TennCare

Plain English Breakdown

The official source material does not provide specific details about additional funding needs or the certainty of federal waiver approval.

TennCare Eligibility Extension for Minors

This bill extends TennCare Medicaid and CoverKids program eligibility until age 18 for minors enrolled in these programs as of July 1, 2026.

What This Bill Does

• Extends TennCare Medicaid and CoverKids program eligibility until a minor turns 18 years old if they were enrolled before July 1, 2026.
• Prohibits the division of TennCare from reviewing or changing a minor's eligibility status unless certain conditions are met after July 1, 2026.
• Requires the director of TennCare to request federal waivers by December 31, 2025, if needed for this bill to take effect.
• Allows minors enrolled in one program to be moved to another program within TennCare and CoverKids to maintain eligibility.

Who It Names or Affects

• Minors currently enrolled in TennCare Medicaid or the CoverKids program who will turn 18 after July 1, 2026.
• The division of TennCare responsible for administering these programs.

Terms To Know

CoverKids Program

A health insurance program in Tennessee that provides coverage to children who do not qualify for other government assistance but still need help paying for healthcare.

TennCare

The Medicaid and Children's Health Insurance Program (CHIP) managed by the state of Tennessee, providing health care services to low-income individuals, including children.

Limits and Unknowns

• This bill only applies if federal law allows for such changes.
• It is unclear how much additional funding will be needed beyond what is currently budgeted.

Official Summary Text

This bill cla
rifies that,
to the extent permitted by federal law, on and after July 1, 2026, a minor who is enrolled in TennCare medicaid or the CoverKids program remains eligible for TennCare medicaid and the CoverKids program until the minor reaches 18.

The director

must
submit to the federal centers for medicare and medicaid services a request for any federal waiver the director deems necessary to effectuate this
bill
no later than December 31, 2025.

On and after July 1, 2026,
this bill prohibits
the division
of T
ennCare

from
subject
ing
a minor
,
who is enrolled in TennCare medicaid or the CoverKids program
,
to a redetermination of eligibility or disenroll
ing
the minor from TennCare medicaid or the CoverKids program unless the division has knowledge to indicate
any
of the following:



The minor's parent or guardian requests the minor's voluntary disenrollment
;


The minor is deceased
;


The minor no longer resides in this state
;


The minor's family income exceeds eligibility limits for TennCare medicaid and the CoverKids program
; or


Initial enrollment of the minor was based on a division error or on fraud, abuse, or perjury by the minor's parent or guardian in a manner that would disqualify the minor for enrollment eligibility in TennCare medicaid or the CoverKids program
.

However,

t
his
bill
does not prohibit the division
of TennCare
from shifting an enrolled minor from TennCare medicaid to the CoverKids program, or from the CoverKids program to TennCare medicaid, for purposes of maintaining eligibility.

Current Bill Text

SENATE BILL 401
By Lamar

HOUSE BILL 1387
By Harris

HB1387
000078
- 1 -

AN ACT to amend Tennessee Code Annotated, Title 71,
relative to TennCare.

WHEREAS, access to health care for children is important to the child, the child's family,
and society at large; and
WHEREAS, access to health care can influence a child's physical and emotional health,
growth and development, and capacity to reach their full potential as adults; and
WHEREAS, children are at increased risk of developing preventable conditions if
appropriate care is not available when they are sick or injured; and
WHEREAS, many children who are under the age of eighteen and Tennessee residents
already qualify for the TennCare Medicaid program or the CoverKids program; and
WHEREAS, this State has a compelling interest to ensure all eligible children in
Tennessee have continuous access to healthcare coverage; now, therefore,
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF TENNESSEE:
SECTION 1. Tennessee Code Annotated, Title 71, Chapter 5, Part 1, is amended by
adding the following as a new section:
(a) As used in this section:
(1) "CoverKids program" means the program created pursuant to the
CoverKids Act of 2006, compiled in chapter 3, part 11 of this title;
(2) "Director" means the director of TennCare;
(3) "Division" means the division of TennCare; and
(4) "Minor" means a person who has not attained eighteen (18) years of
age.

- 2 - 000078

(b) Notwithstanding § 71-5-106 or another law, and to the extent permitted by
federal law, on and after July 1, 2026, a minor who is enrolled in TennCare medicaid or
the CoverKids program remains eligible for TennCare medicaid and the CoverKids
program until the minor reaches eighteen (18) years of age.
(c) On and after July 1, 2026, the division shall not subject a minor who is
enrolled in TennCare medicaid or the CoverKids program to a redetermination of
eligibility or disenroll the minor from TennCare medicaid or the CoverKids program
unless the division has knowledge to indicate that:
(1) The minor's parent or guardian requests the minor's voluntary
disenrollment;
(2) The minor is deceased;
(3) The minor no longer resides in this state;
(4) The minor's family income exceeds eligibility limits for TennCare
medicaid and the CoverKids program; or
(5) Initial enrollment of the minor was based on a division error or on
fraud, abuse, or perjury by the minor's parent or guardian in a manner that would
disqualify the minor for enrollment eligibility in TennCare medicaid or the
CoverKids program.
(d) This section does not prohibit the division from shifting an enrolled minor
from TennCare medicaid to the CoverKids program, or from the CoverKids program to
TennCare medicaid, for purposes of maintaining eligibility.
(e) The director shall submit to the federal centers for medicare and medicaid
services a request for any federal waiver the director deems necessary to effectuate this
section no later than December 31, 2025.
SECTION 2. This act takes effect upon becoming a law, the public welfare requiring it.