What if someone offered you $20 billion?

What if, by taking that money, you could help 350,000 Tennesseeans who desperately need it–and, by extension, everyone else in Tennessee? Would you turn that money down?

Since 2014, the state of Tennessee has turned down around $20 billion in federal funds it could have used to get health insurance to hundreds of thousands of Tennesseans.

These aren’t people living off government benefits. They’re working people who fall into the health insurance “donut hole”: they’re too young for Medicare, they make too much money to qualify for Medicaid (TennCare,) they don’t get health insurance through their employer, and they can’t afford traditional health insurance.

As a result, we have a whole lot of hardworking Tennesseans who are one medical crisis away from financial disaster. Here’s what that looks like. It’s the story of a Tennessee family I’ve known most of my life.

This family owned a small business for about a dozen years. They didn’t make a lot of money, but they made enough to buy a modest home. The dad worked late hours and loved being the face of the business. The mom worked behind the scenes and stayed home with their young kids.

Then the dad had a medical crisis. He needed major surgery and spent months off the job. Friends and neighbors did what they could to pitch in—delivering meals, cutting the grass—but they couldn’t help with the doctor and hospital bills.

This Tennessee family recovered from his medical crisis, but they never recovered from medical debt.

They lost their business. They filed for bankruptcy and lost their house, their equity, and their credit. They never bought another home, never rebuilt the “generational wealth” that could have given their kids a smoother path to adulthood. There was collateral damage that I won’t go into. It’s not my story to share in such a personal way.

And really, I don’t have to—because this isn’t an unusual story in Tennessee. We all know some version of it. Maybe you’ve lived it yourself.

The crazy thing is, there’s a solution on the table: Medicaid expansion. Our state could accept $2 billion a year to get more people covered by TennCare (our version of Medicaid). If we accepted that federal money, and kicked in a little state money, we could insure hundreds of thousands of Tennesseans. It’s an economic no-brainer. We’d come out ahead without so many uninsured people using the ER for primary care, not getting preventive health care, putting off important medical treatment because they can’t afford it, and defaulting on their medical bills. 

Tennessee is one of just 10 states—mostly southern, all Republican led—that have refused to expand Medicaid. This is part of a pattern among Tennessee’s Republican state leaders of acting against the interest of the people they’re supposed to represent.

What motivates them? I have a theory. I’ll tackle that in my next post.

Allison
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