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VOL. 37 | NO. 39 | Friday, September 27, 2013

As health exchanges begin, some state programs end

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NASHVILLE (AP) - As the Affordable Care Act's health exchanges come online, some of Tennessee's state-sponsored insurance programs are shutting down or limiting enrollment.

More than 28,000 residents enrolled in programs like CoverKids, CoverTN, AccessTN and CoverRX will be affected.

Beginning on Tuesday, people losing coverage will be able to shop for new policies through the Health Insurance Marketplace. The exchange offers subsidies toward lowering premium costs, but some people may not qualify for the subsidies.

The 16,000 people enrolled in CoverTN have already been notified that program will end Dec. 31. The limited benefits plan was started during Gov. Phil Bredesen's administration to help fill in the gaps when more than 350,000 people were kicked off the TennCare rolls. But CoverTN does not meet the requirement of the federal health care law because it sets monetary caps.

AccessTN also sets caps, but it has received a reprieve because of a rule that allows high-risk insurance pools an additional year. However, only those with incomes below the federal poverty level and who receive premium assistance will be able to stay on the program. That means that about 1,900 of the 2,600 people currently enrolled will no longer be eligible.

Letters are going out this week about the changes to AccessTN and also CoverRX, a prescription benefit program. The state is closing CoverRX to people who make more than the federal poverty level, which means 10,000 of the 54,000 people enrolled will lose coverage.

Many families already have received notice they will no longer be able to buy in to CoverKids, Tennessee's version of the federally sponsored Children's Health Insurance Program.

The program is free for families earning less than 250 percent of the federal poverty level ($58,875 for a family of four), but parents earning more than that will no longer be able to participate. About 650 children will be cut from CoverKids because their parents make too much money to qualify.

And a rule that prevents parents from buying subsidized insurance for their children on the exchange if the parents are covered by an employer's plan could affect thousands of Tennessee families.