Orlando Harmon
Tennessee's state-run Medicaid program, TennCare, and CoverKids, a smaller program for children who live below 250% of the poverty line, have purged at least 128,000 children from their enrollment over a two-year period. This has resulted in a sharp increase in the number of uninsured kids in the state, with many families only finding out their children were no longer covered when they took them to the doctor.
| Characteristics | Values |
|---|---|
| Number of children who lost insurance | 128,000 |
| Time period | 2 years |
| Cities with the biggest decreases | Nashville, Memphis |
| County with the largest drop | Cheatham County |
| Percentage change in CoverKids cuts since January 2018 | 39% |
| TennCare eligibility criteria | Families living close to or below the poverty line |
| CoverKids eligibility criteria | Families with income below 250% of the poverty line |
| CoverKids requirements | Cannot be part of any other health plan |
| Latest proportion of uninsured kids in Tennessee | 4.5% |
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What You'll Learn
- TennCare and CoverKids insurance programs cut at least 128,000 children over two years
- Many parents were unaware their children lost insurance
- TennCare is Tennessee's state-run Medicaid program
- CoverKids is part of the Children's Health Insurance Program
- Tennessee's uninsured children rate is down from 9% in 2020 to 4.5% in 2024
TennCare and CoverKids insurance programs cut at least 128,000 children over two years
Tennessee's TennCare and CoverKids insurance programs have cut at least 128,000 children over two years, according to a 2019 report by The Tennessean. TennCare is Tennessee's state-run Medicaid program, which uses federal funding to provide healthcare for the state's poorest and most vulnerable residents. CoverKids is part of the Children's Health Insurance Program (CHIP), which provides health insurance to uninsured children across the US. It is available to children and pregnant women who are not eligible for TennCare.
The report revealed that many families did not know their children had lost insurance until they arrived at the doctor's office. For instance, a story was shared of two grandparents who rushed their grandchildren, aged 3 and 5, to a doctor's office outside Chattanooga. The children had pneumonia, a lung infection that is particularly dangerous for young children. Upon arrival, the grandparents discovered that their grandchildren no longer had TennCare insurance.
The Tennessean's analysis of enrollment data showed that the biggest decreases occurred in Nashville and Memphis, with about 14,000 and 22,000 children losing coverage, respectively. The single largest drop was in Cheatham County, where nearly 20% of kids in TennCare were removed from the program. The decrease in the CoverKids program was even more significant, with 39% of recipients being disenrolled since January 2018, including 18,000 children in June alone.
According to state officials, the cuts were a result of TennCare and CoverKids reducing their enrollment after years of allowing the programs to expand. Families were disenrolled if they were no longer eligible or failed to respond to mandatory renewal forms. While some children transitioned to private insurance, it appears that many joined the ranks of the uninsured in Tennessee, contributing to an overall increase in the number of uninsured children in the state.
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Many parents were unaware their children lost insurance
In 2019, it was reported that Tennessee had erased insurance for at least 128,000 kids, with many parents unaware of the changes until they tried to use their insurance. TennCare and CoverKids, two Tennessee government health insurance programs for low-income families, had purged these children from their enrollment, often due to families not responding to mandatory renewal forms. This led to scenes of families discovering their lack of insurance only when they needed to use it, such as a pair of grandparents whose grandchildren, aged 3 and 5, had pneumonia.
TennCare is Tennessee's state-run Medicaid program, which uses federal funding to pay for healthcare for the state's poorest and most vulnerable residents. Eligibility for the program is notoriously complicated, but it is most generous with children, covering those from families that live close to or below the poverty line. CoverKids is a smaller program for children who live below 250% of the poverty line, providing full health coverage with an emphasis on preventive health services.
The biggest decreases in enrollment occurred in Tennessee's two largest cities, Nashville and Memphis, where about 14,000 and 22,000 children lost coverage, respectively. The single largest drop occurred in Cheatham County, where nearly one in five kids in TennCare were disenrolled. The drop in the CoverKids program was even more dramatic, with 39% of recipients disenrolled since January 2018.
The sharp cuts were a result of TennCare and CoverKids pruning their enrollment after years of allowing the programs to swell. State officials claimed that families were cut because they were no longer qualified or because they did not respond to renewal forms. However, TennCare officials could not estimate how many were cut purely due to a lack of paperwork. The disenrollment of so many children from these programs led to a sharp increase in the number of uninsured kids in the state, according to studies from Georgetown University and the University of Tennessee.
While Tennessee experienced a decrease in children insured through TennCare from 2022 to 2023, the overall lack of insurance among Tennessee children remained low in 2024. The decrease in TennCare enrollment was attributed to a switch to private insurance, as well as the end of a federal requirement that states keep Medicaid participants continuously enrolled during the pandemic. In 2023, states began redetermining eligibility, leading to transitions to other sources of insurance. Despite these changes, Tennessee has made progress in returning to the relatively low rate of uninsured children it had before the pandemic.
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TennCare is Tennessee's state-run Medicaid program
The eligibility criteria for TennCare are notoriously complicated, and financial eligibility requirements change annually and vary with marital status. Tennessee offers multiple pathways toward Medicaid eligibility, and the program is most generous with children, paying for the care of kids from families that live close to or below the poverty line.
In 2016, the state ramped up a renewal process that identifies and cuts ineligible families, leading to the removal of at least 128,000 children from the TennCare and CoverKids programs over a two-year period. Many families did not know their children had lost insurance until they arrived at the doctor's office. Some families were cut from the program because they no longer qualified, while others did not respond to the mandatory renewal forms mailed to them.
In response to rising costs, the state implemented several program changes in 2005, including removing about 190,000 participants, limiting the number of prescription medications each participant could receive, and reducing some other benefits. In 2019, a new system was launched under the name TennCare Connect, and in 2020, a class-action lawsuit was filed on behalf of 35 adults and children who alleged they were illegally denied Medicaid and other benefits by the TennCare Connect system.
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CoverKids is part of the Children's Health Insurance Program
CoverKids is a health insurance program that provides coverage for eligible children aged 18 and younger, as well as pregnant women who are unable to afford employer-sponsored or individual insurance. It is a part of the Children's Health Insurance Program (CHIP), which offers health insurance to uninsured children across all 50 states. CHIP provides low-cost health coverage to children and pregnant women whose family income is too high to qualify for Medicaid but still need assistance in obtaining health insurance.
CoverKids is a guaranteed issue policy, meaning there are no pre-existing condition exclusions for its members. Families who meet the income guidelines are exempt from paying monthly premiums but are required to pay copayments for certain services, such as sick visits and medications. These copayments vary based on income, with federal guidelines capping a family's total annual out-of-pocket costs at 5% of their annual household income.
CoverKids emphasizes preventive health services, and well-child visits and vaccinations are provided free of charge. Additionally, children who are Native American or Alaskan natives may be eligible for additional benefits if they include federally recognized tribal paperwork with their application.
To apply for CoverKids, individuals can create an account and apply online, apply over the phone by calling TennCare Connect, or send in a paper application. In-person application assistance is also available at local health departments throughout Tennessee.
Unfortunately, in 2019, it was reported that Tennessee had purged at least 128,000 children from their TennCare and CoverKids programs over a two-year period. This resulted in a sharp increase in the number of uninsured children in the state, with many families only discovering their children's loss of insurance when they arrived at the doctor's office.
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Tennessee's uninsured children rate is down from 9% in 2020 to 4.5% in 2024
Tennessee's uninsured children rate has seen a significant drop from 9% in 2020 to 4.5% in 2024, according to the latest analysis of the Tennessee Child Health Poll. This decline in the uninsured rate is a positive development for the state, which has faced challenges in ensuring access to healthcare for its younger residents.
Back in 2019, Tennessee made headlines when it was reported that the state had cut health insurance for at least 128,000 children over a two-year period. This sudden loss of insurance was due to disenrollments from TennCare and CoverKids, two government health insurance programs for low-income and vulnerable families. Many families were unaware that their children's insurance had lapsed until they arrived at medical appointments, causing distress and concern.
The reasons for the mass disenrollment were attributed to either families no longer meeting the eligibility criteria or failing to respond to mandatory renewal forms. TennCare and CoverKids had allowed enrollment numbers to swell over the years, and the programs subsequently undertook a rigorous renewal process to identify and cut ineligible participants. This led to a sharp increase in the number of uninsured children in the state.
However, the recent poll numbers indicate that Tennessee has made strides in reducing the number of uninsured children. The decrease in uninsured children enrolled in TennCare in 2023 was largely due to families switching to private insurance. TennCare has also made efforts to retain eligible enrollees, although disenrollment due to paperwork issues remains a concern.
While the decline in the uninsured rate is encouraging, the same polls indicate that mental health concerns among Tennessee children are on the rise. Nearly one-third of Tennessee children have a mental health diagnosis, with anxiety and depression being the most prevalent conditions. Access to mental health treatment is a challenge that needs to be addressed to ensure the overall well-being of the state's youth.
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Frequently asked questions
Yes, in 2019, Tennessee removed at least 128,000 children from their TennCare and CoverKids insurance programs.
TennCare and CoverKids insurance programs dropped children because they were no longer qualified, or their families did not respond to the mandatory renewal forms mailed to them.
Children who are no longer eligible for TennCare may be eligible for CoverKids if they meet the eligibility criteria. CoverKids is part of the Children's Health Insurance Program (CHIP), which provides health insurance to uninsured children in all 50 states.
