Herron: Why Tennessee should expand Medicaid

Thursday, October 10, 2013

If you have health insurance, why should you care that Gov. Bill Haslam and Republican legislators have refused federal funds to insure 330,000 working Tennesseans?

Because their decision will have major consequences for you.

Here are 10 reasons you should care whether 330,000 Tennesseans get health insurance -- or don't.

1. The rejection of a billion dollars a year will severely impact caregivers. Hospitals near you may close, cut services or fire workers, as at least four hospitals near my rural Tennessee home have done.

2. Without the hospital, your doctor may move -- and other doctors won't come to a county without a hospital, leaving you with fewer options and farther to drive for care.

3. Without a hospital or doctors, companies will not move to your county or may leave, taking jobs from you, your family and friends.

4. In an emergency, how many of your family or friends may not survive a longer trip to life-saving care from a hospital or doctor?

5. You may have to attend more funerals because denying people access to reliable health care costs lives. Applying a recent New England Journal of Medicine study to Tennessee indicates expanding Medicaid coverage, in the first year alone, would save more than 1,000 Tennesseans.

6. If federal funds aren't spent, your city and county will collect less in sales taxes, putting more pressure on local governments to raise your property taxes.

7. Similarly, your city and county may collect less property taxes from for-profit hospitals and from doctors and employers who leave, again forcing your taxes up.

8. Even if your hospital survives, your neighbor, your family member or even you may lose your job, like the 1,000 health care workers that even Vanderbilt University Medical Center is letting go. Or you may lose your job because others lose their jobs and don't have money to spend with the business where you work.

9. Because of staffing cuts, you may wait longer when you go to the doctor, nurse or hospital.

10. Your insurance premiums will be higher due to hospitals shifting the cost of care for those without health insurance to those of us with health insurance.

A University of Memphis study projected that the Affordable Care Act would reduce uncompensated care and bad debt by $2.3 billion a year in Tennessee. That's $2.3 billion of cost that will be dumped onto insured patients through increased premiums. Without Medicaid expansion, this cost shifting will continue to drive up premiums for people with insurance -- by more than $1,000 a year for some insured families.

Furthermore, you and your family will be denied the insurance savings that consumers are seeing in states where officials accepted the funds to provide basic health insurance for low-income families.

Recently New York insurance regulators approved rates averaging at least 50 percent lower than those currently available. Beginning next month, individuals now paying $1,000 a month or more for coverage will pay as little as $308. For some, federal subsidies will lower the cost even more.

USA Today reported, "In the 25 states that have decided to expand Medicaid, 12.4 million uninsured Americans will be eligible to pay less than $100 a month ..."

In states where officials refused the Medicaid expansion, like Tennessee, citizens will miss out on these dramatic savings.

Refusing to take the federal funds and not insuring Tennesseans shifts costs to those of us with health insurance. Call it a "sick tax" or an "uninsured tax," but whatever you call it, refusing the 100 percent federal funds will cost those of us with insurance more as we are forced to pay for the care of families without insurance.

Roy Herron, a former state senator, minister and author, is chairman of the Tennessee Democratic Party.