This weekend, there were two stories about healthcare in Tennessee. In The Tennessean, there's a story about how our local homeless healthcare clinics are in danger of losing their funding because we haven't expanded Medicaid.
Gov. Bill Haslam wants to use federal funds for Medicaid expansion in a manner modeled after private health insurance that would curb the volume of usage. He has not yet worked out an agreement with the U.S. Department of Health and Human Services or the state legislature for what he has referred to as the “Tennessee plan.”
Without a guaranteed revenue stream, community health centers in states such as Tennessee face the prospect of cutting staff and curbing operations — undoing all their ramp-up preparations for the Affordable Care Act.
“There is a possibility that up to 70 percent of what has been built will disappear and that we will see layoffs and closings and major reductions in the capacity of the system to serve people,” said John N. Lozier, executive director of the National Health Care for the Homeless Council.
Let's be clear. There is no "Tennessee plan." It's the name for Haslam's wish that there was some way of appeasing the Feds and state-level Republicans. But a wish is not a plan.
But it's not just the "Tennessee plan" that relies on us all just agreeing to pretend that things are other than how they actually are. Check out this story from the Times-Free Press:
The blue card explained that she — and anyone else applying for TennCare — must apply online through HealthCare.gov, the federal insurance website as of Jan. 1.
But until state contractors finish a new TennCare application website, Tennesseans can apply for Medicaid only through HealthCare.gov — the federal site that has only recently begun to recover from its disastrous rollout.
Let this sink in. You can't apply for TennCare on paper anymore. You have to use HealthCare.gov, even though Healthcare.gov is supposed to be so terrible that Tennessee Republicans are trying to protect Tennesseans from having to use it. Not to mention that poor people need TennCare and poor people are the least likely people in the state to have internet access. (For a fascinating look at all the places in the state where there just isn't broadband access, check out this map from Connected TN.) And yet, this is being sold as being more convenient. Again, from the TFP story:
"Before, you had to write up a paper application or travel to DHS and apply in person," said TennCare spokeswoman Kelly Gunderson. "This is a much more convenient process, where you are able to submit your information online."
Online from where, though? If you have to travel into town to get on the internet — say at the library — is that really an improvement over applying in person?
Sometimes, I really feel like the people running our state have no idea how the people who need social services in our state live. Just because you and everyone you know have reliable internet access doesn't mean everyone in Tennessee does. Just because you and your friends have easy access to doctors whenever you "really" need it doesn't mean that everyone in the state does. And just because you and your friends think Obamacare is so terrible doesn't mean that people don't want something—anything, even a sucky thing—so that they can go see a doctor.
If Haslam can act like wishing counts, then I will, too. And I wish, sincerely, that our state leaders would spend some time with the people in our state who need healthcare.