Pam's Points: Comparing the state's Tenncare shame; Chattanooga's gang damper

Pam's Points: Comparing the state's Tenncare shame; Chattanooga's gang damper

July 28th, 2014 in Opinion Times

TennCare's ACA snub is shameful

The doorway to TennCare is like "the eye of a needle," according to legal and health care experts.

The analogy comes from Sam Brooke, a Southern Poverty Law Center attorney handling a lawsuit filed last week against Tennessee for its "disgraceful" and "atrocious" long delays in the TennCare application process.

Eleven plaintiffs are named in the federal class-action lawsuit -- all with applications pending for more than 140 days and some for as long as six months. The plaintiffs include a Soddy-Daisy mother who applied for TennCare in January during her pregnancy. She was initially approved but now she and her 3-month-old baby remain without coverage, delaying doctors appointments and vaccinations. She's called more than 30 times with no resolutions, just pledges from state workers that her call would be "escalated." Then finally, just over a week ago, she was told her application was not in the state's system at all.

The suit claims the state has broken federal law and "broken a decades-old promise to its most vulnerable residents," newborns, pregnant women and the elderly. The suit is the first of its kind filed against a state for how the state has handled its Medicaid enrollment since the Affordable Care Act went into effect.

Attorneys say Tennessee "is among the worst, if not the worst, offenders" in its failure to connect eligible applicants with coverage, and the state is a "national outlier" in how it sends applicants to apply for TennCare programs solely through Healthcare. gov -- which was never designed or intended to screen for such a wide array of Medicaid programs.

Federal law mandates that states respond to Medicaid applicants about whether or not they will be covered within 45 days of submitting their applications. But Tennesseans are being forced to wait more than two or three times that long, the lawsuit alleges.

Lawyers even contend that the state is "arbitrarily terminating coverage for newborns after they are carried out the hospital door."

The lawsuit seeks an injunction that would force Tenn-Care to abide by the 45-day limit and find ways to get people signed up more quickly. The legal filing comes just weeks after the U.S. Centers for Medicare and Medicaid Services sent state officials a harsh letter saying that the state's Medicaid program was failing to meet six of seven "critical success factors" required by federal health care law -- more than any other state highlighted for such failings.

All of this is happening because the state's GOP lawmakers and governor just wanted to make a political and partisan point to demonize the president and his Affordable Care Act.

It shames us.

So much for being the "Volunteer" State.

Curbing violence with hope

Five months into Chattanooga's new violence reduction program, shootings haven't continued to increase and some perpetrators of past trouble are turning around their lives, according to Chattanooga police.

The choice was really pretty simple: stop shooting and get help, or keep shooting and wait for police to nab you and everyone you associate with. So far, 58 of Chattanooga's most violent offenders who sought help have landed jobs with the city's assistance. And 42 of those people have held on to those jobs, officials say.

On the other side of the numbers where there was continued shooting, 21 gang members have seen stepped-up police enforcements: 10 have been arrested, two on federal charges.

It's a great start. Yes, it is true that we've still had almost as many shootings and deaths in the city this year as we had in the first six months of 2013. But think what the number of shootings might be like if those now-employed 42 young men were still in the gang life.

Kudos, Chattanooga! Kudos, to you 42 young men with new jobs!

Effort is always better than apathy, complacency and bitter retaliations.