Tennessee health insurance exchange
Tennessee tenth among HHS-run exchanges for number of completed applications with plans selected
By Louise Norris
November 27, 2013
By November 2, exchange applications had been completed for more than 33,000 individuals in Tennessee, and 992 of them had finalized their plan selection. This puts the state in tenth place – out of the 34 states where HHS is running the exchange – in terms of the number of people who had selected a plan in the first month of open enrollment.
In December 2012, Gov. Bill Haslam announced Tennessee would not develop its own health insurance exchange, citing a lack of information from the federal government. Prior to his 2012 announcement, Haslam had leaned toward a state-run exchange. He believed local state control was preferable and that the state could run the exchange more cost-effectively that the federal government. However, Republican legislators opposed the exchange, Tea Party supporters staged repeated protests, and Tennessee eventually ended up with an exchange run by HHS.
Four companies are selling individual health insurance through the marketplace: Blue Cross Blue Shield of Tennessee, Cigna, Community Health Alliance, and Humana. According to a report released by the U.S. Department of Health and Human Services (HHS), the average cost for a bronze plan —the lowest-cost option — in Tennessee is $184 — well below the national average of $249 a month. Early numbers from Blue Cross Blue Shield of Tennessee, released in late November, indicate that the vast majority of enrollees so far are selecting plans with low (or zero) deductibles. Only 20% have chosen bronze plans.
The Tennessee Department of Commerce and Insurance drew attention for emergency rules issued shortly before the Oct. 1 launch of the new marketplace. The emergency rules require individuals who will help others use the new health insurance marketplace be fingerprinted and undergo background checks, and would have forbidden lay people from assisting their friends and neighbors with health insurance applications. Religious and community groups questioned the motivation behind the rules and sued to block the rules. A judge didn’t block the emergency rules, but did agree they were too broad and could be interpreted to apply to those giving informal advice, and a temporary restraining order against the rules was issued. Two lawsuits were brought against the emergency rules, and by mid-October the state government had backed off of the rules, making it easier for people to assist others in Tennessee, both formally and informally.
According to HHS, nearly 900,000 people in Tennessee are uninsured and eligible to use the marketplace to purchase insurance. HHS estimates that more than 834,000 of those people will either qualify for a subsidy to purchase insurance through the exchange or for Medicaid if the state were to expand its Medicaid program as allowed under the Affordable Care Act. As of late November, Haslam is still undecided on expanding Medicaid, and TN is one of very few states that has not made an official decision on the issue yet. Haslam prefers his “Tennessee plan,” in which he has asked the federal government to allow the state to assist people in purchasing private insurance rather than covering them through TennCare, as Medicaid is called in the state. Regardless of whether Tennessee expands Medicaid, the exchange is expected to direct up to 52,000 people to TennCare who are already eligible for Medicaid but not enrolled. In mid-November, TennCare requested an additional $180 million for its budget as a result.
Tennessee health insurance exchange links
Health Assist Tennessee
Helps connect Tennesseans with public and private programs to meet health care needs and assists TennCare members with access to medical care.
State Exchange Profile: Tennessee
The Henry J. Kaiser Family Foundation overview of Tennessee’s progress toward creating a state health insurance exchange.