Get Full Government Meeting Transcripts, Videos, & Alerts Forever!
Get email alerts on the Tenncare Overview topic
No spam. Unsubscribe anytime.
TennCare director tells committee program is fiscally stable, covering 1.4 million and producing shared savings
Summary
TennCare Director Steven Smith briefed the House Insurance Committee on March 25, describing TennCare’s enrollment (~1.4 million, about 20% of state population), an $18.6 billion budget, nearly $1 billion in shared-savings over the first three years of the TennCare 3 waiver, and reserve levels with roughly $300 million unobligated.
TennCare Director Steven Smith and agency leaders told the House Insurance Committee on March 25 that the Medicaid program now covers about 1.4 million Tennesseans (roughly 20% of the state population), operates with a budget exceeding $18.6 billion and has generated nearly $1 billion in shared savings in the first three years of the TennCare 3 waiver.
Smith described the program’s evolution and said TennCare has improved both fiscal outcomes and quality measures. “TennCare has never been more successful than it is today,” Smith said, noting expanded services that include a comprehensive adult dental benefit and investments to reduce waiting lists for long‑term services and supports. He attributed recent fiscal stability to managed care, value‑based payment strategies and the shared‑savings structure established under the TennCare 3 waiver.
Smith said TennCare covers about half of births in Tennessee each year and covers roughly 1.4 million people. He told members the program budget exceeds $18 billion and that TennCare receives about 65% of its funding from the federal government. On reserves, Smith said the TennCare reserve stood near $1.4 billion at the end of fiscal year 2024 but that about $1.1 billion of that balance was already obligated; he said roughly $300 million was unobligated and available for other uses, noting that large program budgets mean even several hundred million dollars cover only a limited number of operating days.
Smith reviewed the shared‑savings record of TennCare 3, implemented in January 2021 under a waiver negotiated with the prior federal administration, saying the program has produced significant reinvestments in services and provider rates. He said those shared savings have been used for initiatives such as dental expansion (affecting about 600,000 adults in Smith’s description) and investments in long‑term care and behavioral health.
Committee members asked detailed questions about member cost sharing, plan choice and eligibility thresholds. Kim Hagen, TennCare director of member services, said traditional Medicaid co‑pays are nominal for most members (she referenced pharmacy co‑pays in the range of $0.50 to $2.50). Smith and his staff also described eligibility thresholds: for example, TennCare covers children up to about 250% of the federal poverty level and parent/caretaker relatives at about 100% of the poverty level, though Smith cautioned thresholds vary by eligibility category.
Members raised concerns about rising drug prices and the complexity of the national prescription drug delivery system during the session; Smith said federal actions such as limited Medicare drug‑price negotiation could help over time but that broader national reforms are required.
The committee thanked TennCare leaders for the presentation and moved on after a series of questions and answers.
Key figures noted in the presentation - TennCare enrollment: ~1,400,000 members (≈20% of state population) - TennCare budget: >$18.6 billion (state and federal combined) - Federal share: ~65% of total funding - TennCare reserve: cited ~$1.4 billion at 6/30/2024 with ~$300 million unobligated - TennCare 3 shared savings: ~ $1 billion in first three years - Dental expansion referenced as affecting ~600,000 adults (as described by TennCare director)
