Two and half years after the Affordable Care Act was enacted and 17 months after Gov. Bill Haslam announced the alternative plan he twice tried to get his own GOP colleagues to pass, some Tennessee Republicans hope we'll forget that the state has lost out on $2.6 billion and left 280,000 working but poor Tennesseans without insurance.
They hope we'll think they care and that they are showing leadership when some of them meet in Chattanooga today to consider the long-awaited Republican alternative to Obamacare and Insure Tennessee. They hope we've forgotten that the $2.6 billion that would have paid to expand health insurance to all in Tennessee was our federal tax dollars that we've already paid - tax dollars that neither we nor our fellow Tennesseans will ever benefit from.
We hope they mean what they say about finding an alternative.
Last month, state Rep. Beth Harwell, R-Nashville, and Speaker of the House, facing a contested re-election contest in November and perhaps looking toward her own eventual run for governor, announced the creation of a task force she hopes will come up with ways to improve access to health care.
She calls it the "3-Star Healthy Project." Democrats have called it a "pathetic" attempt to give Republicans political cover for rejecting Insure Tennessee.
"This is simply designed to give the false impression that the House Republican leadership is willing to do anything about health care," House Democratic Caucus Chairman Mike Stewart of Nashville said in April. "It's clearly not. This is a charade, it's an effort to delay, and to not simply pass Gov. Haslam's Insure Tennessee plan."
Just after Harwell announced her plan, the Tennessee Justice Center helped 25 sick and ailing Tennesseans living in the coverage gap write and sign a letter urging legislators to extend health insurance to them and all working poor people.
But - big surprise - the 25 got no response from Harwell or their legislators.
Now some of them have taken part in a video message (watch it on the Chattanooga Times Free Press web page) that then was sent to each legislator to show our lawmakers "the faces" of Tennesseans caught in the gap - the gap of making too much money to qualify for TennCare and not enough to buy commercial health insurance." Michele Johnson, executive director of the Tennessee Justice Center, says the video received nearly 17,000 views in just three days.
Meanwhile, Harwell and her task force of four Republican House members say they hope to ready a plan in the form of a Medicaid waiver to take before the U.S. Centers for Medicare and Medicaid Services in June (before a July 1 deadline). Never mind that Haslam's plan has already received a waiver OK, and state hospitals had pledged to cover the entire $74 million state share money for that plan that would have drawn down the $2.6 billion in federal Medicaid funds over two years. That's water under the bridge at this point. What we must hope for now is that this task force will begin to show some urgency about fixing the problem.
A year ago, federal officials tallied the "missed opportunities" in states that rejected the ACA. At that time, the report estimated that Tennessee's failure to expand Medicaid resulted in 220 deaths a year and meant that 483,000 doctor visits didn't happen that should have. The report also estimated that 25,500 Tennesseans borrowed or skipped payments to pay medical bills that would have been covered had Tennessee opted in. Some $190 million a year was estimated in uncompensated care.
But the faces in the video say far more than another set of statistics and numbers: "We are your constituents," says one person. Then, over three minutes, heart-felt messages unfold.
"Most of us has [sic] worked hard in Tennessee for decades. We are construction, factory and health care workers, restaurant servers and cooks. Twenty-four thousand of us are veterans. Some of us are students. We've rung you up in the store, made your beds in motels, painted your houses, parked your cars, remodeled your homes, cleaned your offices.
"Some of us were born with health care problems. Some of us have developed medical care problems through years of hard work. Some of us work more than one job. We all pay taxes, and our taxes pay your state health insurance. You have acted like delaying [Insure Tennessee] for another year didn't matter to you. But it matters to us. It means we get sicker, suffer for no reason and face the constant risk of bankruptcy. We're not asking for handout. We just want access to the health care that we deserve through all our years of work. "
Studies have shown that expanding affordable access to people healthy enough to work will spread out the cost of health care costs and therefore insurance premiums. That means this isn't really a fiscal issue. And a Vanderbilt poll last week shows more than 60 percent of Tennesseans think Insure Tennessee or some form of Tennessee Medicaid expansion should be approved, so it shouldn't be labeled an issue that bucks constituent opinion.
But it shouldn't be a partisan issue, either.
It's simply the right thing to do.