennessee 's uninsured children. As part of Gov. Bredesen's multipronged insurance initiative, Cover Tennessee, CoverKids will provide comprehensive health coverage for children age 18 and under with household income below 250 percent FPL. Additionally, CoverKids will provide maternity coverage for pregnant women. Families with annual incomes higher than 250 percent FPL will be able to purchase insurance through the program for a monthly premium.
CoverKids benefits include preventive care, such as well-baby and well-child exams, and age-appropriate immunizations with no co-payments. Families will not have to pay a monthly premium but each participant will pay reduced co-payments for services.
The state is allocating $63 million over the next three years to pay for CoverKids, which will be matched at a three-to-one ratio by the federal government. Tennessee officials hope to enroll 75,000 of the state's 130,000 uninsured children in CoverKids over the next three years.
Tennessee
(St@teside Published June 26, 2006)
In March 2006, Tennessee Governor Phil Bredesen (D) proposed several coverage expansions to the legislature. On June 5, the Governor signed into law Senate Bill 3895 which contains several coverage components.
• The Cover Kids Act
- Creates a separate, stand-alone health care program for all children under the age of 18 in Tennessee which will be a State Children's Health Insurance Program (SCHIP).
- Uses $7 million in state funds for Fiscal Year 2007 (six months) and Title XXI funds (SCHIP) from the federal government to cover children and pregnant women up to 250 percent of the federal poverty level (FPL).
- Eligibility is layered over current TennCare levels.
- Offers a buy-in program for children who do not qualify for the subsidized product.
• Cover Tennessee
- Aims to provide a new, portable, and affordable product for the working uninsured in Tennessee who earn less than 250 percent FPL, as well as for small firms who do not currently offer insurance.
- Allows workers to keep their policy if they switch employers.
- Based on the three share concept where participating employers and the state each pay $50 per member per month (pmpm) and the individual covers the rest of the premium.
- Premium amounts charged to employers, employees, and individuals will not increase more than 10 percent per year, for the first three years, to maintain affordability.
- The state will contract with at least two carriers to offer a product ($150 pmpm medical loss) with low or zero dollar deductibles for preventative health services.
- The procurement process to contract with those health plans is under development.
• Access Tennessee
- A high-risk pool that pool covers:
- Residents of Tennessee who are uninsured for six months or longer, and who do not have access to other forms of public or private insurance due to a medical condition.
- Residents of Tennessee who qualify under federal law (HIPAA, COBRA).
- Authorizes board leadership to:
- elect to enroll any TennCare Standard recipient who lost coverage after August 1, 2005 and others as determined eligible; and
- develop two benefit packages, one modeled after the state employees PPO plan, and a second option that is a high-deductible health plan coupled with a health savings account.
- Will be funded by a combination of premiums, assessments on carriers and third party administrators, state appropriations, and possible federal funds pending grant release from the Centers for Medicare and Medicaid Services.
- Premiums charged to pool enrollees will be capped between 150 - 200% of a commercial benchmark plan after moderate medical underwriting.
- Authorized a premium assistance program for those who cannot afford the premiums.
• Other Programs
• Safety Net Program
- Provides affordable prescription drugs for high priority populations with chronic diseases.
- Will be available for adults who earn less than 250% FPL.
• Project Diabetes Program
- Funds endowment grants to high schools and health care entities to combat the epidemic of diabetes and obesity in the state.
Additional Information
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