NAMI-TN Helpline [800] 467-3589
NAMI Tennessee’s Tips and Talking Points
  • Establish who you are then make clear that you are opposed to the proposal and explain why using your personal experience or expertise.
  • If you are a NAMI member say so and acknowledge that TennCare is the largest payer for mental health and substance use treatment services in the state.
  • Medicaid employment services like Tennessee’s Employment First have been successful at getting people with disabilities, including mental illness, into the workforce because they provide additional tailored services that address the unique barriers they face. Work requirements, in contrast, are a punitive condition on eligibility that does not accommodate the needs of individual Medicaid beneficiaries, with or without mental illness, and provide few if any additional services or resources to create new job opportunities or employment supports.
  • Tennessee has not expanded Medicaid (TennCare) so those subject to the work requirement would mainly be caregivers for children on Medicaid, pregnant women, and women with breast or cervical cancer. Those Tennessean’s eligible for TennCare are disproportionately affected by mental health issues and this proposal puts families at risk of losing mental health care.
  • When parents lose health care, children get hurt. TennCare improves access to needed care, improves parents’ mental health outcomes and strengthens families’ financial security; taking away would do the reverse.
  • The loss of TennCare coverage will increase health care system costs and contribute to poor mental health, including premature mortality and increased mental health morbidity.
  • Exemptions are not protections: research and experience show that work requirements impose complex administrative burdens on individuals and families. Many people are at risk of losing their coverage due to confusion or bureaucratic hurdles. For these reasons, even people who are supposed to be exempt may not be able to claim exemption because of these bureaucratic challenges, a particular risk for individuals and families living with mental health conditions or disabilities.
  • If spillover loss of coverage (i.e., loss of coverage by exempt beneficiaries unable to comply with documentation requirements) is the primary mechanism by which work requirements decrease TennCare enrollment and spending, these savings would likely come at a substantial cost in terms of mental and physical health.
  • In the last legislative session there was an amendment to the work requirement bill exempting people going through substance abuse treatment, or who have a history of addiction or mental illness. The amendment failed and Amendment 38 draft fails to mention how TennCare beneficiaries will be protected or supported if they have certain mental health conditions.
  • Catch-22: Many people who meet the work requirements will still lose mental health coverage because they will make too much money to qualify for TennCare any longer, but their low wage job won’t provide health insurance.
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