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March 6, 1996


Author Affiliations

University of Tennessee Memphis
University of Memphis Memphis, Tenn

JAMA. 1996;275(9):684. doi:10.1001/jama.1996.03530330027019

In Reply.  —We take pleasure in responding to comments elicited by our article. Drs Himmelstein and Woolhandler report a lower rate of insurance coverage in Tennessee than we did. Our data were derived from state reports. A University of Tennessee survey in August 1994 also reported an uninsured rate of 5.9%, a fall from 9% in 1993 before TennCare. TennCare enrollment currently includes more than 400 000 previously uninsured citizens.1 Thus, TennCare did have a positive effect on coverage. Differences in quantitative values from those of other surveys are likely the result of methodologic differences, not the more pejorative reason of "sleight of hand."Dr Gore raises several issues that reflect differences of position more than inaccuracies. Whether a 60% response rate of initial enrollment was high or low is clearly one of perspective. We agree with the recent report by the Henry J. Kaiser Family Foundation and the