Refusal to expand Medicaid in Tennessee is a moral failure | Opinion

Ten years ago Tennessee’s then governor, Bill Haslam, wrestled with President Barack Obama’s Affordable Care Act and its proposal for the expansion of Medicaid, (TennCare in Tennessee), providing coverage to the working poor.

At that time 27 states plus Washington, D.C., had approved expansion and 21 states had announced they would not expand Medicaid.

Critically, and in a possibly unconstitutional usurpation of executive authority, in the 2014 legislative session the Tennessee House and Senate passed a bill requiring legislative approval by joint resolution before the governor could negotiate any type of expansion with the Obama administration. Interestingly, both the Senate primary sponsor and the House primary sponsor of that bill have since left the legislature on less-than-honorable conditions, one with a federal conviction, the other being expelled from the House.

Haslam was unable to convince the legislature to move on the issue before he left office. Our current governor, Bill Lee, recently elected to his second term, indicated as early as his primary election in 2018 that he was not in favor of an expansion. Instead he signed a short-sighted block grant law, which, rightfully so, is dead in its tracks.

Opposition legislators voiced many reasons for their non-support of expansion through the years. These reasons have proven to be false, with one exception, as voiced by Americans for Prosperity Tennessee State Director Andy Ogles.

When the bill was passed prohibiting expansion without the legislature’s consent, Ogles said, “Obama’s policies have eliminated jobs across the country, driven down wages, and served as a hindrance to our nation’s economy. Today Tennessee took a stand against Obama’s failed policies and over-bearing federal mandates.”

Ogles is the newly elected U.S. congressional representative for Tennessee’s 5th District. Frankly, the connection of expansion to former President Obama appears the only reason the legislature and ultimately the governor continue to ignore the voices supporting expansion.

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There is no moral, medical or monetary reason not to expand TennCare. Since 2014, Tennessee has forfeited more than $20 billion dollars, a portion of which were taxes paid by Tennesseans. If expanded, 300,000 uninsured people would receive health care and hospital closures would be reduced, especially in rural areas. In addition, care for people with mental illness and substance abuse, including the attendant use of dangerous fentanyl, a reduction of uncompensated care expenses, thousands of new jobs, increased access to all types of medical care and better long-term health outcomes would follow.

It is important to note that since 2014, other states have expanded Medicaid, leaving only 11 states not doing so.

Four of the eight states surrounding Tennessee have expanded and there are serious discussions in two other states. Mississippi, in spite of a ballot initiative that its state Supreme Court declared unlawful, and at least one of the candidates in this year’s gubernatorial race are making Medicaid expansion an issue. In North Carolina, the president pro temp of the state Senate switched his long-held opposition to support expansion. Predictions from both states say expansion may happen within two years. And in Tennessee, where the losses for our state continue to rise because of non-expansion, the prospective benefits continue to increase as well.

Estimates based on actual statistics in expanded states clearly show Tennessee would have the same or better results, especially because of our ranking in areas such as rural hospital closures, number of uninsured citizens, infant and maternal care, and poverty.

Meanwhile, as the Tennessee General Assembly begins its annual session, a bill to reduce the number of elected representatives on the Metro Nashville Council, possibly in retaliation for the council turning down a chance to host the next Republican National Convention, sailed through its first House committee. A bill banning gender-transition health care for minors in Tennessee passed on Feb. 13. At the same time, nearly 300,000 Tennesseans who were enrolled in TennCare during the COVID-19 pandemic are projected to be removed from the rolls beginning this April.

It is way past time for our legislature to get over its problems with "Obamacare" and the governor to put an immediate stop to this 10-year moral failure, one of the worst in Tennessee history. Medicaid's longtime success and popularity make a wise and fiscally responsible choice for Tennessee to expand its this legislative session.

Craig Fitzhugh is the mayor of Ripley, Tennessee, served 24 years in the Tennessee House of Representatives and has been a vocal proponent of Medicaid expansion in Tennessee since its inception.

This article originally appeared on Nashville Tennessean: Opinion: Refusal to expand Medicaid in Tennessee is a moral failure