Congress is considering a law that will cut federal Medicaid payments to Tennessee by an average of $500 million a year. It will have devastating effects on small towns and rural communities, where Medicaid is the principal source of coverage for families and children. Small town hospitals and nursing homes, and rural clinics are very dependent on Medicaid, and many will be forced to close.
The proposed law, known as the American Health Care Act, treats Tennessee very unfairly in comparison to other states. Medicaid patients receive substantially less in federal funding for their care if they live in Tennessee than they would if they lived in, for example, Mississippi or Arkansas. Tennessee’s Medicaid program, known as TennCare, ranks behind 46 other states in the amount it spends on children with severe disabilities. Federal Medicaid spending for Tennessee’ frail elderly is a fraction of the federal support for senior care in other states.
The AHCA would make these inequities permanent by basing future federal support on 2016 funding levels. It will shift an ever-increasing share of Medicaid’s costs to state taxpayers. Obviously, a state like Tennessee, that gets less federal support to begin with, will be hit much harder.
Medicaid covers over half of pregnant mothers and babies in Tennessee. Tennessee’s neonatal intensive care units are majorly funded by Medicaid, which benefit mothers and babies born even if they’re not enrolled in Medicaid. Medicaid also covers over half of all Tennessee kids and is the single most important payer for services for children with severe health care needs. Medicaid covers a quarter million Tennesseans with disabling illnesses. In addition, Medicaid pays for 61% of nursing home care in Tennessee. And it is the largest single payer for mental health and addiction services, a crucial role in Tennessee where the opioid and meth addiction epidemics are among the worst in the nation. In all its varied roles, Medicaid is especially important in rural Tennessee, where it is the principal source of coverage for families and children.
Congress proposes to cut $834 billion from Medicaid over the next several years. Our elected officials must understand what that would mean for Tennessee, and must ensure that Congressional actions do not harm rural Tennesseans’ health.
The impact goes beyond health care. Hospitals are among the largest employers. When a hospital closes, the county hemorrhages jobs. Without a hospital, it’s hard to recruit new industry. Young people move away. Communities wither, a cherished way of life fades.
Congressional leaders say the bill will give states more flexibility in administering Medicaid. But President Trump’s first executive order already gives the states the flexibility they need. Tennesseans shouldn’t face increased taxes just to gain flexibility it has already received from the President. Our Senators and Representatives should amend the AHCA so that Tennesseans get our fair share.
Who benefits? According to the nonpartisan Congressional Budget Office, the AHCA will benefit the very wealthiest taxpayers, who generally live in the cities and suburbs. As the conservative business magazine Forbes summarizes the AHCA, it “will result in a huge tax cut for the rich, 24 million without insurance.”
Tennessee stands to lose a lot. We already lead the country in the rate of rural hospital closings. The AHCA will cut Medicaid funding for addiction treatment services that are already inadequate to deal with the state’s opioid epidemic. The bill will cost thousands of jobs, and Tennessee’s small towns are already finding that the lack of local health care makes it difficult for to recruit new employers.
The National Rural Health Association has called on the Senate to reject the House bill. Congress needs to get its priorities straight and protect rural America. It’s time for Congress to enact real health reform.
Please, Congress, don’t rush health reform. Rural Tennessee is depending on you to get it right and protect the programs, such as Medicaid, that are vital to our communities.