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Nashville health care advocates discuss Medicaid expansion, access to health care in Washington County

Brandon Paykamian • Jul 13, 2018 at 11:40 PM

When Tennessee Justice Center organizers Hayes McAlister and Loring McDonald visited Johnson City Thursday as part of the Bring It Home campaign to push for Medicaid expansion in Tennessee, one thing they learned is that access to health care is a top concern among many local residents.

While 63 percent of Tennesseans support the expansion of Medicaid, legislators have repeatedly refused to vote in favor of expansion after passing a law in 2014 that bars the state from accepting federal funds to expand coverage.

The two Nashville-based health care advocates have some optimism that this could change during the next legislative session in 2019, but McAlister said the public still needs to be informed of the implications of Medicaid expansion, or lack thereof, in Tennessee.

“A lot of Tennesseans across the state are kind of unsure what our Medicaid provision is and what kinds of people are covered under Medicaid and TennCare in Tennessee,” McAlister said. “So when we meet with communities, we want to provide them with all the background that we’ve been hearing about Medicaid expansion from our legislature.”

The two organizers have been throughout Middle and East Tennessee talking to people in each community about their health care concerns and how Medicaid expansion might affect them. While 11.8 percent of Tennesseans go without insurance altogether, about 17 percent go without in Washington County and 13.8 percent go without health care in Johnson City, according to conservative statistics from Ballad Health.

McAlister said Medicaid expansion could help reduce these numbers and help sustain some of the rural hospitals in neighboring counties, some of which are hard-pressed for funding. Tennessee has lost eight hospitals since 2010 because of this lack of federal funding, McAlister said.

“Currently, Tennessee leaves $3.8 million on the table every single day that is raised by Tennessee tax paying dollars and goes right out of the state to Washington (D.C.) and then goes to other expansion states to increase their health care networks,” she said. “That equates to $1.4 billion a year.

“Tennessee is just losing this money — generating this money and truly losing it,” she continued. “If we can make that the focus and have Tennesseans understand that we could be doing this and we are simply not, that is hopefully going to be the catalyst.”

The opioid epidemic that has plagued Northeast Tennessee is another major concern the two advocates said should prove to be a catalyst in generating more support for the expansion of Medicaid.

“We have yet to talk to a person who doesn’t have a personal connection to this, and that’s what’s so striking, that everyone has a way that this touches their lives,” McDonald said.

McAlister said the expansion of Medicaid could compensate for the lack of funds proposed by Gov. Bill Haslam for 2019 to combat the epidemic. Haslam proposed $30 million as part of his Insure Tennessee program, but that money might not have been needed with the expansion of Medicaid.

“If we expanded Medicaid, we would have all that funding for the full fiscal year in 10 days,” she said.

And for local residents suffering from chronic illnesses, McAlister said the expansion of Medicaid could make affordable health care more accessible.

Local resident Dan Fehr said his chronic illness has continued to cause him financial hardship. Even with past insurance plans, Fehr has had issues paying for health care.

Now uninsured since last year, Fehr is worried about what to do when it comes to receiving adequate health care.

“Luckily my ulcerative colitis has been under control since then, but now, without insurance, I’m playing Russian roulette with getting sick, and if I got bad off on a flare, I would not be able to keep a job due to the physical strain it puts on your body.”

McAlister said stories such as Fehr’s are not uncommon in Tennessee.

“It’s the same stories of people saying, you know, all it takes is one bout of illness or one trip to the emergency room to decrease your well-being significantly,” she said. “Everybody has a story about that; everybody knows somebody who does not have access to health insurance, and when a catastrophe happens, that can be the end of their life. It’s those kinds of stories that we hear across the board.”

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