In the spring of 2024, one of TJC’s pregnant clients faced an impossible situation. She lost her job, so she applied for TennCare under the pregnant woman category. Despite being eligible, she didn’t hear back from TennCare for over two months. In this time, she also lost the insurance from her former employer. Leaving her alone to navigate a high-risk pregnancy without insurance. Of course, she still needed prenatal care despite the delays with TennCare, and her medical bills piled up.
She was admitted to the hospital before her scheduled inducement, urgently needing care. Still, there was no response from TennCare. TJC stepped in, reaching out to TennCare General Counsel and filing a Wilson appeal, urging them to review her eligibility and provide retroactive coverage as soon as possible. Thankfully, TennCare approved the request shortly after.
This retroactive coverage is monumental for her. It will cover the costly medical bills from her high-risk pregnancy, as well as birth and postpartum care. Now, she can give birth and take her infant home without the constant worry of unaffordable out-of-pocket costs. This coverage ensures she has access to necessary medical services during her postpartum recovery, giving her peace of mind and financial relief.
In Tennessee, approximately 50% of births are covered by Medicaid. Impending cuts to Medicaid at the federal level put babies and mothers across the state at risk. Tennessee already has a high maternal mortality rate that is ask risk of growing if more people lose healthcare. Protecting Medicaid is essential to safeguard the health and financial stability of our state.