TennCare program does not meet federal health law coverage criteria
The state of Tennessee this month notified thousands of residents that they will lose coverage under a TennCare-sponsored program that helps small businesses and the self-employed buy health insurance because of the Affordable Care Act.
The letter states that as a limited-benefit plan, CoverTN does not cover all the services required by the federal law and will no longer exist as of Jan. 1. CoverTN had a $25,000 annual limit on benefits. The federal health law does not allow yearly expenditure caps.
CoverTN was established in 2006 as a program in which the state, employer and employee would evenly split premium costs based on an individual's age, tobacco use and weight.
Stacy Harris of Nashville used CoverTN for preventive care and supplemented it with another policy that had a $15,000 deductible. The private insurer had notified her it would stop offering the high-deductible policy before she got the letter from the state.
"It was all I had," Harris said.
The law establishes subsidies tied to incomes to help people buy coverage on the Health Insurance Marketplace, the federal exchange. But Harris, who publishes the the Internet guide Stacy's Music Row Report and has investment income, said she made too much money to get much help.
"I figured it out," she said. "It's not pretty."
Families USA, an advocacy organization for health-care consumers, was critical of CoverTN, calling it a "bare-bones health plan" in a 2009 report. The organization pointed out the plan's limits on hospital coverage, prescription drugs and cancer treatment.
U.S. Sen. Lamar Alexander, R-Tenn., said CoverTN had merit.
"The new health-care law has destroyed an innovative state health insurance plan that is helping 16,000 Tennesseans afford health-care coverage," Alexander said. "Like all Americans, these Tennesseans were promised by President Obama that under his health-care law they'd keep their coverage, but will likely be forced by the law into the Obamacare exchanges, where the affordability of health insurance, security of their personal information, and ability of doctors to take new patients are all in question."
The Health Insurance Marketplace does not go active until Oct. 1. That's when Harris can get a definitive answer on any possible subsidy. However, she used the online subsidy calculator of the Kaiser Family Foundation, a nonprofit committed to providing accurate information about health-care costs, and learned that her chances are slim.
Harris can still get coverage with better benefits, even if she has a pre-existing condition, but it will cost her more. The one thing she does know is that she has lost the health plan that best fit her budget.
"I was one of the people who was advocating the Affordable Care Act because I believed the president when he said if you like what you have, you can keep it," Harris said.