"No TennCare, No Peace" may be one of the rallying cries heard outside the state office building at 170 N. Main Wednesday, as enrollees and supporters affected by the potential dissolution of the state's health-care program rally for a last-minute reprieve. The Memphis Center for Independent Living organized the rally in conjunction with a Nashville rally planned for the state capital on the same day. National Peace and Justice Center workers organized the Nashville rally with the intent of saving the program and its 1.3 million enrollees.
"The people we help are concerned with the dissolution of TennCare, which will affect not only the 430,000 that we hear will be without care but also the remaining [enrollees] statewide," said Independent Living community organizer and advocate Randy Alexander.
Governor Phil Bredesen has been in talks with the program's advocates this week working on an agreement to halt litigation barring benefit reductions. He had predicted a dissolution of the Tenncare program and a return to the federal Medicaid system if an agreement could not be reached. Bredesen has maintained that the pending lawsuits against TennCare along with the active court-ordered consent decrees have spurred the program's rapidly increasing costs. To control those costs, the governor proposed a reform plan that would limit enrollee benefits, including doctor visits and prescription medications.
Alexander is working with other local advocacy groups and clergy who represent TennCare enrollees. Leonard Dawson, pastor of Cane Creek Baptist Church, encouraged his members to participate in the rally. "We've sent countless letters to the governor before this asking him not to cut benefits," said Dawson. "We have a number of older members, and they are concerned most about prescription restrictions and new co-pay requirements."
The TennCare Bureau has received more than 2,400 calls from enrollees concerned about the disolution of the program.
The governor's announcement of the end of TennCare is a scare tactic, said Alexander. "We feel the governor is bullying the advocacy community. He is working really hard to make the advocates and those fighting for the rights of individuals to appear to be the reason why we may lose TennCare," he said. "Instead, he wants to put in place his new plan that is not very enrollee-friendly."
Alexander said the governor has also manipulated the media and Tennessee residents by pitting them against advocacy groups.
Undoubtedly, TennCare's expenses are increasing. During last week's TennCare budget meeting, program director J.D. Hickey predicted a $3.1 billion price tag to operate the program by 2005. A private-industry report last year showed TennCare accounting for 80 percent of the state's revenues by 2008. The proposed cuts in the governor's plan would reduce that amount by $1 billion.
But cost-saving measures introduced by attorney Gordon Bonnyman, who is representing the Tennessee Justice Center (TJC) and thousands of TennCare enrollees in legal battles against the state, have not been considered by the governor, said Alexander. In an interview with the Flyer, Bonnyman cited five areas where funding could be reduced, including expanding the existing preferred drug list to include behavioral health medications, which were estimated to save $35 million. His most far-reaching measure involved a revision of the pharmacy plan to include a drug use review (DUR). Ideally, the DUR targets the overuse of prescription drugs by patients and limits the number of drugs prescribed by doctors. These measures have been presented to the governor and TennCare director, who have not instituted the plans.
If talks with the TJC are unsuccessful and the state reverts to a Medicaid program, only about 900,000 TennCare enrollees would be covered. The remaining 400,000 would be without health-care coverage.