By Tony Garr

We are facing tough times. We’ve faced them before and pulled our neighbors and ourselves through by making people a priority. This is what the state needs to do now.

More than a quarter million Tennesseans have lost their jobs and their health insurance since the recession began. It is estimated that more than a million Tennesseans are uninsured and have few options for changing that in the near future. Yet, the state seems determined to continue to whittle away at public health programs that combine to serve as the medical safety net. It’s time to get our priorities straight.

Times are tough in each state, yet Tennessee is the only state to cease enrollment in the Children Health Insurance Program, which we call CoverKids and is viewed as a good program by policymakers from both the Right and Left. Forty-nine other governors understand that this is not time to be blocking health care coverage for children of low- to moderate-income working families. Tens of thousands of Tennessee children are eligible for CoverKids and Tennessee gets three federal dollars for each state dollar it invests in the program, so closing it to enrollment is simply penny-wise, pound foolish.

The state has promised since 2005 to reopen the Medically Needy (aka Spend Down) TennCare program. This program is designed as a bridge, like COBRA, for eligible children, elderly, caregivers and those with disabilities to get a year of TennCare after they spend a significant portion of income toward medical bills; thus, they “spend down” to eligibility. It’s estimated that this program would help about 100,000 Tennesseans facing medical debt and lacking coverage.

Also, the state must not continue viewing county jails as part of the mental health safety net. Cuts to state mental health programs passes a huge burden onto local governments, which have neither the financial nor medical means to deal with the complexities of mental health services. State cuts to mental health result in a system that is throw-back from a century ago, with people with mental health challenges being locked up rather than receiving the compassionate and effective care we have come to know as a basic human right.

Tennessee has a $400 million TennCare Reserve and $700 million Rainy Day Fund. For too many years the state has siphoned the TennCare Reserve to shore up other areas of the state budget while losing out on the 2-to-1 federal match. This year the state must get its priorities straight and use monies designated for TennCare to reopen the Medically Needy category which the administration has been promising to do this since 2005.

It has been raining on Tennessee’s working poor for a long time, now is the time to provide families and individuals with some shelter from rain. Let’s invest some of the Rainy Day fund into the medical safety net to help communities with physical and mental health services.

A state budget, like any budget, is about priorities. This year, let’s make vulnerable Tennesseans a priority. The good news is that, despite tough times, we have a TennCare Reserve and a Rainy Day Fund, both designed to be there to meet human need in tough times. So, let’s do the wise and decent thing and use them for their intended purposes.
Garr is executive director of the Tennessee Health Care Campaign.
Copyright (C) 2010 by the Tennessee Editorial Forum. 1/10