Tennessee pulls health care benefits from woman with ALS

From WSMV-TV:

NASHVILLE, Tenn. -- A wheelchair-bound ALS patient who was cut off TennCare should have been covered under a program Gov. Phil Bredesen promised to set up, but never did, according to an attorney at the Tennessee Justice Center.

Channel 4 News reported on Oct. 14 that Heather Bridges of Nashville lost her TennCare coverage when she began to receive her murdered father's Social Security check last year.

That $248 check, when added to her own disability income, caused Bridges to lose her TennCare. The state calculated she made too much money to qualify.

Tennessee Justice Center attorney Michelle Johnson said Bridges should have been covered under what's called a "spend down" category that the governor promised to open, but never did.

"That's a program that the governor has promised to open, and money has been appropriated to open at least five times over the last five years," said Johnson.

In 2007, Bredesen said he would reopen the program, which had been frozen in 2005. The program allows TennCare to consider a person's medical bills when deciding if they qualify for TennCare.

Johnson said TennCare should be using $300 million in stimulus money the state got for TennCare, but instead put the money in its rainy day fund.

TennCare said the governor doesn't consider the $300 million "TennCare money", but money for the whole state.

TennCare Director of Communications Kelly Gunderson released the following statement:

"TennCare has said all along that the Adult Standard Spend Down category could only be opened if there is funding available to sustain an expansion. Nation-wide states are struggling with revenue shortages and Tennessee is not immune. In fact, figures were released just this week that predict next year's budget will have to be reduced by more than $1.1 billion due to revenue shortages. Also, during tough economic times the demand for social services increases. This year, TennCare has seen monthly enrollment increases reach as high as 8,000 new members in a single month."

"The one-time Recovery Act money Tennessee is drawing in through Medicaid is not meant to be used solely for the Medicaid program. As Governor Bredesen explained in his State of the State address, these funds should be considered “Tennessee Funds”. This means that Medicaid is a way for the state to bring in more federal dollars to financially assist the state as a whole. Thankfully the Recovery Act funds have allowed the state and TennCare to offset some budget reductions in the current fiscal year and will continue to help offset reductions until the funds run out December 31, 2010. Using these one-time funds for a Medicaid expansion would prove to be unsustainable especially in these tough economic times."