Federal Judge Extends Order Against TennCare

US District Judge William Haynes, after two days of testimony in his Nashville court, on Thursday agreed to extend a restraining order issued last month prohibiting TennCare from closing its enrollment to people who cannot get medical insurance. Haynes will rule on the merits of the case once he has had time to review them. TennCare is the state's health insurance program for poor people.

The immediate result of Haynes' decision suspends Tennessee's attempts to begin revamping the program to pass over the hard-to-insure. These are individuals who don't have insurance elsewhere and can't get it because of an existing medical condition. The new policy would markedly affect those who are disabled, those who have chronic or acute medical conditions, those who are chronically mentally ill, and those who have incurable diseases, like HIV/AIDS. Some of these individuals have Medicare, but that federal entitlement does not pay for prescriptions.

Total TennCare enrollment is 1.47 million. It has an enrollment cap of 1.5 million. The state can have more than 1.5 million people in the program, but all of those over 1.5 million would be paid for entirely with state dollars. TennCare Director Mark Reynolds said about 2,100 of the 8,000 new TennCare enrollees per month fall into the uninsurable adult category.

The federal government pays two-thirds of the cost of the other enrollees. But Tennessee officials say that closing enrollment now could save the state $7.5 million by not allowing new enrollments to push the TennCare budget above $37.5 million. However, according to Gordon Bonnyman of the Tennessee Justice Center, who brought the lawsuit on behalf of future TennCare enrollees, other state agencies have indicated that they will need tens of millions of dollars to handle the people who would no longer be eligible for TennCare. Bonnyman also said that there was no need to stop enrolling eligible people because of the enrollment cap. "If need be the cap can be increased at the request of the state," Bonnyman said. Dr. Stephen Raffanti, a Vanderbilt University professor and medical director of several HIV clinics, called TennCare "crucial for HIV-positive individuals."

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