TennCare director reports program growth, shared-savings investments and $18 billion budget to House Health Committee

TennCare officials briefed the House Health Committee on the Medicaid program’s scale, recent fiscal performance and program investments during an informational session on Jan. 1, 2025. Director Steven Smith described enrollment, budget figures and the state's use of federal shared-savings funds under the TennCare 3 waiver.

Why it matters: TennCare covers about one in five Tennesseans and is a major state budget item; recent shared-savings under the federal waiver have funded new benefits and targeted investments that committee members and agency leaders said are affecting access and services.

Director Steven Smith told the committee TennCare covers roughly 1,400,000 Tennesseans, about 20% of the state population, and that the program's annual budget now exceeds $18 billion. “When it comes to our mission, TennCare is more successful today than at any point in our 30 year history,” Smith said, and he credited long-term management changes and the TennCare 3 waiver for generating reinvestment dollars.

Smith described TennCare 3 — a Section 1115-style waiver implemented in January…