Health Care Promises Broken, Again

By Greg Williams/Special to the Herald Courier
Published: May 18, 2008

BY GREG WILLIAMS
SPECIAL TO THE HERALD COURIER

In 2005 when Gov. Phil Bredesen cut 170,000 people from TennCare, he closed the medically needy (or spend-down) program. He promised soon to reopen it to 100,000 very sick, elderly or disabled people. 
He once again is breaking his promise. He is proposing that, when this program finally re-opens in October 2008, it will be capped at 20,000. He would cut another 80,000 Tennesseans. In his May 17 budget address, he had the nerve to describe this as “an expansion cutback.”
BREDESEN’S NEW plan cuts $460 million from the state budget; $80 million of it from TennCare. When thousands of positions in state government remain unfilled, why slash very sick, needy people? Why cut folks who require kidney dialysis or have HIV/AIDS or other serious medical conditions?
The cuts are likely to be higher than originally estimated. Darin Gordon, TennCare’s director, estimated more than 40,000 people probably will lose their eligibility. About 50,000 are temporarily qualified as “medically needy,” but all are going through a re-verification process to determine whether they’re still eligible. Gordon said results, thus far, indicate only about 10,000 will be eligible; perhaps as few as 5,000.
The Tennessee Health Care Campaign proposed amendments to House Appropriations Bill 4219 that would have transferred $125 million to the Department of Health to recreate a safety net. We anticipate more than 100,000 adults and 20,000 children will lose their coverage. People undergoing serious medical treatments will be cut. Therefore, we should have done what we did in 2005; recreate – and strengthen – the safety net.
Before more people are cut, we needed to transfer to the Department of Health some of the money set aside in the TennCare budget for medical care. This would’ve recreated the safety net for people receiving critical, life-sustaining care.
THIS WASN’T about dollars. After all, this administration has refused to close more than $150 million in multi-state corporate welfare loopholes that would have placed Tennessee’s small, independent business owners on a level playing field with large corporations. 
This wasn’t about TennCare reserves – $550 million – or the $750 million Rainy Day Fund. It’s one-time money in the TennCare budget. It wasn’t about Cover Tennessee, which is no solution. According to the state comptroller’s own numbers, Cover Tennessee “covers” fewer than 16,000 adults. While it’s much easier to see what this wasn’t, someone needs to explain exactly what the reasons were behind this.
We suggest opening enrollment immediately for everyone; allowing people to count all their medical bills during the redetermination process for the spend down category; and allowing new applicants to apply medical bills going back farther than 90 days. If the General Assembly cannot stop a repeat of the mass terminations from TennCare that we experienced in 2005, then at least they should’ve invested in an improved safety net before creating one more uninsured Tennessean!
This wasn’t about the federal government. Concerning a halt to the steep increases in health care spending, no consensus among relevant experts exists.  Widespread agreement that employers pass those increases to consumers does exist, however, and some would drop health coverage entirely. Shifting some of the health cost burden to their employees relates to a movement that is often erroneously referred to as “consumer-driven” care.  Certainly, the federal government needs to accept more responsibility as numerous state legislators (both Democrats and Republicans) are quick to exclaim. Regardless of who assumes the presidency next January, nothing major will happen for some time thereafter.
This is about Tennesseans and being true to our decency and community values. Our neighbors are hurting; they need our support. And sensible answers were within reach. We needed our policy makers to step forward and aim for reasonable, sensible, fair solutions that were on target with our needs and values.

Greg Williams of Kingsport is the East Tennessee regional organizer for the Tennessee Health Care Campaign.