A TennCare block grant authorization passed the state Senate on Thursday afternoon, putting Tennessee a step closer to becoming the first state in the nation to receive federal Medicaid funding in a lump sum.
Authorization would offer state officials more autonomy on administering the program and a potential for savings, state officials said.
Barreling through the Tennessee Legislature at a rapid pace, the proposal passed four House committees and the Senate Finance, Ways and Means Committee on Thursday before moving to the Senate floor.
Senators approved the block grant authorization on a party line vote of 25-6. The House is scheduled to take up the authorization proposal Friday morning for a likely final vote.
If authorized by the Legislature, the block grant would overhaul how Tennessee’s Medicaid program, TennCare, receives federal funding. The federal government currently funds a portion of TennCare’s costs, regardless of fluctuations each year. Under the block grant, the state would receive federal TennCare funds in a lump sum, and have more flexibility in administration of the funds.
TennCare provides health care services to about 1.2 million low-income and disabled Tennesseans.
Legislation to begin the block grant application process was passed by the Legislature in 2019, and TennCare since has negotiated a 10-year block grant waiver agreement, which federal Medicaid officials approved Friday.
Senate Democrats criticized the effort to push significant legislation for approval on the second day of the session.
Sen. Brenda Gilmore, D-Nashville, said that during hearings the state previously held on the block grant proposal, more than 1,600 people opposed it, while only 10 people were in favor.
Senate Minority Caucus Chairperson Raumesh Akbari, D-Memphis, proposed an amendment to require TennCare to prioritize the state’s most vulnerable populations with savings brought by the block grant.
“Health care, to me, is not a privilege. It’s a right,” Akbari said. “I think what we’ve seen during this pandemic is how deadly it can be when folks don’t have access to a doctor on a regular basis when they have to rely on emergency rooms and hospitals for their basic health care needs.”
Akbari’s amendment was rejected along party lines.
Sen. Paul Bailey, R-Sparta, said TennCare’s priorities to reinvest savings resulting from the block grant include expanding maternal health coverage, serving additional needy populations and clearing the current waitlist of people with intellectual and developmental disabilities.
“The same ranking system that puts us in fiscal stability ranks us 43rd in health care,” said Sen. Heidi Campbell, D-Nashville. “Of course we are going to be first in fiscal stability if we do not take care of our citizens.”