By Tony Garr

We’re in a pretty tough economic time. We’ve seen this before and have pulled our neighbors and ourselves through by using our good sense and decency.

But, help me understand this:

More than a quarter million Tennesseans have lost their jobs and their health insurance since the recession started in December 2007. Before then, there were 850,000 uninsured Tennesseans. In May 140,000, TennCare enrollees began receiving notice that their TennCare would be ending. By the end of September, as few as 20,000 will retain their eligibility. In February of this year, Tennessee got good news when it learned that it was getting an additional $1.1 billion for its TennCare program to help people stay enrolled, keeping Tennesseans secure in these insecure economic times.

Stay with me, I have some more puzzling information.

The state closed the Medically Needy TennCare program for adults in May 2005, promising to re-open it soon. Now May 2009 has passed, and it‘s still shut tight. In 2005 the program was frozen, closed to new enrollees, leaving 97,000 enrolled. In 2007, the state changed the eligibility rules, allowing people to count only medical bills that they owe that are only three months old, not older medical bills. As a result, when TennCare conducted an eligibility determination in 2008, less than 1,000 people remained eligible. Now the governor proposes to keep the program closed. Does the governor think that because he’s shut the door on these folks they no longer exist—that Tennesseans aren’t hurting like other Americans; therefore, there is no need to re-open this program?

Now, for the tough part: tricky political math. State funds, not federal, proposed for the TennCare budget for fiscal year 2010 are less than they were for fiscal year, 2009, yet TennCare will actually cover fewer people and receive over $300 million additional federal dollars for fiscal year 2009, over $500 million for fiscal year 2010, and over $200 million for fiscal year 2011.

Of course, the state needs to balance its budget, but, it can do so without sacrificing some of its citizens who are in the economic abyss. So should it be okay for the state, the place for service of last resort for the most vulnerable of its citizens, to shrug its shoulder, turn away, and just say, “You are on your own. Good luck!”?

There are thousands of struggling families and now is the time--not during good times, but during bad times--when folks really need help. And there is no good reason for the state not to help. There is an existing program and more than enough existing funds reserved for health care to help Tennessee families.

Now is the time to re-open the TennCare Medically Needy program. This is a no-brainer. It will help thousands of eligible Tennesseans obtain medical coverage. It will do it with less state money and more federal money, and it will not obligate the state for future coverage beyond 2011 when the stimulus money runs out.

Here’s how it works:

• Tennessee will get three federal dollars for each state dollar under the stimulus package. It used to get only two federal dollars; • People who qualify can only get coverage for one year. This is like a bridge, like COBRA. For this reason, one-time money is what is needed. No problem here because TennCare has a reserve of about $500 million dollars and the state has a rainy day fund of 750 million; • It will only help people who have low incomes and who are either disabled, elderly, or the caregivers of children under the age of 21. By opening this program, it will not help everyone, but it will help thousands of very vulnerable Tennesseans.

It all adds up to priorities. Are working, low-income folks worth it? Or are they somehow undeserving because they have nothing to give to a re-election campaign?

Do state legislators care? Do Tennesseans care? In these tough times, are we still the decent people we say we are? I believe we are.
Garr is executive director of the Tennessee Health Care Campaign.
Copyright (C) 2009 by the Tennessee Editorial Forum. 6/09