Three days after Tennessee officials announced approval of a Medicaid block grant to fund TennCare, the state’s program for sick and needy residents, Congressman Jim Cooper sent President-elect Joe Biden a letter asking him to rescind the plan.

Tennessee’s Republican leaders say a block grant will enable the state to run the healthcare program more efficiently and possibly even serve more people, using projections from years of savings to bolster the program. But Cooper, a Nashville Democrat, contends it could lead to diversion of the money and reduction of people from the TennCare rolls.
In his letter to Biden, Cooper said the Trump Administration’s decision to approve the Medicaid waiver just 12 days before Biden takes office was designed “to handcuff” the administration and state for a decade and stop the goal of “universal” coverage under the Affordable Care Act.
“This radical waiver makes Tennessee the first block grant Medicaid state, in other words, treating Tennesseans like guinea pigs,” he said in the letter.
The Centers for Medicare and Medicaid had the state’s waiver request in its office for 18 months but didn’t announce approval until Jan. 8.
Cooper also broached talk that “secret side” agreements were made between Gov. Bill Lee’s administration and the federal government that could be “unprecedented and probably illegal.”
Gov. Lee hailed the agreement, saying it will enable Tennessee to continue to “innovate, lead and improve” the TennCare system, which is mainly for the state’s pregnant women and children and its most fragile residents.
“We have sought to fundamentally change an outdated and ineffective Medicaid financing system that incentivizes states to spend more taxpayer dollars rather than rewarding states for value, quality and efficiency,” Lee said.
Based on the legislation passed two years ago, the state Legislature must approve the agreement between Lee and the Trump Administration before it takes effect.

State Sen. Paul Bailey, who sponsored the legislation, applauded the waiver’s approval.
“This will give Tennessee the regulatory flexibility we need in order to better serve our citizens and increase quality and access to patient-centered health care in our state,” said Bailey, a Cookeville Republican.
Sen. Raumesh Akbari bashed the move, saying she will oppose the effort to “sabotage” TennCare.
“The Legislature should reject any last-ditch effort by the lame duck Trump administration to endanger the health coverage of millions of Tennesseans. Instead, lawmakers of both parties should be focused on working with President-elect Joe Biden to extend health coverage to every working Tennessean in the state.”
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