TennCare Designs Block Grant Proposal With Expansion Of Services In Mind

Sep 11, 2019

TennCare director Gabe Roberts, right, meets with Gov. Bill Lee on a visit to TennCare's offices earlier this year.
Credit TN photo services

Tennessee’s Medicaid program is preparing to finalize the country’s first block grant application within days. The plan would reimagine the way the federal government funds health care for low-income Tennesseans, and according to TennCare officials, it envisions expansion of service rather than cuts.

The block grant proposal is not just a request for a lump sum, as critics feared. TennCare has come up with a formula that gives the state even more incentive and flexibility to keep medical costs down. That’s something TennCare has already done better than most state Medicaid programs.


In the future, TennCare proposes splitting any money it saves the federal government. That could be worth hundreds of millions of dollars a year in extra funding, and the state would commit to spending that money on health care.

So, director Gabe Roberts believes block grants could mean the agency might offer more coverage to more people.

"Once we understand where we kind of stand financially, then we will be able to roll out some ideas through the governor, some of the things that support his policies, that would be able to meet people where they are in Tennessee and provide — hopefully — some really good, life-changing services to them," he says.

The block grant proposal has some protections for the state. One provision is that Tennessee would get more money from the federal government if enrollment swells during a recession. Some of the most expensive medications were left in the traditional funding model and out of the block grant application since their prices can be so unpredictable.

But this is just a proposal. It has to be submitted by Nov. 20, and before it can be sent, TennCare has to hold public hearings in the three grand divisions of the state.

It also has to be approved by the Trump administration. It has encouraged states to experiment with block grants, but it's not clear whether it's prepared to go along with TennCare's latest plan.