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The number of uninsured children in Tennessee fell from 2.8 percent in 2020 to 2.5 percent in 2021, according to a new study by the University of Tennessee, Knoxville’s Boyd Center for Business and Economic Research. Among adults, the uninsured rate held steady at the 2020 rate of 9.9 percent, and the uninsured rate across all ages remained the same as last year at 8.3 percent as well.

The Impact of TennCare: A Survey of Recipients, 2021, shows that 92 percent of TennCare recipients were happy with the program’s quality of care, marking the 13th straight year in which satisfaction with TennCare exceeded 90 percent. Survey participants also indicated they were happy with the care their children were receiving: 88 percent of all heads of households reported excellent or good care, while 85 percent of TennCare heads of households reported the same.

The frequency of visits to a doctor’s office largely rebounded to prepandemic levels during the span of the survey, indicating that doctors’ offices and patient behavior has returned to some level of normalcy. The sharpest increase was among TennCare heads of households, with 31 percent reporting seeing a doctor at least weekly or monthly in 2021 versus 26 percent in 2020.

Affordability continues to be the top reason for failing to obtain health insurance in 2021, with 86 percent of uninsured respondents listing it as a major or minor reason they did not obtain coverage—a decrease from the 91 percent who cited it in 2020.

“Although we are still experiencing the effects of the COVID-19 pandemic, these results show me that Tennesseans are feeling more comfortable to seek the care they need,” said the study’s lead author, LeAnn Luna. “TennCare continues to provide excellent health care to the Tennessee families who participate in the program.”

Luna, a professor of accounting and information research, and Boyd Center research associate Alex Norwood coauthored the study, which examines the health coverage status of Tennessee residents, the use of medical facilities, and satisfaction with medical services received.

The annual survey of 5,000 Tennessee households was conducted between May and July 2021, before the delta variant of COVID-19 became prevalent in the United States. About 21 percent of respondents said that COVID-19 had affected their quality of care; of those respondents, 28 percent said the quality of care was better.

Although many doctors’ offices were closed to nonessential care at times in the past year, 87 percent of those surveyed said they were able to make an appointment. About 87 percent of TennCare households were able to obtain all their nonemergency medical care from a TennCare provider.

“TennCare remains committed to improving the lives of TennCare members through high-quality cost-effective care,” said TennCare director Stephen Smith. “We are encouraged to see our state’s collective efforts once again recognized by our customers, who have indicated continued high levels of satisfaction with the care they receive through the TennCare program.”

COVID-19 continues to change the way respondents access health care services, with more people finding care in new ways. Approximately 31 percent of respondents said they now use telehealth options more frequently, and almost 9 percent said they now use behavioral health services more often. About 61 percent of TennCare respondents said TennCare or their TennCare health plan provided communications about available services and testing for COVID-19.

The Boyd Center, located within UT’s Haslam College of Business, has conducted the survey each year since 1993 under contract with the Tennessee Department of Finance and Administration.


Lindsey Owen (865-974-6375,

Erin Hatfield (865-974-6086,