Letters: Are health care block grants right for Tennessee?

Johnson City Press • Mar 17, 2019 at 6:00 AM

In a previous edition, we asked for your thoughts on a state proposal to secure federal health care dollars as block grants. Here are some of your responses.

Proposal won’t expand coverage

Former Governor Haslam, who may have been the most pragmatic effective governor this state has ever had, spent a lot of political capital on a proposal that would allow block grants to the state to allow people in the income gap go to the health care exchanges and buy coverage with the block grants funding the premiums.

This approach would have allowed the state to take advantage of the Medicaid expansion dollars but limit liability which was a big issue with the original TennCare program. His own party would not even bring it to a vote. Contrary to what you may hear, the exchanges work and have helped numerous people in this state and other states buy insurance based on their income.

What the Republican-controlled Legislature has proposed now sounds good but will do nothing to help people that do not have employer provided coverage. Transparent pricing, open competition, across state lines, limited coverage, risk pools, etc. have all been tried and don't work. Facts are the private sector can't price a product and make a profit at premiums that people can afford. That was the intention of the Affordable Care Act (Obamacare), to use the tax code to base premiums on a person's income and reconcile it with their tax return, an original Republican idea proposed by the Nixon Administration in 1972.

In the future, the only approach that will work for everybody is to eliminate employer provided coverage (most employers would welcome this) raise the Medicare tax and have everybody with Medicare as their base coverage. Then the private sector could offer products such as the Medicare Advantage Plans and individual supplements to cover what Medicare doesn't. People could pick and choose as to what best fits them.


The state helps those who help themselves

I have concerns. I don’t claim to know all there is about block grants or how exactly this whole system works. What I do see is an abuse by some who benefit from the coverage.

I’m not heartless, but I would like to know if there is a verification process for those receiving benefits. For anyone who has a legitimate disability, I absolutely have no problem with those folks being entitled to benefits. It’s the ones who choose to be lazy, sit back and take whatever comes their way at the expense of others that bothers many.

I am speaking as to what I have personally witnessed. Many today have made a conscious choice not to work and help themselves. As I said, I’m not heartless, I have been fortunate in good health and continue to provide my own supplemental plan.


Money wouldn’t address needs

I think not. It would be too easy for unscrupulous politicians to get their hands on the money flowing from Washington and disburse it in ways that helped them.

I imagine more money would be spent in Nashville and Chattanooga than in Memphis, regardless of need. If the federal government issued block grants, I predict that some places (white and powerful) would have more resources and better facilities, while other places (black and disenfranchised) would suffer. Just like school systems.

Johnson City

Want to have your voice heard? Send a Letter to the Forum. Authors must sign their letters and include addresses and phone numbers for verification. Letters may be no longer than 300 words and will be edited for grammar, style and length. Send your submission to Mailbag, P.O. Box 1717, Johnson City, TN 37605-1717 or [email protected].

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