How 128,000 Low-Income Kids Lost Health Care In Tennessee Over 2 Years

NPR's Audie Cornish speaks with Nashville Tennessean reporter Brett Kelman about why Tennessee's health insurance programs dropped more than 100,000 low-income children from the rolls over two years.

AUDIE CORNISH, HOST:

In Tennessee, well over 100,000 children have been cut from state health insurance in the last few years; that works out to 1 in every 8. These were children enrolled in two state programs - TennCare, the state's Medicaid program and CoverKids, which covers low-income families that make too much money to qualify for Medicaid. Reporter Brett Kelman broke this story for The Tennessean. He's here with us now. Welcome to the program.

BRETT KELMAN: Thank you very much. It's an honor to be here.

CORNISH: How did this issue come to your attention?

KELMAN: There are some social justice advocates in Tennessee who have been sounding the alarm on this for quite some time. Eventually, they bent my ear enough that I went and pulled the enrollment data and checked it and realized that they were completely right; in both of these programs, there had been this just massive dive of enrollment over the past year or two.

CORNISH: What did you find was the explanation? Why were these children losing coverage?

KELMAN: What the state of Tennessee has said is that, either their families are no longer eligible - most likely because they now make too much money - or they didn't properly respond to renewal paperwork that is sent out once a year to make sure they're still eligible. And if you don't return that paperwork, you are automatically disenrolled.

CORNISH: You heard from lots of parents who didn't know that they'd lost coverage until they took their sick kids to the doctor. Can you tell us one of those stories?

KELMAN: So I actually heard from a family yesterday, after the story came out, who described their child who was born with a birth defect in her legs that prevented her from walking and was able to get surgery on one leg through TennCare and had scheduled surgery on the second leg, but on the eve of doing it, discovered they didn't have TennCare anymore and were now looking at a bill that was several tens of thousands of dollars; and I think that sort of illustrates how abruptly these families have lost this coverage and how dumbstruck they are when it happens.

CORNISH: When you reached out to TennCare and CoverKids, what was their explanation?

KELMAN: Well, their explanation was largely that this is mostly normal. There were several years where they sort of deprioritized taking people out of this program and allowed families that they say were no longer eligible to stay in. And now they have restarted disenrolling people and expected a significant number of children to be cut from enrollment. I think there are still very large questions about how many of those families were removed because they are no longer eligible and how many were removed because they did not properly do paperwork.

CORNISH: What's your response to people who say, look, this is the responsibility of the parents - what's so difficult about filling out some forms?

KELMAN: Well, I have seen the packet, for one, and it's not easy. And two, even if tens of thousands of parents drop the ball, it's not the kids' fault. Is that really what we want, is a state where lots and lots of kids don't get health insurance, to which they are legally entitled, because their family didn't fill out paperwork or the state sent that paperwork to the wrong address or it got lost in the mail or any of many possible procedural errors that could have happened somewhere in this paperwork?

CORNISH: Your story came out earlier this week, and the governor has since acknowledged this reporting. What's been the fallout so far?

KELMAN: Governor Bill Lee has said he is going to examine TennCare and CoverKids and make sure the families who are entitled to this coverage are getting it. Also, the mayor of Chattanooga and some social justice groups in the state have begun publicizing that they are going to help families appeal or reapply because they believe there are large numbers of families in Tennessee who are entitled to this coverage and just need a little bit of guidance on how to get it back.

CORNISH: That's reporter Brett Kelman. He covers health care for the Tennessean. Thank you so much for speaking with us.

KELMAN: I'm thrilled to do it.

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