State candidates split on Medicaid expansion during social worker forum

Zach Vance • Oct 4, 2018 at 10:47 PM

Expanding Medicaid in Tennessee dominated the conversation at Thursday’s candidate forum, hosted by the National Association of Social Workers’ Northeast Tennessee branch, and the four state House candidates were clearly divided on the topic.

Republican incumbents Matthew Hill, 7th House District, and Micah Van Huss, 6th House District, expressed fiscal concerns about Medicaid expansion, concentrating on how the program would be paid for.

But their respective opponents Democrat Nathan Farnor, 7th House District, and Independent Murphey Johnson, 6th House District, both said they would advocate for expansion, regardless of cost.

Dr. Marty Olsen, the Democratic nominee for Tennessee’s 1st Congressional District, also participated in the forum and discussed various ways he would tackle the opioid epidemic. His opponent, incumbent U.S. Rep. Phil Roe, did not attend the event.

This is what the candidates had to say:

Van Huss: When asked about his thoughts, Van Huss said expansion needed to be approached “cautiously.”

While he did not serve in the legislature in 2007, when Gov. Phil Bredesen had to cut roughly 300,000 people off TennCare due to rising costs, Van Huss said other legislators described it as a horrible experience, and obviously not something he wants to happen again.

The Jonesborough lawmaker was later asked what would need to occur for the state legislature to look at expansion.

“Obviously, it gets into the question of whether we are a socialist country, or are we not. With the makeup of Tennessee, I don’t know that anytime soon that would happen. I’m just trying to answer it as honestly as I can ... I don’t foresee it in the near future,” Van Huss said.

“It gets into the question of helping folks who need the help, and getting into the biblical narrative of helping your fellow man, someone who needs help. For me, there is a big difference between voluntarily helping somebody and your government telling you, ‘You have to do this.’”

Johnson: After his introduction, Johnson immediately said he would fully support Medicaid expansion.

“Whatever we need to do to make a deal and stop flushing $3.4 million a day down the toilet, federal money we could get,” Johnson said, as the crowd of social workers responded in applause.

Johnson then offered an analogy about the objections being made not to expand Medicaid.

“Say you just bought something from Lowe’s or Home Depot. You’re walking out the door with cash in your hand, a $20 bill. You walk past a table and there are kids at a table selling cookies or popcorn, and you say to them, ‘I’d really like to help you out ... but unfortunately, I can’t guarantee that the next time I come out of Lowe’s or Home Depot, I’m going to have $20 in my hand and I’ll feel so bad that I don’t even want to do it this time,” Johnson said.

“That’s about the way I view it. If the money’s not there next time, well at least we insure people for a full year, nearly 300,000 people.”

Hill: First elected to the General Assembly in 2004, Hill said he was around for the “disenrollment” of TennCare, and he took umbrage to Johnson comparing health insurance to kids selling cookies and popcorn.

“It’s not a popcorn or cookie kind of thing to watch hundreds and hundreds of thousands of people be taken away from their health care,” Hill said. 

“I agree with the one person who said we want to be able to get the health care even if it’s for a limited amount of time. Respectfully, that sounds very good, except for two main problems: No. 1, the state cannot financially sustain it, even with the government match ... The second reason is if they have it for a year, it’s better than not having it all. That’s just not true if they’re on things like chemotherapy or radiation or dialysis. Then you have to take it away from them.”

Years ago, Hill said he served on a commission that attempted to negotiate behavioral health and substance abuse coverage with the Centers for Medicare & Medicaid Services.

“They would not agree to it, but had they agreed to our waiver changes, we’d been able to cover behavioral health and substance abuse, which would have covered the vast majority of the 300,000 uninsured,” said Hill, who later advocated that he would support the federal government giving a block grant to cover the uninsured in Tennessee.

Farnor: Since emotions were high, Farnor bypassed the introduction and immediately said the time is now for Tennessee to expand Medicaid.

“We’ve got 300,000 people in the state who live without health insurance, and 14,000 of those people, keep in mind, live right here in our community,” Farnor said. 

“We’re losing $3.4 billion a year in our taxpayer money, we’re leading the country in terms of opioid-related deaths, we’re leading the country in terms of rural hospital closures ... and infant mortality is on the rise because women don’t have access to health care. Regardless of what the excuses are or the background, it’s been 14 years. That’s been plenty of time to figure it out, and now is the time. It makes sense ethically and economically. We need to do it.”