The Biden Administration has rescinded Trump-era guidance that sought to solidify changes made to state Medicaid programs, putting TennCare’s new financing structure at risk of being withdrawn, the Tennessee Journal reports. 

The Centers for Medicare and Medicaid Services published its earlier guidance days before announcing the approval of TennCare’snew financing structure on Jan. 8. The controversial plan — opponents say it could cut funding and coverage for vulnerable groups and reduce federal oversight and accountability — was then approved by the Tennessee General Assembly on Jan. 15 so as to implement the waiver prior to President Joe Biden’s inauguration. 

In a letter to TennCare director Stephen Smith notifying the state of the decision, Acting CMS Administrator Elizabeth Richter underlined the need for continued federal oversight and regulation of the safety net insurance program and said the Trump-era guidance contained “procedural issues.” 

A staunch advocate for expanding Medicaid, Biden’s first step toward undoing Trump administration health care policies comes as no surprise. The new administration has already explored alternative deals to pitch to the 12 states, including Tennessee, that have so far rejected the additional federal funding (made available by the Affordable Care Act) to expand Medicaid enrollment.

Gov. Bill Lee has said prospective shared savings under the block grant-esque financing structure approved by the Trump team would eventually allow the state to expand services to more people on the federal government’s dime but added that accruing enough money to accomplish that would take several years. Lee has also proposed using the funds to create health programs for pregnant women and support rural hospitals, among other health-related objectives. 

A representative for TennCare did not immediately respond for comment prior to publication. 

This post originally appeared in our partner publication, the Nashville Post

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