Federal Government Approves Tennessee’s Medicaid Proposal, Swapping a Block Grant for an Aggregate Cap

The federal government approved Tennessee’s proposed Medicaid aggregate cap, granting a lump sum for a self-imposed, fixed budget. The ten-year agreement, referred to as “TennCare III,” is the first of its kind nationwide. It also allows for the state to reserve any unused funds and apply them to other government programs, with up to 55 percent of those savings potentially matched by additional federal funds for state health programs.

The Centers for Medicare and Medicaid Services (CMS) described the measure as an “innovative financing approach.” Unlike what various reports claimed, federal officials explicitly stated that this agreement wasn’t a block grant. This agreement allows the state government to be flexible with its spending cap under certain circumstances – like last year’s pandemic and related unemployment crisis. 

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