DAY FORTY: The Bell Tolls in Federal Court.

Judge Nixon gives partial go-ahead to the enormous healthcare reduction.

(NASHVILLE, July 29, 2005) The Tennessee Healthcare Campaign continued to ring a bell every four seconds to symbolize the hundreds of thousands of Tennesseans that will lose their healthcare. People from all over the state have been ringing the bell since noon yesterday, and will continue day and night until Sunday at about 9:00 pm. As the tolling of a bell continued to ring out over the state capitol, a federal judge ruled yesterday that Tennessee’s five-prescription limit for Medicaid can go into effect with the August 1st, TennCare changes. The judge did not make a final ruling on the Grier Case and the state’s lawyers were unclear what impact the partial ruling would have.

"They've got more than enough money now," said Gordon Bonnyman the enrollee’s lawyer.

Governor Bredesen, who personally approved the settlement with TennCare enrollees last year, has taken the enrollees back to court to modify the agreement. The governor has broken his promise to fix TennCare and needed to change the Grier settlement to push his new Medicaid plan on Tennesseans. Bredesen’s plan will disqualify 290,000 people from benefits, and limit healthcare to over half a million citizens.

The state lawyers said that the provisions on which Judge Nixon did not rule would determine its overall impact on the TennCare budget. Although Governor Bredesen gave no hint that he would scrap his plan if the state lost the case, most analysts were seeing the ruling as a “go-ahead” for the massive cutbacks that start Monday.

The federal court was only ruling on the “consent decree” and not questions of the medication limitation being a violation of federal civil rights law. The 1990 Americans with Disabilities Act uniquely defines institutionalization as discrimination faced by citizens with disabilities. Bredesen’s plan favors expensive institutionalization by cutting services that help people remain in their own homes and providing unlimited drugs to people in nursing homes while those in the community are limited to five.

Main parts of the Grier Ruling:

• Judge Nixon ruled the state could proceed with a new five-drug-per-month benefit limit for some 400,000 people on TennCare beginning Monday. The Judge expected that the state would allow exceptions, but there were no qualifications. 
• The Judge approved the state's list of drugs available without prior permission.
• The judge ruled the state could eliminate coverage of over-the-counter drugs.
• The Judge granted the state permission to give pharmacists authority to determine whether to issue an emergency three-day supply of drugs to a client, even if not approved by a doctor.

-Tim Wheat