Medicaid expansion good for all Tennesseans

This does not need to be! Tennessee has the opportunity to access a Federal government program, which provides 90% of the cost, to cover these 350,000 Tennesseans, through expanding Medicaid. Sixty-two percent of the state’s citizens are in favor of Tennessee accepting the Federal funds and expanding Medicaid. Thirty-nine states and DC have approved Medicaid expansion and covered almost all of their uninsured adults. These states have seen positive growth health-wise and economically.

Here are other factors. Do you know that Tennessee ranks first in the nation with the closure of hospitals in rural areas? Do you know that due to the uninsured issue, many doctors will not practice in rural Tennessee because they can’t get paid for their work? Furthermore, Tennessee ranks on top for mortgage foreclosures due to unpaid medical expense. Do you know that young adults, who have Medicaid coverage with their families, lose this coverage when they turn 21? It does not matter what kind of health problems they have or how expensive the medicines they need are.

To help us understand the issue, here are two true stories from Dr. David Wood:

One of my patients is a previously healthy young man, who at 17 developed a seizure disorder. He will require medicines the rest of his life to control the seizure, go to school, get a job, drive, and be a productive member of society.

At 19 he lost Medicaid. A month later his medication ran out and he could not afford to buy it. Predictably, he had another seizure and had to go to the emergency room and was hospitalized for a few days.

The cost of the ER visit and hospitalization could have paid many times over for cost of his medicines for decades, not to mention the trauma he and his parents experienced waiting for and then experiencing the recurrence of his seizure disorder.

I had another patient with Type 1 diabetes who lost insurance at 21. We enrolled him in a Medication Assistance Program so that he could continue to get insulin, but he could not afford to pay to see a specialist. Without physician guidance, he slowly drifted into diabetic ketoacidosis or DKA, and almost died. He was in the hospital over 1 week and in the ICU two days. The cost of that hospitalization would have paid for his medicines and specialty care for many, many years.

Here is a disability story.

Forrest Phillips was in a car accident last year, leaving him paralyzed from the waist down.

“I was on the interstate, everyone was slamming on their brakes, and I didn’t and ran into a semi-truck,” said Phillips.

He is not surprised by the Tennessee Disability Coalition’s rating of a D-plus. Phillips describes it as an overall grade. One area where Tennessee falls short is housing. There is not enough accessible and affordable housing for people with life-disability disability.

“The only place for people like me is to live with a caregiver or go to a nursing home. I live with my 73-year-old Dad,” he said.

Why don’t we consider expanding Medicaid? It is principally due to the power of the speaker of the House along with the lieutenant governor, who leads the Senate.

Neither one of these leaders have permitted this issue to come out of respective committees for debate. Furthermore, their actions are strengthened since the governor has opposed expanding Medicaid.

Why? Because expanded Medicaid is part of the Affordable Care Act (AKA Obamacare). The Republicans do not want to support any program associated with the Democrats, even if it will help insure 350,000 Tennesseans with the federal government picking up 90% of the costs.

Thirty-nine states have expanded Medicaid, many deep red states with Republican dominated legislatures, including Kentucky, W. Virginia, and Arkansas, because they knew it was best for their citizens and for their states’ economy and for their rural hospitals and health systems.

Another reason that Tennessee does not expand Medicaid is because we, the common citizens who vote, don’t advocate for it! We are not aware of the incredible impact this program would make on our fellow citizens’ health, helping grow our economy, and creating a healthier work force.

While most are aware of the financial and health problems that arise for those who are unable to afford medical coverage, most don’t realize how many Tennesseans are in that boat!

We have attempted to raise the issue and the stories with two of our local regional state representatives. There was no reply about the current status. The governor, during the election process, boasted his support for the health of Tennesseans. Yet he provides no response to this issue. He will not meet with the media to respond to these concerns. It seems like this is too hot a topic for them to do what is right for the people of Tennessee.

We are in a “Bible Belt” state. The Tennessee Assembly readily makes known that they embrace Christianity. Yet scripture demonstrates that the God we follow puts a very high priority on caring for the poor, disabled, and the ill. He has always identified with the marginalized.

Aren’t those concepts basic to the Christian belief system? Importantly, when God instructed the Israelites to care for the poor, he was talking to the political leaders of that society.

In addition, when God condemned Israel for callously turning its back on the poor, this criticism was directed to the political leaders of that time. If anyone declares themselves to be Christian, they should rise up and demand that political leaders do all that they can to support Medicaid expansion.

Other states have had citizen-initiated referenda to get this by their Republican controlled legislatures (e.g. Oklahoma), but the people of Tennessee are not allowed to initiate referenda. So call the speaker of the House along with the lieutenant governor and our local legislators and let them know that 350,000 Tennesseans should not go without health insurance.

Edward Wolff is a Jonesborough resident and host of the community discussion group Black/White Dialogue. Dr. David Wood is a pediatrician in Johnson City.