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Red Tape Blamed for 220,000 Kids Losing, or Almost Losing, Health Care in Tennessee

The majority of these kids likely lost their coverage because of late, incomplete or unreturned eligibility forms.

When the leukemia was finally gone, Tricia Sewell thought her family’s nightmare was over.

It was October of last year. Sewell’s 5-year-old son, Abel, had just finished three years of chemotherapy, all of which had been covered by Tennessee’s state Medicaid program, known as TennCare. Chemo was successful, but now Abel needed monthly blood tests to check if the cancer ever came back.

At the doctor’s office, something went wrong. The staff discovered Abel’s TennCare had vanished. His mom paid out of pocket for the blood test. Then she realized she'd pay again next month. And the following month. And months and months after that.

“I was livid because I knew the costs,” Sewell said. “In the back of my mind, I always knew what this all costs.”

That was eight months ago, and the family's financial struggle was just beginning. Sewell said state insurance dropped her teenage son, Jacob, who has ADHD, in December. The boys' medical bills now amount to as much as $900 a month, Sewell said. To cover the costs, the family extended its mortgage, adding decades of debt to a modest home that was nearly paid off. Ultimately, the family resorted to skipping a few blood tests – putting Abel’s health at risk – because it can’t afford to pay.

“It has felt horrible,” Sewell said. “But when these bills come in, it makes you feel even worse.”

At least 220,000 Tennessee children were cut, or were slated to be cut, from state health insurance in recent years in an unwieldy TennCare system that was dependent on hard-copy forms and postal mail, according to a Tennessean investigation. The majority of these kids likely lost their coverage because of late, incomplete or unreturned eligibility forms.

Caroline Cournoyer is GOVERNING's senior web editor.
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