Sohn: Tennesseans are mired in medical debt

Sohn: Tennesseans are mired in medical debt

May 12th, 2019 by Pam Sohn in Opinion Times

A nurse gives a patient a shot. One in four Tennesseans have medical debt that hurts their credit report. (AP Photo/Jacquelyn Martin)

Photo by Contributed Photo /Times Free Press.

It seems a sad irony that in one of the states where Donald Trump has some of his strongest support — in part because he's mistakenly admired for his supposed good business sense — one in four Tennesseans had medical debts that hurt their credit history in 2016.

In fact, Tennessee has the 10th highest rate of medical debt in the country. The median amount of medical debt on Tennesseans' credit reports was $739. Hamilton County's number is higher still: 29% had medical debt in collections on their credit reports, with a median amount of medical debt of $769. Nationally, the rate is about 18%.

The research into Tennesseans' medical debt was performed by the Sycamore Institute, an independent, nonpartisan public policy research center for Tennessee, and funded by the Annie E. Casey Foundation.

That research also found, unsurprisingly, that while medical debt is common across most demographic and socioeconomic groups in Tennessee, it is more common among the uninsured, those with lower incomes or education levels and people of color.

Why does it matter?

Because despite the bravado of our president who says he's with the little guy even as he pushes tax breaks for the extremely wealthy and refuses to talk about his own taxes, we live in a time when 40% of all other American adults say they would have trouble covering an unexpected $400 expense.

That means medical bills don't have to be huge to create additional financial hardships. And a bad credit report can reduce access to jobs and refinancing credit — the very things that can help people pay down debt and build better financial security.

A 2015 National Financial Capability Study found that a person with medical debt is more likely to have credit card debt, student loans, car loans, mortgages and payday loans. In fact, the study found that 51% of Tennesseans with unpaid medical bills (vs. 23% without) reported taking a payday loan in the last five years.

Here's another stinger: Having insurance is not guaranteed to help. Almost every employer-sponsored insurance plan in Tennessee now requires a deductible, and the average family plan deductible has nearly tripled — to about $4,000 — since 2002.

And it isn't just national politicians who seem determined to kick people fighting to keep their finances in the black.

Earlier this month, a new conservative study from the American Legislative Exchange Council ranked Tennessee as one of the top states for its economic outlook. But that same week, we learned that over the past two years, the state had been dropping health insurance coverage for about 130,000 low-income children enrolled in TennCare or CoverKids, including 5,500 in Hamilton County. Chattanooga Mayor Andy Berke has called for legislative oversight to stop the purge.

The price of health care can't really be budgeted the way a car payment can. When patients go to the doctor or parents take their children to the emergency room, they often don't know the price of medical care before it is provided to them.

Worse still, they can get trapped between providers and insurers.

One study found health marketplace insurers in Tennessee denied between 8% and 23% of claims by in-network providers in 2017. That could be because providers didn't properly bill the insurers or used incorrect billing codes. Or perhaps the insurer disagreed with the provider about whether the service was medically necessary.

Still, patients are often asked to pay the disputed bills, even while insurers and providers try to negotiate the dispute. If they don't pay during that time, the debt often is turned over to collections.

Rather than pass consumer-helping health care legislation, our state lawmakers sent a bill to the governor that will in effect cap the amount of federal dollars, $7.5 billion currently, that pays for two thirds of state-provided health care.

Under Tennessee's current Medicaid and TennCare waiver with Washington, if the state's costs increase — for whatever reason — more enrollees, natural disaster injuries, pandemics, whatever — the federal government share will accordingly increase. But Republicans in government — state and federal — have long been so eager to undo anything in health care that might ever have been touched by "Obamacare" that they have practically chanted block grant, block grant, block grant. Thus Tennessee has now directed our governor to ask for federal permission to use a block grant, which will let the federal government off the hook for its guarantee of a continuing 2-1 match.

Tennessee has the seventh-fastest growing economy of any U.S. state, but we're ranked 41st worst in WalletHub's "best health care systems" list. Add to that: In a 2014 Kaiser Family Foundation study Tennessee was found to make the 13th lowest health care expenditure. And now we learn that we have a higher than national average number of Tennesseans whose medical debt is hurting their credit.

Go figure. Is it any wonder that Tennessee is one of the unhealthiest states in the nation, with more adult diabetes, poor mental health days, obese adults and low birth-weight babies?

Getting Started/Comments Policy

Getting started

  1. 1. If you frequently comment on news websites then you may already have a Disqus account. If so, click the "Login" button at the top right of the comment widget and choose whether you'd rather log in with Facebook, Twitter, Google, or a Disqus account.
  2. 2. If you've forgotten your password, Disqus will email you a link that will allow you to create a new one. Easy!
  3. 3. If you're not a member yet, Disqus will go ahead and register you. It's seamless and takes about 10 seconds.
  4. 4. To register, either go through the login process or just click in the box that says "join the discussion," type your comment, and either choose a social media platform to log you in or create a Disqus account with your email address.
  5. 5. If you use Twitter, Facebook or Google to log in, you will need to stay logged into that platform in order to comment. If you create a Disqus account instead, you'll need to remember your Disqus password. Either way, you can change your display name if you'd rather not show off your real name.
  6. 6. Don't be a huge jerk or do anything illegal, and you'll be fine.

Chattanooga Times Free Press Comments Policy

The Chattanooga Times Free Press web sites include interactive areas in which users can express opinions and share ideas and information. We cannot and do not monitor all of the material submitted to the website. Additionally, we do not control, and are not responsible for, content submitted by users. By using the web sites, you may be exposed to content that you may find offensive, indecent, inaccurate, misleading, or otherwise objectionable. You agree that you must evaluate, and bear all risks associated with, the use of the Times Free Press web sites and any content on the Times Free Press web sites, including, but not limited to, whether you should rely on such content. Notwithstanding the foregoing, you acknowledge that we shall have the right (but not the obligation) to review any content that you have submitted to the Times Free Press, and to reject, delete, disable, or remove any content that we determine, in our sole discretion, (a) does not comply with the terms and conditions of this agreement; (b) might violate any law, infringe upon the rights of third parties, or subject us to liability for any reason; or (c) might adversely affect our public image, reputation or goodwill. Moreover, we reserve the right to reject, delete, disable, or remove any content at any time, for the reasons set forth above, for any other reason, or for no reason. If you believe that any content on any of the Times Free Press websites infringes upon any copyrights that you own, please contact us pursuant to the procedures outlined in the Digital Millennium Copyright Act (Title 17 U.S.C. § 512) at the following address:

Copyright Agent
The Chattanooga Times Free Press
400 East 11th Street
Chattanooga, TN 37403
Phone: 423-757-6315