Letter to the editor: Refusing health care money hurts state’s poor, uninsured

Apr. 06, 2013 @ 06:05 PM


I could not disagree more with U.S. Rep. Phil Roe’s column in the April 3 paper. Rep. Roe supports Gov. Bill Haslam’s decision to refuse to accept the return to Tennessee of $1 billion of Tennessee taxpayers’ federal taxes, to provide health care for uninsured Tennesseans next year.

There are approximately 1 million uninsured Tennesseans, and about one-third of these would have been eligible for high quality, low cost health insurance under the offer Haslam refused. The largest group of uninsured folks benefiting would be those working at minimum and low wage jobs, of which Sevier County’s tourist industry has many.

Apart from the health benefits, this $1 billion would have huge economic benefits for our state and, proportionally, for our county. Tennessee hospitals, including Covenant Health which runs LeConte Medical Center here, have acknowledged that cuts in other federal assistance is creating serious financial problems which this $1 billion would relieve.

Rep. Roe says the Feds may not come through with their promised support. Well, just last week the Feds reaffirmed that the federal monies will be available as promised for the next several years. While things can always change, we all literally bank on just such promises.

Rep. Roe feels Tennessee learned our lessons about such expansions of care when we had to dis-enroll 300,000 from TennCare some years ago. This expansion is not at all like the prior TennCare expansion in that then the state took on all the additional costs itself, this time the Feds are taking on 100 percent of the cost for three years and then will provide a minimum of 90 percent of the cost into the long-term future. Also, TennCare was unprepared then to manage such a large program; now it is one of the best run Medicaid programs in the country.

Rep. Roe reports that TennCare payments for doctors are too low and the program too restrictive for its enrollees. Under the proposal Gov. Haslam refused, Medicaid payments would have been raised to the same level as Medicare for primary care services. Restrictive or not, Medicaid in Tennessee has an over 90 percent satisfactory rating by its enrollees.

Finally, Rep Roe feels the governor has a better plan which he can negotiate for with the Feds. The core of this plan is using the $1 billion to enroll uninsured folks into private insurance. Well, personally, this looks to me like just a form of corporate welfare since private insurance can take 20 percent for overhead under Fed rules, but TennCare has a 2-3 percent overhead. But, if that’s the way Gov. Haslam wants to do it, then just last week the Feds issued a statement agreeing to this sort of plan. The state also clearly has the right to end the program at any time and also to use new types of payment options to lower costs.

So, I call on Gov. Haslam (and Rep. Roe) right now to declare victory, and do what he needs to do to get this money flowing for 2014. If he doesn’t act the $ 1 billion will go to other states, it will be lost forever for Tennessee.

Richard Henighan