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Eligibility for 61% of TennCare members retained

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(The Center Square) – TennCare has renewed eligibility for 61% of those in the program during its annual redetermination process, which began in April for the first time since a federal COVID-19 pause halted the process.

That compares to 50% nationally who have been renewed during the process.

TennCare reached its peak of enrollment at nearly 1.8 million in June and TennCare Director Stephen Smith told the House Finance, Ways and Means Committee on Tuesday that the department still believes enrollment will be back near the prepandemic numbers of 1.4 million once the year-long process is completed.

“Nothing has occurred that would lead us to believe that projection is not the best projection,” Smith said.

In November, 1.67 million were still enrolled.

Automatic renewals are at 42% based on data the department or state already had and 20% have been determined eligible through redetermination paperwork.

TennCare says 31% have had coverage terminated; the national average is 27%. TennCare had 24% determined ineligible for failure to respond and 8% were determined ineligible based on the return of information.

“It’s a pretty substantial undertaking for us and the members going through it,” Smith said.

Of those who failed to respond, TennCare says 43% have other health insurance.

Smith said the federal enhanced match funding related to increased enrollment due to the pandemic eligibility check pause was phased out in 2023 and ended completely in December. But TennCare has $500 million in a reserve account to cover the additional costs of inflated membership.

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