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TennCare proposes "Pathway to Independence" pilot to help members transition off Medicaid
Summary
TennCare Director Steven Smith told the House finance committee the agency will pilot a four‑year program offering capped private‑insurance premium assistance (up to $2,000) to members who gain income, with participant cost sharing and navigation supports. The plan is untested nationally and would be funded from shared savings.
TennCare Director Steven Smith outlined a new pilot called Pathway to Independence during the Finance, Ways and Means Committee's Feb. 25 budget hearing, saying the program would offer time‑limited subsidies to help people who lose TennCare because of higher income enroll in private insurance.
"We will provide 12 months of assistance up to $2,000 total limited to those who do not exceed 250% of the federal poverty level," Smith said, describing a 12‑month premium assistance allotment paired with navigation help. He said participants would pay a modest monthly contribution and that unspent funds could reimburse verified cost‑sharing expenses.
Smith framed the pilot as experimental: "No state has attempted this," he told the committee, adding that if it works it "will be transformational." TennCare officials said the pilot would be funded from the program's shared‑savings pool and stressed uncertainty about outcomes and federal interactions.
Why it matters: TennCare officials say shared savings have produced more program investments in recent years and that the pilot aims to reduce churn — people who leave Medicaid, become uninsured and later return. Committee members pressed for detail on eligibility, fiscal exposure and how success would be measured; TennCare committed to follow‑up reporting and more granular cost estimates.
Provenance: topicintro SEG 051, topfinish SEG 208.
