5/1/19 Update on TN TEFRA/Katie Beckett Bill

ON APRIL 30, 2019, THE TN HOUSE ADOPTED AMENDMENTS #1 AND #2 AND PASSED HOUSE BILL 498, AS AMENDED.

AMENDMENT #1 rewrites this bill and directs the commissioner of finance and administration to submit, no later than 120 days after the effective date of this bill, to the federal centers for medicare and medicaid services a waiver or waivers pursuant to Section 1115 of the Social Security Act for the purpose of establishing a distinct Katie Beckett program. The Katie Beckett program must be designed in consultation with the commissioner of intellectual and developmental disabilities and must, subject to approval by the centers for medicare and medicaid services, be composed of two parts as described below and be administered in accordance with this amendment.

AMENDMENT #2 specifies that it is the intent of the general assembly that the program be composed of two parts, instead of requiring the program be composed of two parts; and authorizes the administration of either Part A or Part B of the program if the centers for medicare and medicare services only approves one part of the program.

Today, 5/1/19, FOX news reports the TN House and Senate approved HB 498 and signed off on a $38.5 billion spending plan for the upcoming fiscal year, which includes funding for providing Medicaid assistance to disabled children. The budget still needs final approval and a signature from Gov. Bill Lee.

If approved, this bill will provide health insurance to children and adolescents with disabilities who don’t currently qualify for Medicaid because of their parent’s income.

The TN Katie Beckett Waiver bill would allow states to give Medicaid to children with disabilities as a way of preventing their placement in an institution, even if their parents earn too much for them to qualify.

Similarly, the TEFRA program provides Medicaid coverage to children with severe disabilities younger than 19 who require an institutional level of care, without using their family income as an eligibility criterion. The TEFRA program would benefit children who receive extended care in an institution and would make the eligibility determination based solely on the child’s income.

The current proposed bill addresses the need in TN for a Katie Beckett Program. The “Whereas” section that outlines the bill’s rationale establishes that the financial and personal costs of caring for a child with a long-term disability or complex medical need at home are often “excessive” and private insurance is insufficient.