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Tennessee Governor Explains TennCare Coverage Cuts

Tennessee Gov. Phil Bredesen on Friday defended his decision to scale back the TennCare program, a move that consumer groups and patient advocates say will likely leave more than 300,000 people without medical care.

Economics, the Democrat said, forced him to make cuts to the country's most generous Medicaid program. "What we have has become unsustainable, and I am going through the very painful process of trimming it back to something our state can afford," he said in remarks made at the National Press Club.

"This is not the right thing to do. This is what we're being forced to do," he said. "We need to balance our budgets every year." Individuals who are losing their TennCare coverage are optional enrollees "that are not on the program in any other state," Bredesen said.

Bredesen said the decision to scale back TennCare was debated and voted on by the state legislature. He also said that consent decrees agreed to by previous administrations have placed additional financial burdens on TennCare.

One such decree he noted was one that requires the state to prove why an appeal was denied. In other states, he said, the petitioner must prove there are grounds for an appeal. "We get 10,000 appeals a month and we lose almost every one of them," Bredesen said.

While Bredesen said it is important to overhaul TennCare to make it financially sound, "I can't tell you how much I hate to tell someone they have to come off this program," he said.

Some of those Tennessee recipients who will lose their TennCare benefits were in the audience Friday. Lori Griffin, who suffers from thyroid cancer and a series of other medical disorders and cannot work because she is her ailing husband's full-time care-giver, asked Bredesen where she will get her health care once she is dropped from TennCare. Bredesen told her that her county health care system may be able to help her and he also offered to have his staff help her find health care coverage.

"You are a poster person ... you are someone I want to help," Bredesen said.

Tony Garr, executive director of Tennessee Health Care Campaign, Inc., a group that opposes the TennCare cuts, said later that a county health department would not offer the medical treatment that Griffin needs.

Ron Pollack, executive director of Families USA, which also opposes Bredesen's plan, said the TennCare cuts will not only eliminate coverage for 323,000 residents but also cause those still in the program to have their health care "determined by state bureaucrats rather than doctors."

Pollack said that Bredesen's claims that consent decrees agreed to by previous governors undercut the state's ability to provide coverage under TennCare were "totally disingenuous," adding that such decrees cover a "tiny proportion" of the state's population.

The seniors lobbying group AARP also criticized Bredesen's remarks. In a statement, AARP Chief Executive Officer Bill Novelli said while AARP was sympathetic to the budget concerns that Bredesen faces, "we don't believe that the unprecedented cuts facing vulnerable Tennessee beneficiaries—both in enrollment and services—are the answer."

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