The rate and number of Tennesseans without health insurance is up for the third consecutive year, the University of Tennessee’s Boyd Center for Business and Economic Research reports in a new study on TennCare.
The decline and rise in uninsured adults and children in the state parallel the start of the Affordable Care Act in 2014 and the beginning of a new presidential administration in 2017.
Data comes from “The Impact of TennCare: A Survey of Recipients, 2019,” a followup of previous annual surveys conducted for the state since 1993, the last year of Medicaid before the state adopted TennCare.
The study was authored by LeAnn Luna, an accounting professor in the Boyd Center, and Emily Pratt, a Boyd Center research associate.
“Our studies aren’t intended to explore why something may have increased or decreased from last year. But we do know that when we were at the peak of the uninsured rate, what was the lowest rate did coincide with the Affordable Care Act. We know that,” Luna said Tuesday.
The survey does not research reasons for changes in the data, but parallels can be drawn to historical fact. In this case, the Affordable Care Act going into effect on Jan. 1, 2014, begins the year when the number of uninsured Tennesseans was 472,008. In 2015, the number fell to 370,115 — a decrease of 7.2% to 5.7%.
After three years, when the percentage of uninsured Tennesseans declined, the numbers began to grow with the changeover from the Obama to Trump administrations in 2017. After a low of 5.6% in 2016, the rate grew to 6.9% this year, with the number of uninsured increasing to 468,096.
“We know that the downward trend coincided with changes taking place in the federal government,” Luna said. “And there have been additional changes that have taken place at the federal government that would help explain the upward trend in the uninsured population. We don’t explore it, but they’re consistent with things that are happening.”
During the period 2016-19, the rate of uninsured Tennessee adults rose from 6.7% to 8.1%, as the rate for children grew from 1.8% to 2.8%.
While the numbers of uninsured is growing, satisfaction of TennCare members remains consistent and high. Overall, 94% of TennCare households are satisfied with the program. That’s 11 years straight that satisfaction levels exceeded 90%.
Luna said she’s seen data from earlier surveys when satisfaction with TennCare was in the mid-80s percentage range, a significant difference from mid-90s percentages. She said that improvement likely can be attributed to changes made to the program over time.
“Remember this is a set of population that probably realize that if they didn’t have this, they might not have anything, particularly with the responses about affordability,” Luna said.
The report concludes that affordability continues to be the major reason for not having health insurance, cited by about 80% of respondents across all income categories.
With 94% of respondents expressing satisfaction with TennCare, the Boyd Center report concludes, “This positive feedback is a strong indication that TennCare is providing satisfactory medical care and meeting the expectations of those it serves.”