The Big Beautiful Bill will cut Medicaid, including TennCare, Tennessee's version of Medicaid. (Photo by Shauneen Miranda/States Newsroom)

Tennessee’s one-of-a-kind TennCare Medicaid waiver program crossed over $1 billion in savings, TennCare Director Stephen Smith told state officials during the agency’s budget hearing Thursday.

The program, referred to as “shared-savings,” is a Medicaid waiver that allows the state to access about half of the money it saves from its federal allocation to pay for insurance coverage for the state’s poorest residents.

Tennessee is the only state to receive such a waiver. The state applied for the program in 2021, despite concerns that the only way to save money was to remove people from TennCare or reduce services.

About 1.4 million Tennesseans, or 20%,

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