New Order from Joe Biden Could Put Tennessee’s Block Grant at Risk

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U.S. President Joe Biden has decided he wants to change certain terms that former U.S. President Donald Trump put in place on Medicaid, and that could affect TennCare.

TennCare is the state of Tennessee’s Medicaid program.

TennCare spokeswoman Sarah Tanksley told The Tennessee Star Tuesday that Centers for Medicare and Medicaid Services Acting Administrator Liz Richter notified officials at her agency in a letter earlier this month. Richter’s correspondence, Tanksley went on to say, addressed a separate letter that members of the Trump administration sent out in January to all Medicaid directors operating an 1115 Demonstration.

According to, Section 1115 of the Social Security Act gives the Secretary of Health and Human Services authority to approve experimental, pilot, or demonstration projects likely to promote the objectives of the Medicaid program. These demonstrations give states additional flexibility to design and improve their own programs to better serve Medicaid populations.

Tanksley said in an email Tuesday that Richter’s letter “provided states with more details on states’ due process rights if CMS decides to withdraw or modify an 1115 waiver, in particular the effective dates for such a decision.”

“The current administration has taken steps to rescind those provisions as it pertains to procedures for withdrawing or suspending an 1115 waiver demonstration. The letter does not directly address nor does it rescind the TennCare III waiver. There has been no status change to the approval of the TennCare III waiver,” Tanksley said.

“The current administration does have the authority to review Medicaid waiver demonstrations, as is the case when any new administration takes office. We look forward to any discussions the Biden administration would like to have about the TennCare III waiver and the positive impact it will have on the Tennesseans we serve. We are confident those discussions would result in a recognition that the waiver provides a great opportunity to only enhance the TennCare program and the benefits and services we provide to TennCare members.”

As The Star reported last month, Tennessee Democrats made multiple pleas to Biden to rescind federal approval for Tennessee’s Medicaid block grant waiver, which is set to allow the state to receive Medicaid funding in a lump sum.

Under the new funding mechanism known as a block grant, Tennessee would receive federal money for the state Medicaid program, TennCare, all at once instead of periodically. Proponents of the structure said the block grant mechanism will provide the state more flexibility in administration of the funds, and allow the state to benefit from efficient administration of the TennCare program. Tennessee is the first state to receive a Medicaid block grant.

After seeking federal approval for a block grant in 2019, Tennessee received approval January 8, days before the presidential inauguration. The Tennessee General Assembly quickly passed legislation before Biden was sworn in, authorizing TennCare to implement the block grant.

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Chris Butler is an investigative journalist at The Tennessee Star. Follow Chris on Facebook. Email tips to [email protected]











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2 Thoughts to “New Order from Joe Biden Could Put Tennessee’s Block Grant at Risk”

  1. jamesb

    federal aid means federal control. tell him to stick the money where the sun dont shine which is what the democrats are wanting.

    stay poor. vote democratic

  2. Kevin

    Biden, I mean, Obama/Harris, are sure looking to just p*ss off everbody. Aren’t they!

    Obama is feeling like he didn’t “fundamentally change America” enough that Trump couldn’t but it back on track. And Kamala, well, she’s angry that she wasn’t born a man. But the good news is that she’s part of the Party that doesn’t believe in God-given gender, so she can “claim” that she is a man. The bad news, if the Party doesn’t allow gender identification, she can’t claim to be the “first female VP” and boy her head is going to explode when she takes over from creepy Joe. Quite the conundrum!