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Committee rejects bill to extend continuous TennCare eligibility for children to age 18
Summary
The Senate Health and Welfare committee voted 3–6 against SB 401, a proposal to stop routine annual redeterminations for children and automatically keep eligible children enrolled until age 18; sponsors said the change would cover an estimated 59,000 children for about $15 million, while TennCare staff warned federal matching funds could be lost without CMS approval.
Senate Bill 401, which would prohibit routine annual redeterminations and establish continuous eligibility for children through age 18, failed in the Senate Health and Welfare committee on a 3–6 roll call.
Sponsor remarks framed the bill as a stability measure. "This bill establishes continuous eligibility for children 18, allowing coverage to renew automatically unless a child's eligibility actually changes," the sponsor said, and argued that the change would keep eligible children covered and reduce uncompensated emergency care. The sponsor cited a state report showing a 6.5% uninsured rate among Tennessee children in 2024 and estimated that about 59,000 eligible but uninsured children could be brought into coverage for roughly $15,000,000—about $250 per child.
TennCare officials told the committee that current federal rules require annual redeterminations and explained the agency's renewal workflow: an automated 'no-touch' renewal attempt through the state's TEDS system, follow-up letters, and a 90-day reconsideration or backdate option. TennCare staff said they had renewed roughly 83% of children through the automated process in early 2025. They warned that a statewide shift to continuous eligibility up to age 18 would likely forfeit federal matching funds unless CMS approved a waiver, noting a prior CMS letter indicating reluctance to approve additional waivers.
Committee members debated whether the bill's language would prohibit Tennessee from requesting eligibility information and whether the statute as written would violate federal law. The sponsor pointed to statutory text that limits disenrollment only when the division has knowledge of disqualifying facts (death, out-of-state residence, voluntary disenrollment, or income exceeding eligibility limits) and said the bill is intended not to violate federal law. Opponents questioned how the state would detect changes in circumstance without routine redeterminations.
The clerk recorded the roll call: Senators Hale, Harshbarger, Hensley, Jackson, Reeves and Watson voted no; Senators Massey, Yarbrough and Chairman Crow voted aye. The chair and clerk announced the tally as "3 ayes, 6 nos," and the committee did not advance the bill.
