On September 17, 2019, Tennessee released a draft amendment proposal to its 1115 “TennCare” waiver that would restructure its Medicaid program into a block grant. Though this option has been discussed in various states, and encouraged by CMS under Administrator Seema Verma, Tennessee is the first state to release a detailed proposal. Under Tennessee’s proposed block grant, the state’s program would be subject to fixed spending limits on payments for traditional Medicaid beneficiaries in exchange for significant new flexibilities. Expenditures on prescription drugs and uncompensated care payments would be excluded from the block grant proposal. The state also is proposing a per capita adjustment in the event of increased enrollment. The public comment period is open until November 20.
