Tennessee is being sued for depriving eligible residents of Medicaid coverage.
The changes to the state's Medicaid program, TennCare, following the implementation of the Affordable Care Act have resulted in thousands of individuals being blocked from coverage they are entitled to, according to a lawsuit filed Wednesday in the U.S. District Court for the Middle District of Tennessee in Nashville. And the firms involved argue it's because of politics related to the health care law.
"Tennessee officials are sacrificing the health of the state's most vulnerable citizens just to score political points," said Sam Brooke, staff attorney for the Southern Poverty Law Center, which is filing the lawsuit along with the Tennessee Justice Center and National Health Law Program. "They're throwing a monkey wrench into their own Medicaid program so they can demonize the federal government. People in dire need of medical care are being sacrificed."
Medicaid law requires applications to be adjudicated within 45 days, yet many residents in Tennessee have not received any response from TennCare in as long as three times that period, the lawsuit says. Furthermore, the state is not allowing hearings in the event of a denial or no determination, leaving applicants in limbo with no recourse to get coverage.
The organizations filing the suit say these delays are a result of changes to TennCare that were put into place following the Obamacare rollout. On Jan. 1, the state stopped accepting direct applications for coverage, instead requiring consumers to apply through HealthCare.gov — something they say the federal marketplace was never meant to handle alone.
If there are determination issues between the federal system and the state office, applicants are out of luck, because the state also ended in-person assistance last fall.
Tennessee is the only state without in-person guidance or an enrollment system of its own.
TennCare, however, places the blame on the federal government for any problems that have arisen.
"The state has not only shouldered its own responsibilities, but also has devoted substantial resources to mitigating problems arising from the federal marketplace flaws," TennCare Director Darin Gordon wrote in a letter to the Centers for Medicare and Medicaid Services earlier this month. "A small percentage of applicants have had difficulty completing the enrollment process, but almost all of those problems have been the result of flaws in the federal government's HealthCare.gov website."
The remarks were a response to a request from CMS at the end of last month for a plan of how TennCare will meet Medicaid requirements. Similar letters were sent to five other states with large backlogs of Medicaid applications: Alaska, California, Kansas, Michigan, and Missouri.
Yet while the other states have taken measures to address the problem and reduce their backlogs, the suit's filers say, Tennessee has taken steps backward. CMS's only recourse aside from a slap on the wrist is to revoke Medicaid funding from the state — a last resort the suit's filers say no one wants, and one they hope to avoid through court intervention.
Like most red states, Tennessee has declined to participate in Medicaid expansion, but it is the first state in the country to face litigation over its Medicaid practices since the ACA went into effect.