Those reserves were higher over the past few years as Tennessee budgeted for TennCare expense increases due to inflated numbers due to a halt on eligibility checks during the COVID-19 pandemic between March 2020 to March 31, 2023.

During a special session last fall, Watson said the Legislature was able to pass new spending bills and close the books on last fiscal year despite the shortfall because $508 million was reverted from TennCare.

Those higher budgeted amounts, along with an influx of federal funds to the program, led to reserves.

“Under a 2021 agreement with the federal government, Tennessee can keep up to 55% of the federal share of any difference between the cap and actual spending without committing any additional state money,” Sycamore Institute wrote. “Referred to as ‘shared savings,’ these federal dollars must be used on specific state-funded activities that expand or improve health coverage, access, delivery or outcomes for low-income Tennesseans.”

The timeframe for the year-long unwinding of Medicaid programs from the COVID-19 eligibility pause is now complete, with composite results including March expected to be posted by TennCare soon.

Through February, Tennessee had checked the eligibility of more than 1.4 million through February with nearly 877,000 retaining eligibility and nearly 456,000 losing coverage with nearly 80,000 still pending a determination.

As of April, the state had 1.5 million enrolled in some area of coverage, down from a peak of 1.8 million.