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TennCare outlines $2,000 premium-assistance pilot and shared-savings investments
Summary
TennCare Director Steven Smith presented the FY27 budget and a four-year 'Pathway to Independence' pilot offering up to $2,000 in 12-month premium assistance (targeting up to 15,000 parents up to 250% FPL) plus rural health shared-savings funding; director emphasized program success under the waiver and cautioned that the pilot is unproven.
TennCare Director Steven Smith and his leadership team presented the FY27 budget and a year-4 shared-savings plan that includes a proposed four-year pilot called Pathway to Independence. Smith said the pilot would provide up to $2,000 per participant in premium assistance for 12 months, target up to 15,000 parents and caretakers up to 250% of the federal poverty level, and require a $15 monthly participant contribution where premiums exceed that amount.
Smith characterized TennCare's longer-term record as a "turnaround story" with more than $5 billion in combined provider investments and said shared-savings dollars make the pilot possible. He was explicit about uncertainty: "We don't know if this is going to work. No state has attempted this." Committee members asked about selection criteria, evaluation, and impacts on provider taxes; TennCare said the pilot will be statewide, first-come, first-served, evaluated by an independent evaluator, and it is financed from one-time shared-savings dollars. The committee moved the budget and related shared-savings items to the next steps in the process.
