Sohn: Andy Berke right to challenge TennCare cuts, changes

Sohn: Andy Berke right to challenge TennCare cuts, changes

April 17th, 2019 by Pam Sohn in Opinion Times

Staff Photo by Robin Rudd UTC Nursing Student Brianna Erwin takes the blood sugar reading from a patient during a 2017 Hamilton County Minority Health Fair.

Photo by Robin Rudd /Times Free Press.

One must worry for the priorities of Tennessee. Read yesterday's paper, and you'll understand why.

On the same day a new conservative study from the American Legislative Exchange Council ranked Tennessee as one of the top states for its economic outlook, we also were reminded that over the past two years, the state has been dropping the health insurance coverage of 130,000 low-income Tennessee children — including 5,500 in Hamilton County.

Our economy is going great guns, yet we are systematically choosing to drop Tennessee children from the state's insurance program for the poor.

What's worse, our legislature is perilously close to passing a bill that caps the amount of federal dollars, $7.5 billion currently, that pays for two thirds of state-provided health care — no matter how much or how fast the cost of Tenncare and Coverkids rises.

Under Tennessee's current Medicaid and Tenncare waiver with Washington, if the costs increase — for whatever reason: an increase in low-income enrollees, tornado injuries, pandemics, whatever — the federal government share will accordingly increase.

But Republicans in government have long been so eager to undo anything in health care that might ever have been touched by "Obamacare" that they are practically chanting block grant, block grant, block grant. Thus a bill already passed by the House and now before the Senate would replace the current waiver agreement between Tennessee and Washington with a block grant — in effect, letting the federal government off the hook for its guarantee of a continuing 2-1 match.

How do children get kicked off TennCare and CoverKids even as our state is enjoying historically low unemployment and our GDP grew by 43.1 % over the decade ending in 2017?

How do we reconcile being the seventh fastest growing economy of any U.S. state and above the national average in all but two years of the past 10 with the fact that we're ranked 41st worst in WalletHub's "best health care systems" list and 13th lowest in health care expenditure, according to a 2014 Kaiser Family Foundation study?

Is it any wonder then that Tennessee is one of the unhealthiest states in the nation? We rank lower than national average for adult diabetes, poor mental health days, obese adults and low birth-weight babies, according to data provided by the Sycamore Institute.

Some of our lawmakers pushing the block grant bill justify it by saying they want "more flexibility" in designing state health care programs, which could mean they want to delete required coverages like, say, birth control or pre-existing conditions.

But the Trump Administration has already made clear that it is completely open to giving states with waivers more flexibility in designing their Medicaid programs than ever before in Medicaid's 53-year history, according to health care policy experts like the Tennessee Justice Center. So why are our lawmakers not doing their homework?

This bill is a solution to an non-existent problem. The state can get flexibility without subjecting the state budget to the enormous financial risk that comes with a cap on federal funding. And still cover children.

Bottom line: We don't tax much (we have no state income tax and we're phasing out estate and investment taxes) and our economy grew like gangbusters, but what did we do? We cut off the health care for 130,000 Tennessee kids in a state where we already spend next to dead last for health care.

TennCare officials have said the disenrollments came after years of significant TennCare growth, and the children were dropped because they no longer qualified, according to reports from the Tennessean. But the newspaper also reported TennCare officials said "many members" were disenrolled because they didn't respond to the required renewal forms that cannot be forwarded to new addresses.

This week, Chattanooga Mayor Andy Berke sent a letter to Gov. Bill Lee, Speaker Glen Casada and Lt. Gov. Randy McNally asking them to stop disenrolling kids from TennCare until the signup renewal process is reformed. He also wants to prioritize coverage for qualifying families and to begin TennCare oversight hearings in the General Assembly.

"Once we have made sure that kids in our state can receive quality medical care for themselves, we need to get to the bottom of what happened," Berke told the Times Free Press. "Oversight is a big piece of how we find out what improvements need to be made. Gov. Lee didn't cause this but we know that these serious problems are there. The Legislature can use its powers to expose that and make sure we can fix it."

Yes, it could. But right now it seems more intent on making Tennessee's health care worse and capping federal dollars that pay for it.

Michele Johnson, the Justice Center's executive director, praised Berke's leadership and his effort to rally other city and state leaders.

"This was all on the strength of Mayor Berke's idea, moral clarity and ambitious dreams for the children of his city," she said. "This is what leadership looks like."

Let's hope the Tennessee Senate pays attention.

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