TN Republicans Reject Protections for Pre-Existing Conditions, Rural Hospitals, Seniors in Nursing Homes

House Republicans have rejected four measures that would increase health care security for families enrolled in the state Medicaid program known as TennCare.

The measures, introduced by Democratic members of the House Insurance Committee, would have amended HB1280, a bill that directs the governor to apply for a Medicaid block grant from the federal government.

It would be the first such waiver of its kind in U.S. history. (Click here to learn how a Medicaid block grant could cost Tennessee $1 billion in federal funding by 2027.)

GOP Defeats Four Amendments

Protect coverage for pre-existing conditions: House Amendment 5080, presented by Rep. Darren Jernigan, D-Old Hickory, District 60, would ensure that Tennesseans with pre-existing conditions would still receive coverage if the block grant was approved.

Republicans voted it down.

Protect rural hospitals: House Amendment 5004a, presented by Rep. Dwayne Thompson, D-Cordova, District 96, would have ensured rural hospitals received due consideration in negotiations with federal Medicaid officials.

Republicans voted it down.

Expand TennCare coverage to working poor: House Amendment 5165, presented by Rep. Larry Miller, D-Memphis, District 88, would expand negotiations to include TennCare health insurance for working families in Tennessee, whose incomes are below 138 percent of poverty line. Generally speaking, these are the Tennesseans who would gain health coverage through Medicaid expansion—a measure supported by 66 percent of Tennesseans.

Republicans voted it down.

Protect nursing home coverage for elderly Tennesseans: House Amendment 5212, presented by Rep. Jason Hodges, D-Clarksville, District 67, said his measure would protect Medicaid coverage for elderly Tennesseans who live in nursing homes. More than six out of 10 nursing home residents in Tennessee are Medicaid recipients. The legislation “doesn’t guarantee we’re protecting our elderly,” Hodges said.

Republicans voted it down.

In questioning the bill sponsor, Rep. Jernigan said one of the chief concerns of a Medicaid block grant system is funding unexpected coverage increases if circumstances change, for instance, a surge in eligibility surge during an economic downturn. “Would we have to use state dollars at that point to make it up?” Jernigan said.

The bill sponsor Rep. Timothy Hill, R-Blountville, District 3, said, “the concern you’re bringing is a classic concern and a valid concern.” But rather than building guidelines for Tennessee’s negotiators, Hill said, it should be addressed during negotiations.

As of January 2019, there were nearly 32,000 TennCare enrollees in Sullivan County, where Rep. Hill lives. Holler at him HERE.

As a reminder, Block Grants would actually mean cuts to TennCare, don’t do anything about covering uninsured Tennesseans or saving rural hospitals, and are currently illegal and opposed by Children’s hospitals.

Here’s more on WHY. Meanwhile we lose $4 Million every day we don’t expand medicaid.

You can watch the full House Insurance Committee meeting here.

How they voted:
House Insurance Committee, March 5; Voice Vote, Ayes prevail:
Rep. Ron Travis, R-Dayton, District 31
Rep. Mark Hall, R-Cleveland, District 24
Rep. Scott Cepicky, R-Culleoka, District 64
Rep. Ron Gant, R-Rossville, District 94
Rep. Johnny Garrett, R-Goodlettsville, District 45
Rep. Timothy Hill, R-Blountville, District 3
Rep. Matthew Hill, R-Jonesborough, District 7
Rep. Justin Lafferty, R-Knoxville, District 89
Rep. Dennis Powers, R-Jacksboro, District 36*
Rep. Tim Rudd, R-Murfreesboro, District 34
Rep. Cameron Sexton, R-Crossville, District 25*
Rep. Robin Smith, R-Hixson, District 26
Rep. Mike Sparks, R-Smyrna, District 49
Rep. Bryan Terry, R-Murfreesboro, District 48
Rep. Jason Zachary, R-Knoxville, District 14

Voting No:
Rep. Jason Hodges, D-Clarksville, District 67
Rep. Darren Jernigan, D-Old Hickory, District 60
Rep. Larry Miller, D-Memphis, District 88
Rep. Dwayne Thompson, D-Cordova, District 96

Bill Sponsors:
Rep. Timothy Hill, R-Blountville, District 3
Speaker Glen Casada, R-Franklin, District 63
Rep. Matthew Hill, R-Jonesborough, District 7
Rep. Ron Gant, R-Rossville, District 94
Rep. Clay Doggett, R-Pulaski, District 70
Rep. Jason Zachary, R-Knoxville, District 14
Rep. Dan Howell, R-Cleveland, District 22
Rep. Bruce Griffey, R-Paris, District 75
Rep. Paul Sherrell, R-Sparta, District 43
Rep. David Byrd, R-Waynesboro, District 71
Rep. Chris Todd, R-Jackson, District 73
Rep. Scott Cepicky, R-Culleoka, District 64
Rep. John Crawford, R-Kingsport, District 1
Rep. Rush Bricken, R-Tullahoma, District 47
Rep. Mike Carter, R-Ooltewah, District 29
Rep. Bryan Terry, R-Murfreesboro, District 48
Rep. Robin Smith, R-Hixson, District 26
Rep. Michael Curcio, R-Dickson, District 69
Rep. Dale Carr, R-Sevierville, District 12
Rep. Andrew Farmer, R-Sevierville, District 17
Rep. Jay Reedy, R-Erin, District 74
Rep. James “Micah” Van Huss, R-Gray, District 6
Rep. Clark Boyd, R-Lebanon, District 46
Rep. Bud Hulsey, R-Kingsport, District 2
Rep. Iris Rudder, R-Winchester, District 39
Rep. Debra Moody, R-Covington, District 81
Rep. Andy Holt, R-Dresden, District 76
Rep. John Ragan, R-Oak Ridge, District 33
Rep. Cameron Sexton, R-Crossville, District 25

VIDEO: Survivor Speaks Out At Williamson Town Hall, Casada A No-Show

This morning in Williamson County at a Town Hall event Speaker Casada was billed to be attending, Casada was a no-show.

The rest of the Williamson delegation – Senator Jack Johnson, Rep. Sam Whitson, and Rep. Brandon Ogles -were all there, as were some CNN cameras, but Casada was nowhere to be found.

Had he been there he would’ve been confronted by survivor Ashley Massey of Lawrence County, who bravely spoke up anyway about Casada’s support for David Byrd, who can be heard admitting on tape to sexual abuse with his former high school basketball players.

Here’s the video:


Sam Whitson got up and left, and Brandon Ogles attempted to perpetuate the false notion that anything in the Casada video posted earlier this week was being taken “out of context”.

Please share the video on Twitter and Facebook, and if you have a problem with the way they reacted, holler at Sam Whitson HERE and Brandon Ogles HERE.

VAN HUSS ON HEARTBEAT BILL: “Incest Sometimes OK, Rape Sometimes Woman’s Fault”

Yesterday House Bill 77, the “heartbeat bill”, cleared the Public Health Subcommittee and has been referred to the Health Committee. The Senate version of the bill – SB1236, carried by Sen. Pody – was referred to the Senate Judiciary Committee last week.

Read more

Dems Meet Gov. Lee To Plead For Medicaid Expansion – Children’s Hospitals Against GOP Block Grant Idea

This week a group of Democratic state representatives met with Governor Lee to implore him to reconsider his stance against expanding Medicaid in Tennessee, as most states already have.

Studies show the states that have expanded Medicaid have seen better health results, economic benefits, and fewer rural hospital closures.

Tennessee is losing $26 Billion over 10 years by not accepting billions in federal Medicaid expansion dollars that would cover hundreds of thousands of Tennesseans, including 30,000 veterans, and as a result currently leads the country in rural hospital closures per capita. The 13th rural Tennessee hospital just announced closure in Celina this week, and Democrats held an emotional press conference in the state capitol about it on Monday.

The group of Democrats calls itself the House Democratic Caucus Medicaid Expansion Task Force. They weren’t sure what kind of impact they had on Governor Lee, but said they’ll continue to try.

The general feeling was that the Williamson County-based governor doesn’t seem to understand how desperate for care some Tennesseans are, many of which don’t have another year or two left to wait for a new plan.

They did however say one thing Lee agreed with was preserving the provision of the Affordable Care Act that guarantees the protection of those with pre-existing conditions from discriminatory insurance company practices, which a Republican lawsuit in Texas seeks to undo.

From Rep. Gloria Johnson:

“We will try to continue the conversation, but it’s going to take the people rising up. The current Block Grant bill the Republicans have only takes current TennCare and turns it into block grants, probably serving fewer people than we even do now.”

The Block Grants proposal is something Tennessee Republicans are starting to push hard, with Senate leader Jack Johnson talking to the Tennessean about it this week.

Medicaid expansion is popular in Tennessee.

Block Granting Medicaid is not popular in America:

President Trump is trying to find a way to provide states like Tennessee with a block grant waiver, since they are currently illegal. Even if the president does manage to push that legislation through, it would instantly trigger lawsuits.

Meanwhile the details of the Tennessee Republicans’ Block Grants plan are “vague”, and nobody seems to be sure how it would solve the problem of covering MORE people who aren’t currently covered.

If anything the opposite would be true. The non-partisan Congressional Budget Office estimates recent Republican block grant proposals could cut Medicaid spending by as much as a third over the next decade. The cuts would start small, growing larger over the years.

Rep. Gloria Johnson also had this to say about Block Grants:

“Any waiver will instantly be challenged in court. This is not a good faith solution. This is folks who know they are getting hammered and want to appear as if they are doing something.”

It should also be noted that Children’s Hospitals, which rely heavily on Medicaid, are extremely against Block Grants, which they say would lead to cuts in coverage. Jim Kaufman, vice president of public policy for the Children’s Hospital Association, explained that proposals to simply block grant or shift costs to the states are the wrong way to go:

“Block grants cause cost-shifting that further burdens the financially strapped state budgets.  Instead, children’s hospitals want to improve access to care while reducing costs.”

And as Republican Senator John Chafee said in opposition to Medicaid block grants back in 1996:

“As states are forced to ration finite resources under a block grant, governors and legislators would be forced to choose among three very compelling groups of beneficiaries.

Who are they? Children, the elderly, and the disabled. They are the groups that primarily they would have to choose amongst. Unfortunately, I suspect that children would be the ones that would lose out.”

Just this week House Minority Leader Kevin McCarthy was heard on a phone call explaining to donors that health care issues like this are the reason Republicans got shellacked in November, and that the pre-existing conditions issue was a particular weakness.

Republicans claim to be the ones protecting the provision, but since they are also suing to undo the provision at the same time nobody seems to be buying it.

Even if you aren’t covered by Medicaid, you probably know someone who would be affected by block granting Medicaid.

To encourage Governor Lee to start listening, holler at him HERE.

FALSE ALARM: Lt. Gov. Mcnally Almost Backs Medicaid Expansion By Mistake

On the Tennessean’s Grand Divisions podcast with Joel Ebert and Natalie Allison this week, Tennessean writer Natalie Allison asked what bills will be most controversial this session, and after listing Medical Marijuana and school vouchers Lt. Gov. Randy Mcnally went on to mention Medicaid Expansion:

Mcnally told the Tennessean:

“On Medicaid Expansion… Senator Bailey is working on some different ideas to take and work with the governor on and try to get an amendment through that would address the population that’s below 138% of the poverty level. And address it on a sliding scale voucher type thing, health savings accounts, there’s a number of different options that we haven’t really fleshed out yet.”

“Under 138% of the poverty level” is where Medicaid expansion would draw the line. What Mcnally was talking about sure sounded a lot like Medicaid expansion. So Natalie Allison asked him about that:

“So will Republicans be pushing a bill to expand Medicaid in some instances, or…?”

Still sounding a bit confused, Mcnally went on:

“Well we’ll be I think looking at an effort to… a lot depends on what we think we can through CMS, but we’re looking at an effort to address the population that probably was most in need of insurance but was left out of health care… Our hope is it’s not expansion of Medicaid, it’s not Obamacare, and that’s – we’re just trying to take care of sick people that lack insurance mainly because they’re incomes are not at a rate that they can afford it.”

So it’s not Medicaid, or Obamacare, it just attempts to do the exact things Medicaid Expansion under Obamacare was trying to do… JUST FOR THE LOVE OF GOD DON’T CALL IT MEDICAID EXPANSION OR OBAMACARE.

This might be a good time to point out that Medicaid Expansion is popular in Tennessee.

Still confused because Mcnally was sounding pretty pro-Medicaid expansion, the Natalie Allison pressed further:

So… you’re saying it’s not Medicaid expansion?”

At this point Senator Jack Johnson swoops in, noticing Mcnally is flailing and maybe almost about to support something that would actually help a lot of people, which would be truly awful.

Sen. Johnson:

 “It absolutely is not… I want to be very clear about that, it’s not a proposal to expand medicaid. It’s a proposal to give us more flexibility with our existing medicaid dollars, ok? And if we’re given that flexibility we believe we can generate savings that will generate additional dollars with which we might be able to cover some additional people, or provide better services- better quality services. That’s one conversation and that needs to stay in its lane right there. Any conversation of drawing down additional federal dollars is a totally different conversation, ok? And I think maybe during some of this those two things have gotten interwoven.”

So if you’re one of the hundreds of thousands of Tennesseans without coverage, good news – maybe what they’re proposing might cover some other people if they can scrounge up some loose change somewhere, but as for the $26 Billion over 10 years the federal government wants to send us to cover you, that’s a still big NO THANK YOU — because who wants that?
They know they need to seem like they’re trying to help people get the care they need – but actually helping people would be a bridge too far.
Basically their block grant proposal is to take the money that is supposed to go towards health insurance for low-income people in a lump sum, and trust that the guys who up until now haven’t seemed to care that vulnerable Tennesseans can’t get the care they need will A) make sure it goes to the right place, and B) Be able to make those dollars go further somehow.
That’s some plan.
The Tennessean reporters then went on to commiserate about how confusing the whole thing was. Natalie Allison:
“All the reporters sitting there were pretty confused. We thought he was saying Republicans were going to launch a medicaid expansion effort this session. We eventually realized that wasn’t the case and went on to talk about the block grant program.”
She then pointed out that it remains to be seen how they would actually secure coverage for those currently in the coverage gap:
“When we asked them how they were going to pay for that, there isn’t really a clear answer… the bill itself is pretty vague.”
As Rep. John Ray Clemmons and Gloria Johnson say in the video below, the Republican-proposed block grants may not even be legal, won’t cover anyone new, and won’t help rural hospitals.
It doesn’t fix the problem.
It’s time to expand Medicaid like most of the country already has. It would help a lot of people, and pay for itself. Let the Republicans call it whatever they want, let’s just do it.
Holler at Governor Lee if you agree.

VIDEO: “Please Expand Medicaid, Governor Lee. People Are Dying.” – A Cry For Help As Another Rural Hospital Closes

This week we learned Clay County’s Cumberland River Hospital would be shutting its doors, making it the 13th rural Tennessee hospital to shutter since the Republican refusal to expand Medicaid took hold.

The numbers show rural hospital closures are far more common in states that refuse to expand Medicaid. Hospitals in Medicaid expansion states were 84 percent less likely to face hospital closures than their peers in non-expansion states, a new Health Affairs study shows.

As part of a #WeAreCelina Day of Action yesterday, in solidarity with Celina and Clay County, Democratic officials Rep. John Ray Clemmons, Rep. London Lamar, Rep. Mike Stewart, Rep, Gloria Johnson and Rep. Dwayne Thompson held a press conference at the capitol, where they were joined by Tennessee Democratic Party Chair Mary Mancini and cancer survivor/Medicaid recipient Kelly Gregory.

Gregory gave an emotional presentation, and all 5 Democratic reps called on Governor Lee and the Republicans to put politics aside and accept the federal dollars to expand Medicaid as the previous Republican Governor wanted to, pointing out that every year that goes by Tennessee loses billions of dollars – $26 Billion over a decade, in fact – and more people will die unnecessarily as hundreds of thousands of Tennesseans are left without health insurance.

Below is video from the press conference:

OPINION: “That is not infanticide. I know. I went through it.”

This week, before the racist images on his yearbook page came out, Virginia’s Governor Northam’s comments about a proposed late-term abortion bill caused a stir. 

Read more

CLAY COUNTY TO GOV. LEE: “HELP US!” – Hospital Closure Day of Action Planned for Monday

Last week yet another of Tennessee’s rural hospitals announced it would be closing its doors, bringing the total up to a dozen – the most per capita of any state in the country.

This time it’s Clay County’s Cumberland River Hospital falling on hard times.

Read more

STATE OF THE STATE: Unhealthy, Impoverished, Underfunded Ed, Low Pay… But Cheap!

Our friends at Think Tennessee have just put out their yearly breakdown of where Tennessee stacks up with the other states on important things like opioid prescriptions (49th), poverty (41st), education funding (45th), Adult diabetes (45th), infant mortality (47th), mental health providers (45th) life expectancy (44th), and much more.

Some people are doing very well in our state, but on the whole the news is really not very good. We’re unhealthy, there’s a lot of poverty, our education is underfunded, and the jobs – although we have them – don’t pay well.

We deeply appreciate that Think Tennessee does this, and have made a video out of what they’ve found. If you enjoy it, feel free to share on Twitter, Facebook, Youtube, or anywhere else you spend your time.

Meet Rep. Hodges: “TN Needs Medicaid Expansion, Medical Marijuana, Decent Pay“

This week The Holler had a chance to catch up with Jason Hodges, the Freshman TN State Representative out of Clarksville. Hodges is a veteran, a young husband and a dad who just recently beat out Tommy Vallejos for the seat Joe Pitts left behind to go run the city as mayor.

We asked Jason what he’s focused on as the legislative session gets going, and he rattled off some priorities:

“First of all, I think we really need to get some big ticket items like Medicaid Expansion and Medical Marijuana done. They’d lower the cost of health care, which is something both parties agree needs to happen.”

With yet another rural hospital announcing they’ll be closing their doors in Clay County this month, Medicaid expansion is at the top of the list for Democrats, and Hodges really hopes their Republican counterparts will finally see how much damage is being done.

“We’ve lost $6 Billion and counting because they don’t like Obama. I promise you, if Trump wanted to give us $6 Billion to take care of our people, or fix up our roads, we’d take it. People should come before politics. If you want to bring costs down, start there. We can do that tomorrow. “

With regard to Medical Marijuana, Hodges says it comes up in Clarksville often, where constituents would prefer to be treating their various ailments and mental health issues with MM rather than opioids and other more addictive medications.

“In many circumstances Medical Marijuana would further reduce cost when it comes to prescriptions. It can be a substitute for high-priced opiates and help reduce addiction. It’s just a cheaper, safer alternative, and we need to get it done. Every year that goes by where we don’t decriminalize it and make it available, more  Tennesseans suffer needlessly.”

Although Democrats are a super-minority in the legislature, as a group they support Medical Marijuana, and it seems more and more Republicans are starting to come their way. Hodges also points out the economic impact it would have, especially in rural Tennessee:

“I’d like to see us tie it to Tennessee farms. Let’s make it so that any marijuana sold in Tennessee has to be produced in Tennessee. It’ll help our rural economies, and give those communities and our farmers an alternative product to produce – while helping with the opioid crisis and the cost of medicine. It’s a win all around. We trust our doctors to prescribe opiates, which is what heroin comes from, but we don’t trust them to prescribe marijuana? Makes no sense.”

Hodges was also eager to talk about the voting rights bill he’s carrying, which would make it so that any state application you fill out would mean you’re automatically registered to vote.

“SNAP, the DMV… any state application you fill out you need the exact same paperwork as you do to get registered to vote. We should be making it easier on folks, not harder. Anyone who disagrees with that would appear not to be a huge fan of democracy.”

The subject then turned to economic incentives for companies coming to Tennessee, in light of Electrolux announcing they’d be closing their plant in Memphis and moving those jobs to Springfield. Hodges had this to say:

“Look, If we’re gonna subsidize a company to come to Tennessee we should make sure they’re paying a living wage. If they don’t, they should be fined, and the subsidy should be paid back. We can’t subsidize companies who don’t pay people enough to live just so those people then have to be subsidized by the government. That’s corporate welfare. If you want to come to Tennessee, great- you need to treat our people right.”

Seems pretty reasonable. Is he against incentives in general? A passionate Hodges insisted he wasn’t.

“No, I’m not against incentives as a concept. But if the taxpayers are on the hook let’s make sure what we’re getting is worthwhile. There are situations from a competitive standpoint where we have to subsidize to get a company to come here, but at the same time how are we going to pay a company who won’t pay a living wage – then turn around and blame people for mooching off the government? It kills me.”

Pretty sensible ideas. As Hodges gets more and more comfortable in his new role, we look forward to seeing what he can get done up there. Holler at him HERE.