Tenncare Case Study

In 1994 Tennessee began the TennCare program as a way to control Medicaid associated health care costs that were rising at a rapid rate (Baggett, Harkey, & Alexander, 1999). While many other states were going through similar issues at the time, Tennessee did something vastly different. TennCare not only aimed at managing healthcare costs, it also expanded eligibility and coverage to the uninsured, and the uninsurable (Baggett, Harkey, & Alexander, 1999). This was a controversial measure because it didn't make sense to expand the eligibility and coverage to more people when the state's cost of the program was increasing. In order to help offset the costs of the TennCare expansion the state government contracted with managed care organization
Increasing taxes is rarely a popular choice for politicians who want to be reelected, and reducing the number of individuals who would be eligible and benefit from the program already in place was unpopular as well. Thus, they landed on the option of reforming the program as a whole in order to maximize the social welfare function. The new program became known as TennCare and used the rationales of utilitarianism and Rawlsianism to justify the program. The reason TennCare follows utilitarian and Rawlsian principles of benefiting the least advantaged of society in a manner that will do the greatest good overall for those who are affected by the program (Vining & Weimer,
Many state funded socialized healthcare systems around the world have been found to be more effective in terms of cost, efficiency, and patient health (de Bruin, Baan, & Struijs, 2011). Instead of using a Medicaid program with limits, TennCare could change to a single-payer system that allows everyone in the state access to medical coverage and utilize the entire state as a funding pool as opposed to just individuals that currently qualify for TennCare. By using the entire population of the state and the income of all Tennesseans in order to fund a state-run program budgets could be more accurately made and the state would have more leverage to control costs because of their increased buying and negotiating power.
The Future of TennCare
The possible impact of TennCare on the policymaking in Tennessee would more than likely come into play in the realm of budgeting and finance. Currently under the ACA the funding of TennCare has increased making it more stable, however if legislation that is similar to the recently proposed American Healthcare Care Act (AHCA) is proposed funding could be a major issue. The reason funding could become a major issue is the burden of funding Medicaid would shift from the federal government to the state government