Waiting (and Waiting) for Medicaid in Tennessee

Tennessee wasn’t one of the 26 states that expanded Medicaid coverage under the Affordable Care Act when it went into effect in January. But the state did change how it evaluates applicants for its existing program: It eliminated positions for caseworkers who used to handle the applications by hand. Instead it outsourced most of the task to the federal healthcare.gov website, which was already bedeviled by glitches.

Five other states—Idaho, New Jersey, Pennsylvania, Texas, and Wisconsin—also decided to send applicants for public health insurance programs for low-income people to the new federal website. Tennessee is the only one that shut down its own system at the same time. As of Jan. 1, a state bulletin announced, residents “can’t apply for TennCare Medicaid anymore at your local Department of Human Services (DHS) office.” Instead they were directed to apply online. The department promised to make computers available for applicants who lacked Internet access. Tennessee’s approach seems to have been driven in part by antipathy to Obamacare on the part of the Republican-led state legislature. Its members had unsuccessfully pushed Tennessee’s attorney general to join a multistate challenge to the law.