TennCare Swells Under First Year Of Health Insurance Mandate

Darin Gordon is the head of TennCare, which has grown by 120,000 this year even though the state has not expanded who qualifies for the health coverage. Credit: TN Photo Services

The number of Tennesseans on Medicaid has shot up by 120,000 since the beginning of the year, according to newly released data from TennCare. It’s the third largest annual increase in 20 years.

The insurance program for low-income residents has grown despite the state’s refusal to expand Medicaid to include more of the working poor. TennCare director Darin Gordon says these are likely people who were already qualified for coverage and just didn’t know it until the Affordable Care Act’s insurance mandate took effect.

“If you look at what our normal growth trends and then you look at what we actually experienced, it was significantly more than what we’ve seen,” Gordon said.

TennCare now has slightly more than 1.3 million people covered. That’s still well below a high reached around the turn of the millennium when nearly 1.5 million Tennesseans were on the subsidized health insurance.

Last year, TennCare predicted 50,000 people would sign up for coverage after being eligible but not enrolled, a phenomenon known as “the woodwork effect.” Nationwide, at least prior to the ACA’s health insurance mandate, only 80 percent of those who qualified for Medicaid had signed up for benefits.

“The average growth that we’ve seen pretty consistently has been over the average of non-expansion states,” Gordon said. “Every way you look at it, we’re seeing higher enrollment than we’ve seen in a very long time.”

The uptick has occurred even though many people who qualify for TennCare have been prevented from signing up. The main problem is a $35 million computer system to check eligibility, which was supposed to be in place more than a year ago and is still plagued by delays.