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TN Medicaid Block Grant Bill Could Affect Addiction-Treatment Centers

More than 1 million Tennesseans currently receive their health care through the state's Medicaid program, TennCare. (Adobe Stock)
More than 1 million Tennesseans currently receive their health care through the state's Medicaid program, TennCare. (Adobe Stock)

May 9, 2019

NASHVILLE, Tenn. – State lawmakers have passed legislation that would shift federal funding for Tennessee's Medicaid program into a block grant.

Co-sponsored by several lawmakers, including state Sen. Paul Bailey, a Republican from Sparta, and Rep. Timothy Hill, a Blountville Republican, the block grant bill would give the state more flexibility in deciding how to use federal Medicaid money.

Mary-Linden Salter, executive director of the Tennessee Association of Alcohol, Drug and Other Addiction Services, says amid the state's opioid epidemic, any changes to Medicaid billing could mean less access to residential treatment services for people struggling with addiction.

"The people who are Medicaid-eligible now are pregnant women, primary caregivers and those with disabilities, so these are not people that make a lot of money anyway,” she points out. “They would not have the means to be able to afford that kind of care."

Salter says Tennessee is one of a handful of states that have a waiver allowing institutions with more than 16 beds to bill Medicaid. She says many more Tennesseans have been able to receive treatment for addiction under this system, and changes to federal funding could jeopardize substance-abuse treatment for people who otherwise couldn't afford it.

Supporters of the block grant bill say it's a cost-saving measure.

Currently, states have to comply with certain restrictions and coverage requirements in order to receive federal Medicaid funds.

Salter says if Tennessee decides to reprioritize who is eligible for Medicaid funding under the block grant, it will have to figure out how to keep providing residential addiction-treatment services.

"Anybody I've ever met with on this issue has tried to be very reassuring that that's not their intent,” she relates. “I do believe that that's not their intent. But unfortunately, they're not going to know what they're faced with in terms of juggling all of their priorities that they'll have to fund, as they figure out what they're going to pay for using a block grant."

If the governor signs the legislation, Tennessee potentially could become first state in the country to switch its Medicaid program to the block grant structure.

Nadia Ramlagan, Public News Service - TN