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VOL. 133 | NO. 62 | Tuesday, March 27, 2018

Questions for Feds Delay TennCare Work Requirement Bill

By JONATHAN MATTISE, Associated Press

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NASHVILLE, Tenn. (AP) – Tennessee lawmakers have temporarily hit pause on their push to make many able-bodied adults either work, volunteer, or take classes if they don't have children younger than 6, in order to keep their TennCare health coverage.

Lawmakers say they first need questions answered by President Donald Trump's administration.

With the Senate's delay Thursday, lawmakers worried about the tens of millions of dollars it's projected to cost and sought to sort out which low-income patients would be affected. The bill could return for a vote within a week.

The Trump administration has approved Medicaid work requirements in Kentucky, Indiana and Arkansas, all Medicaid expansion states through the Affordable Care Act.

Tennessee, in contrast, shrank its TennCare population by 170,000 people in 2005, and lawmakers have declined to expand Medicaid.

"That I think is probably one of the issues, in that you have a larger base in states that have expanded to initiate work requirements," said Republican Senate Speaker Randy McNally, who called for the bill's delay, but says he wants to pass it. "We have a smaller base, but that's not to say it couldn't work on a smaller scale."

Republican House Speaker Beth Harwell, a gubernatorial candidate in a crowded primary, is championing the legislation that seeks a federal waiver as a way to help people be independent. Republican Gov. Bill Haslam has said he'd sign the bill, which has passed the House.

Most Democrats, the YWCA, Tennessee Disability Coalition, Prevent Child Abuse Tennessee and the Tennessee Justice Center say the proposal could harm vulnerable patients at a huge cost to taxpayers.

TennCare covers a limited group of about 1.4 million people, primarily low-income pregnant women, children up to age 21, the elderly and the disabled. About 86,400 able-bodied adults with dependent children older than 5 would have to work, though an estimated 49,300 of them already do, according to a legislative analysis that has drawn some skepticism.

The plan would cost the state a net $18.7 million annually and another $15.3 million in federal money, the analysis states. McNally wants to ask the Trump administration whether plans to use Temporary Assistance to Needy Families money is allowed.

McNally and Harwell say the work requirement is popular with voters. But McNally said you might get different answers if they're polled with the cost noted.

The legislation says state officials should be "consistent" with federal guideline exemptions on age, disability, responsibility for a dependent, and participation in a drug or alcohol program. The Centers for Medicare and Medicaid Services suggest exempting caregivers or giving them work credit.

In recent days, confusion swirled after a mother on TennCare spoke out about providing constant care to her 4-year-old son Malcolm with congenital cytomegalovirus, which has left him with neurological problems, organ issues, cerebral palsy, partial deafness, autism, seizures and more.

Under the proposal, Danielle Alaimo worries she'd have to work because the bill itself doesn't mention caregivers.

"I've never not wanted to work," said Alaimo, a Nashville resident. "But that's not my priority. My priority is keeping him alive."

Harwell said Alaimo would be exempt, and has pointed to caregiver exemptions. She answered differently when asked if Alaimo would have to work when her son turned 6.

"Then it would be really good for her to work or volunteer or go back to school and learn a trade," Harwell told reporters. "We have a TennCare program that is not an entitlement program for life. It's to help people through rough times."

Harwell also said Alaimo could apply for a hardship waiver.

Adding political drama, McNally and Republican bill sponsor Sen. Kerry Roberts said they've asked authorities to investigate robocalls to people in the middle of the night from the Tennessee Justice Center criticizing the bill. The callback number went to Roberts' legislative office.

Michele Johnson of the Tennessee Justice Center apologized, saying the calls were scheduled for the afternoon, but the vendor said there was a system bug. Johnson said the center cut ties with the vendor.

Copyright 2018 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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