The ATS recently sent a letter to the Tennessee Commissioner of Health expressing deep concern over the state’s proposal to convert its Medicaid program into a block grant. Tennessee is the first state to develop and propose a specific Medicaid block grant plan. If the plan is approved by the federal Department of Health and Human Services, Tennessee could become a test case for other states to potentially follow.

In the letter, the ATS expresses concern about the fiscal constraints Tennessee ’s Medicaid program could face as a result of the change in financial structure and the subsequent potential for reductions in health coverage and associated poorer health outcomes for those that lose coverage. The ATS also voiced reservations about lack of important details in the plan and accountability mechanisms for preserving member access to medically-necessary care. Pointing out Tennessee’s high prevalence of both smokers and individuals with lung cancer, the ATS urges the state to “ensure coverage of important preventive health care services recommended by the U.S. Preventive Services Task Force, such as lung cancer screening and tobacco cessation services, including over-the-counter medications.”

The draft plan proposes to implement a drug formulary which may limit coverage to as few as one drug per therapeutic class, a proposal which the ATS states may be problematic for some patients with respiratory illnesses such as asthma who need access to a range of medications to manage their disease effectively and to prevent costly disease exacerbations. Following review of public comments on the plan, Tennessee plans to submit the block grant proposal to the Department of Health and Human Services for approval, which could happen as soon as mid-2020.