1. Health Insurance Enrollment for Tennessee's Children
Kinika Young
Director of Children’s Health
Chris Coleman
Staff Attorney
November 30, 2017

2. 1.5 million children in Tennessee
1.5 million children in Tennessee

3. How many of them need health insurance?

4. ALL OF THEM!

5. Medicaid/TennCare – 793,000 CHIP/TennCare Standard & CoverKids – 106,000 Marketplace – 19,000 Privately insured – 640,000 Uninsured – 53,000
FY 2016
TennCare enrollment is from October 2017 report:
Private insurance figure is based on 41% figure from Kaiser as the percent of TN kids with ESI-
Population Reference Bureau, analysis of data from the U.S. Census Bureau, American Community Survey.

6. Insurance Coverage for Children
Almost every child is eligible for something!

7. Public Coverage Categories
TennCare (Medicaid)
CoverKids (CHIP)
TennCare Standard

9. TennCare 793,000 children ½ the kids in the state
½ of the babies born in the state

10. TennCare for Children Income Limits
Children up to age 19 can get TennCare.
TennCare for Children Income Limits
 HH Size 1 2 3 4 5 6 7
Child 6-18: 138% FPL
1387
1868
2348
2829
3310
3790
4271
Child 1-5: 147% FPL
1477
1989
2501
3014
3526
4038
4550
<1: 200% FPL
2010
2707
3403
4100
4797
5493
6190
The ACA raised the minimum income eligibility thresholds for kids age 6-19 from 100% FPL (about $20k/year for a family of 3) to 138% (about $28k/year).

11. CoverKids Income Limits
Kids under 19 can get coverage under the state’s CHIP program, called CoverKids.
Cannot be enrolled in another health plan.
Apply through the federal marketplace.
CoverKids Income Limits
 HH Size 1 2 3 4 5 6 7
255% FPL
2502
3386
4270
5153
6038
6922
7806

12. TennCare Standard
Children under 19 that are on TennCare but become ineligible can sometimes roll into TennCare Standard.
No access to employee health insurance
Eligible if they are either
Below 212% FPL, or
have a qualifying health condition

13. Applying for TennCare Explain DHS role
*PE is only available for pregnant women, women with breast or cervical cancer, and newborns.

14. Applying for TennCare Exceptions: Presumptive Eligibility program
CHOICES long-term care program
Medicare Savings Programs (QMB, SLMB, QI, QDWI).
Explain DHS role
*PE is only available for pregnant women, women with breast or cervical cancer, and newborns.

15. Newborns TennCare Deeming CoverKids Deeming Newborn Presumptive
Eligibility (NPE)

16. TennCare Deeming
For moms on TennCare, the child is deemed eligible for TennCare for 1 year.
The coverage starts on the date of birth.
Call Tennessee Health Connection to enroll child ( ).

17. CoverKids Deeming
For moms on CoverKids, the child is deemed eligible for CoverKids for 12 months.
Coverage starts from the date the mother enrolled in CoverKids.
Call CoverKids ( ) to report the birth.

18. Newborn Presumptive Eligibility (NPE)
For babies (12 months and younger) born to mothers on private insurance or no insurance
Coverage starts on the date of application.
NHCHC Question: What is “Presumptive Hospital Eligibility” and how can our clients take advantage of this? Address here that hospitals in TN do not have presumptive “power”.

19. How to apply for NPE:
Parents can call Tennessee Health Connection ( ) to enroll a child in presumptive eligibility.
Parents must still do an application on the Marketplace.
Child remains eligible until a final eligibility determination is made on the full application.

20. Closing the Coverage Gap
280,000 Tennesseans have no access to health care coverage.
31 other states have closed their gap.

21. Private Coverage Categories
ACA Individual Marketplace
Employer-sponsored insurance

22. ACA Individual Marketplace
Open enrollment – Nov. 1-Dec 15
Toll-free 24/7 assistance –
Applications submitted through healthcare.gov
It’s important for everyone to shop the marketplace to see their options, even if you are on an auto-renewal plan.
Changes from last year to this year with affordability

23. Employer-Sponsored Insurance
46.8% of private sector establishments in Tennessee offer health insurance benefits.
53% of Tennesseans have employer-sponsored insurance.
Not all plans offer dependent benefits. If they do, they aren’t necessarily affordable.
Source 1:  
Source 2:
It’s not because people aren’t working – 73% of Medicaid recipients are in working families.

24. Long-term effects of comprehensive coverage for kids
Do better in school
Miss fewer school days due to illness or injury
Are more likely to finish high school, attend college, and graduate from college
Have fewer emergency room visits and hospitalizations as adults
Earn more as adults

25. ACA = big coverage gains for children
Source: CCF analysis of ACS single-year data,

26. What about the 53,000 kids who don’t have health insurance in Tennessee?

27. Uninsured Poverty Level 2016 Below 100% 15,000 (4%) 100%-149%
9,000 (5%)
150%-199%
7,000 (4%)
200%-299%
10,000 (4%)
300% or above
11,000 (2%)

28. Uninsured Age 2016 0-5 14,000 (3%) 6-17 39,000 (4%)

29. Threats to coverage

30. CHIP Reauthorization
The federal government pays 99% of the cost of our CHIP combination program, TennCare Standard and CoverKids
Funding expired September 30, 2017
Congress still has not reauthorized CHIP funding
There is bipartisan, bicameral agreement on a clean 5-year extension BUT arguments over offsets and competing legislative priorities have crowded out CHIP

31. CHIP Reauthorization
Several states have tapped into federal emergency funds and state rainy day funds to keep their programs operational.
Tennessee would not have to take action until next spring, but our separate CHIP program, CoverKids, could be at risk if Congress does not act before the spring.
The only federal parameter for notice for shutting down a program is a “reasonable” length of time.
Tennessee has not announced any shutdown or contingency plans.

32. 165,000 children and adults have lost their coverage in the past 9 months. The numbers are on the uptick by rising slower than they were cut.

33. House Budget Kills ACA by defunding it
$200 billion in cuts to mandatory programs
Medicaid per capita caps or block grants
Medicaid work requirements
Restructuring MediCARE, including means-testing
Also cuts SNAP.
Rep. Diane Black (R-TN) is chair of the House Budget Committee.

34. Tax Reform

35. Barriers Income Immigration status Parents switching employers
Family glitch
Death of a parent

36. Who can help? Tennessee Justice Center Tennessee Health Care Campaign
Family and Children’s Services

37. How can YOU help?
Join us in the new year as begin our Enroll Every Eligible Child Campaign!
Sign our CHIP sign-on letter:
Call our senators and tell them to vote no on the Senate Tax Cut and Jobs Act.
If your work involves children and you’d like to know how to help, please reach out to

38. How can YOU help?

39. Get involved! Join our email listserv: https://goo.gl/GSTosf
Follow us on Facebook:
Follow us on Twitter:

40. Continuing Education Credit
If you would like CLE or CEU credit, please

41. Questions?

42. Thank you for joining us!