NASHVILLE, Nov. 19 - A decade after Tennessee inaugurated a health care plan for the state's most vulnerable residents that was hailed as a model for the nation, the program is once more being held up as a model - of failure in an era of soaring medical costs and voters' aversion to higher taxes.
Today the plan, TennCare, which sought to improve health care for Medicaid recipients while covering those who fall through the federal program's cracks, is on the ropes.
Gov. Phil Bredesen, a conservative Democrat and former health maintenance organization entrepreneur, has threatened the program with extinction, saying that rising costs and generous benefits - TennCare consumes nearly a third of the state's $25 billion budget - make it unaffordable unless it can be radically restructured to save money and limit benefits.
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After more than a week of tense negotiations between the governor and advocates for TennCare's 1.3 million users - nearly a quarter of the state's population, including an estimated
430,000 who would not be covered by Medicaid if TennCare disappeared - the two sides decided to "step back from the brink," as Mr. Bredesen put it.
http://nytimes.com/2004/11/20/national/20tennessee.html?hp&ex=1100926800&en=25da9ef93fba097a&ei=5094&partner=homepage