Introduction
Tennessee is seeking federal permission to impose a work reporting requirement on low-income parents and caregivers receiving health coverage through Medicaid. Under the proposal, these beneficiaries ages 19 to 64 would have to document that they are working at least 20 hours a week or participating in job-training, education, or volunteer activities in order to maintain their TennCare II coverage. One parent in a household with children under age 6 would be exempt. Because Tennessee has not expanded Medicaid under the Affordable Care Act, the only adults targeted are parents whose incomes are at or below 98 percent of the federal poverty level. The impact of the proposal could mean some of the state’s poorest parents would lose health coverage altogether. And that loss of coverage will affect their children, who may lose access to care, as well, even though they are technically exempt.
Tennessee’s proposal does not provide any estimate of how the new reporting rules would affect enrollment in TennCare if the Centers for Medicare and Medicaid Services (CMS) approve the request to amend the state’s section 1115 “TennCare II” demonstration waiver. Nor does the state even mention the real possibility that many of these parents (and some of their children) would become uninsured.