Tennessee No Longer an “Island of Excellence” on Children’s Health Coverage – Say Ahhh! A Children’s Health Policy Blog


Michele Johnson, Managing Attorney, Tennessee Justice Center

In 2006, Governor Phil Bredesen pledged to make our state “an island of excellence” by making sure “every child in Tennessee” had health coverage. He established a new program, to be known as CoverKids.

CoverKids would be Tennessee’s version of the Children’s Health Insurance Program, or CHIP. The federal government covers 75% of the cost for CHIP in Tennessee, and even with that favorable funding, Tennessee remained the only state without a CHIP program. CoverKids would get Tennessee out of last place and put us “in the top ten states in the nation in terms of the percentage of children covered by health insurance.”

Tennessee just became an “island” alright, but not the kind the Governor envisioned. On December 1, Tennessee became the only state in the country to close enrollment in its CHIP program. On that day, the state slammed the door of CoverKids to new applicants.  Far from ensuring coverage for “every child in Tennessee”, as the Governor promised, CoverKids coverage is frozen at 49,000 children, leaving Tennessee’s other 150,000 uninsured kids out in the cold.  

When that decision drew criticism, the state announced that another program, AccessTN, would enroll children. Sadly, that is more about providing cover for elected officials than coverage for kids. AccessTN sells insurance only to people who cannot buy coverage elsewhere because of pre-existing conditions. Last month, the head of AccessTN said the program had no money to help families afford AccessTN’s high premiums. As a result, the program reaches less than 4,000 people statewide. AccessTN is no answer for uninsured children shut out by CoverKids.

Tennessee is the last state in the nation that can afford to neglect the health of its children. Infant mortality in Tennessee is worse than in many developing countries, and the rate of infant deaths in Memphis is the worst of any city in America. The Commonwealth Fund, a foundation that sponsors health quality research, recently ranked Tennessee 47th in children’s health care, measured by the number of children who die of causes that could have been prevented by health care. A state this unhealthy for kids should be striving hard to improve children’s health coverage. Instead, Tennessee has just become an island of neglect, in terms of the health of its children.

Shortchanging children’s health is justified as a budget necessity imposed by the recession. But that is an excuse, not a reason. Every state has been hammered by the recession, some far worse than Tennessee. And unlike other states, Tennessee has $350 million in unspent TennCare reserves. The federal government contributes a higher share of CHIP costs in Tennessee than in most states. Yet no other has responded to its budget problems by abandoning its uninsured children. In fact, 26 states took steps to advance health coverage this past year, and our neighbor, Alabama, expanded eligibility in its CHIP program.

Other states’ leaders know that, if times are hard for state governments, they are even harder for uninsured children and their families. They realize that playing Scrooge not only robs some kids of their health. It costs their states tens of millions of federal dollars and adds to social and medical costs for decades to come.

That’s why, even in a recession, every other state makes children’s health a priority. Tennessee should, too.

The views expressed by Guest Bloggers do not necessarily reflect the views of the Center for Children and Families.

To learn more about the Tennessee Justice Center please visit their Website, Facebook page, and blog. 

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