Tennessee: The TennCare Crisis

Abstract

TennCare was created in 1994 to cover the 800,000 Tennessean Medicaid population, whose expenses for care were rapidly escalating. To receive a waiver from the Health Care Financing Administration (HCFA) to accomplish this, TennCare also included another 500,000 citizens who were uninsured, underinsured, or uninsurable. Therein lies the problem! Providers are dropping out and patients are experiencing difficulty in obtaining access to care, particularly subspecialty care. The fundamental basis of the crisis is that there is not enough money in TennCare to fund the system as it is designed. It is widely accepted that TennCare is so severely underfunded that without resolving the funding problem, no other reforms, however good they may be, will fix TennCare.