Tennessee SSI Recipiects May Lose Health Care Coverage
Since January of 2009, Tennessee has withdrawn coverage for 100,000 residents who were insured through TennCare, Tennessee’s version of the Medicaid program. These cuts come on the heels of a resolution to a decade’s long court battle involving recipients of Supplemental Security Income (SSI).
TennCare’s eligibility guidelines have always stated that anyone who ever qualified for SSI would also qualify for medical coverage under their program. Due to rising costs and the state’s unstable financial situation, Tennessee wanted this provision overturned to withdraw health coverage from those who no longer qualified for SSI. In 1987, a class-action lawsuit involving SSI recipients was brought against the state. The lawsuit resulted in an injunction barring Tennessee from denying coverage under TennCare to all SSI recipients, both past and present.
The state argues that all SSI recipients should qualify for TennCare on their own, taking their current income and assets into consideration. This is the same process that applicants who have never received SSI have to go through to determine their eligibility. State officials say that assuring that everyone follows the same set of rules not only benefits those seeking assistance, but also reduces wasteful spending of state resources by ceasing to pay out benefits to people who clearly are not entitled to them.
TennCare’s spokesperson Kelly Gunderson maintains that SSI recipients are not being unfairly targeted. Gunderson said TennCare is only re-evaluating their eligibility based on income, which is the same process every other TennCare recipient must go through. If their household incomes qualify them for health coverage, they will receive it. However, Social Security is the very income that has put some TennCare recipients over the qualifying threshold in some cases. Further, the vast majority of those losing TennCare benefits under the new ruling were receiving treatments for live-threatening conditions and are now being forced to discontinue those treatments due to lack of health coverage.
Jessica Pipkin is a Tennessee resident who lost the use of her limb in an accident five years ago. She requires 24 hour nursing care in her home, which was covered under TennCare until the recent ruling went into effect. Her husband makes $19,000 a year at his job. Her disability benefits are $14,400 per year. This combined income puts them well over the threshold to qualify for TennCare coverage, even though Pipkin’s care costs $37 per hour.
Thomas Moore, a 64 year old Tennessee resident and cancer survivor also had his health coverage dropped under the new ruling. In 2008, Moore began receiving SSI benefits because of a hip fracture, but was required by the state to move to the Social Security program when he reached the age of 62. The change in programs put his income at too high a level to qualify for TennCare coverage, which he subsequently lost. Moore was still undergoing follow up treatments for his cancer and had a hip surgery scheduled at the time he lost coverage.
