Medicaid Expansion in Tennessee: Saving Money and Saving Lives

September 5, 2013 by  
Filed under Healthcare, Recent Blog Posts

Daniel Horwitz Head ShotBy Daniel Horwitz

In deciding whether or not to expand Medicaid coverage here in Tennessee, Governor Haslam faces a simple choice: accept $10.5 billion in Federal funds over the next six years to provide health insurance for an additional 331,000 Tennesseans, or continue to force our poorest neighbors to get their healthcare in emergency rooms. This decision, of course, is not a difficult one. Expanding Medicaid coverage in Tennessee would not only save Tennessee taxpayers a great deal of money— it will also save our fellow citizens’ lives.

While budget-crunching is frequently tedious, the important numbers to remember are as follows: Until 2016, 100% of the costs of expanding Medicaid coverage in Tennessee would come out of the Federal budget. After that, the Federal government will pay for 95% of expanded coverage in 2017, 94% of coverage in 2018, and 93% in 2019. Beginning in 2020 and beyond, the Federal government will then kick in 90 cents of every dollar for expanded coverage. If accepted by Governor Haslam, these Federal grants are expected to make Tennesseans $10.5 billion healthier by the end of the decade, and would also create an estimated 18,000 new jobs for our state. As most thinking people have realized at this point – including several ultra-conservative GOP governors like Jan Brewer, Rick Scott, John Kasich, Rick Snyder and Chris Christie – with Federal matching rates this generous, “any governor who rejects the Medicaid expansion is committing fiscal malpractice.”

In total, expanding Medicaid coverage in Tennessee will result in an estimated 331,000 new Medicaid enrollees by 2020. While numbers like this can seem inconsequential in the abstract, for these 331,000 people, expanded coverage can literally mean the difference between life and death. Although it’s true that the uninsured can usually get treatment in emergency rooms (the most expensive and least effective care available), as Tennessee’s own Dr. Bill Frist has bluntly explained: “Patients without health insurance die sooner.” And for that reason alone, notes Arizona Governor Jan Brewer, “[expanding Medicaid coverage is] not only a mathematical issue. It’s a moral issue.” A super-majority of Tennesseans agree, and it’s shameful that Governor Haslam doesn’t feel the same way.

Because Medicaid allows the uninsured poor to access regular preventive healthcare that keeps them at work and out of hospitals, expanding Medicaid coverage will also lower the cost of healthcare for the rest of us. As a result, even those who don’t believe that the poor have a moral right to health care should support expanding Medicaid coverage in Tennessee. Put simply: given both the dollars and the lives that would be saved by a decision to accept Federal Medicaid funds, expanding Medicaid coverage is really just common sense.

If you, too, think that Governor Haslam should put partisan politics aside and make the right choice for Tennesseans, please take the time to call the Governor at (615) 741-2001 and tell him to accept the Federal dollars to expand Medicaid.

Daniel Horwitz is a Nashville resident and recent graduate of Vanderbilt Law School.


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