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TN’S MEDICAID BLOCK GRANT: A CAP IS A CUT

TN’S MEDICAID BLOCK GRANT: A CAP IS A CUT

by Kristen Grimm

In the waning days of the Trump administration they have just now approved Tennessee’s request to turn our Medicaid funding into a Block Grant, putting the health care of our neediest citizens into the hands of Governor Lee and the TN GOP. Lee and the GOP in our state have shown us in recent years they are comfortable with human suffering by refusing to expand Medicaid, rejecting $1 Billion yearly in health care funding, and we’ve seen them sit on over $700 million in TANF funds, so putting this giant sum of money into their hands with fewer strings attached is entirely unjustified and unwise.

A block grant would be a cap in federal funding to Medicaid. And let me be clear: A cap is a cut. The idea that the block grant approval will expand coverage is politically deceitful and sinister.

During the Trump administration’s attempt to cut Medicaid and repeal the Affordable Care Act in 2017, they also tried to pass block grants to drastically cut funding to Medicaid.

Healthcare advocacy organizations and people like myself fought hard to protect this nation’s Children’s Hospitals and Medicaid recipients from suffering the potentially catastrophic consequences of capping the federal funding structures to Medicaid.

Block grants were so dangerous to children’s hospitals, the Children’s Hospital Association publicly came out against block granting our federal Medicaid program.

At the time of the cuts, 54% of impatient revenues for all our nation’s children’s hospitals were paid for by Medicaid and 63% of all our nation’s emergency department revenues were paid for by Medicaid.

What we see here was a measure that is so dangerous that the Children’s Hospital Association had to fight against it because every children’s hospital in this nation was at risk of being catastrophically harmed. When there is a capped concrete ceiling for federal Medicaid funding there’s absolutely no way you can expand services in a boxed measure of fiscal containment.

Block grants being proposed by the Trump administration were one of the cruelest measures that they have tried to invoke upon our nation’s federal departments.

This shows us the nature of Governor Lee and the Trump administration’s immorality that they would mess with children’s hospitals. But this is what the Republican leaders are doing. They are not only putting our children’s hospitals at risk, but they are also harming the elderly and vulnerable people all across this state. Thankfully it looks like the Biden administration will be able to reverse this measure before TN has time to do any harm to the most vulnerable in our state.

Kristen M. Grimm
Medicaid and Medicare Advocate
Founder and President
Mothers for Medicare for All

Marquita Bradshaw on Where to Go From Here

“We can look toward Georgia, but I was taught if you want your grass to be green, you need to fertilize and water your own grass.” – Marquita Bradshaw talking with Wade Munday on #ACaseOfTheMundays about where to go from here in Tennessee.

FULL PODCAST available on Apple Podcasts, and wherever else you like to listen.

GUEST COLUMN: “BIG DATA ON ELECTION NIGHT”

Mark D. Harmon is a professor of journalism and electronic media at the University of Tennessee

“BIG DATA ON ELECTION NIGHT”

From the Not-So-Farfetched File…

RACHEL MADDOW: Good evening, and welcome to MSNBC’s Election Night 2020 coverage.

BRIAN WILLIAMS: We still have two hours to go before voting locations close on the East Coast, but we do have public opinion polling to give us some fascinating insights into the electorate.

MADDOW: For that we go to Steve Kornacki at the big board.

KORNACKI: That’s right, Rachel and Brian. We’ve been able to use what data experts call common reference points to link standard election polls to all sorts of other Big Data information. Let’s start with comparisons to 2016.

Donald Trump is down ten points among pick-up truck drivers, but up two points among drivers of vehicles with slogans or female images on mud flaps. Joe Biden’s commuting habits seem to be paying off for him. He is winning three-to-one among people who’ve ever traveled by train, two-to-one among those who as a child had model trains. He’s also winning big among those who ever watched Soul Train, or can sing at least some of the words to “Midnight Train to Georgia.”

MADDOW: You have other information about Georgia as well?

KORNACKI: Yes, we discovered that Georgia Governor Brian Kemp, known for his botched response to coronavirus, is now less popular than the virus itself.

WILLIAMS: But he’s not on the ballot this time around.

KORNACKI: That’s right, but our numbers indicate he would lose a recall effort by roughly twelve to one.

MADDOW: Any other big surprises?

KORNACKI: Yes, going back to 2016 comparisons, turnout overall could be up by as much as ten percentage points. Those who think it’s okay to cast a third-party protest vote is down 93 percent.

WILLIAMS: I understand you also have social media data.

KORNACKI: Oh, large amounts of social media data. Trump and Biden overall are dead even among Facebook and Twitter users—with Trump holding a strong lead among first-time users from foreign domains.

Looking at just Twitter users, Trump leads among those with spelling and grammatical errors in their posts, and with those who use multiple exclamation points, or who link to conspiracy sites. Biden leads only among those who link to established news and information sites.

We have even more on tweets. Song birds that tweet daily are breaking big for Biden. Parrots are tilting toward Trump. We’re pretty sure Big Bird, and most of Sesame Street—excepting Oscar the Grouch—will be going for Biden. Trump, by the way, scores well among vultures and all creatures who feed on dead flesh.

MADDOW: Wow, that’s a broad database.

KORNACKI: Yes, it is. We even have foreign data. Biden is doing much better than Trump with Americans living in France, those who ever have visited France, and among French people who wish they could vote in this election. Trump leads only among those who can’t find France on a map.

WILLIAMS: You also have some other data you’ve told us is hard to categorize.

KORNACKI: Correct. Trump is down ten points among those who use “summer” as a verb, but he’s up five points among residents of mobile homes who have thought about bleaching their lungs or admit to snorting Lysol.

We can’t give away too much, but I can say all indications are this election night will please a lot of people who shop on Thursdays, post photos of children, and drive automatic transmissions.

Mark D. Harmon, a professor of journalism and electronic media at the University of Tennessee, is an award-winning freelance columnist.

VIDEO: “OUR HEALTH CARE SYSTEM IS BROKEN”

WATCH a health care pricing expert tell the TN House Insurance Committee health care costs – particularly hospital costs – far outpace inflation, PRICE VARIANCE is a huge problem… but NOT with Medicare & Medicaid. #M4A #ExpandMedicaid

It’s almost like downward pressure on costs is a good thing.

Of course, the legislators only see it as those programs offer lower reimbursement rates – but at least everyone is covered, and as we learn from this expert’s testimony often the hospital prices are skyrocketing to make up for uncompensated care — which means Tennessee not expanding medicaid and rejecting $1 Billion each year IS COMING OUT OF OUR POCKETS ANYWAY.

From the TN HOUSE INSURANCE COMMITTEE yesterday… Hospital service costs are increasing at 5x inflation:

Hospital price variance is wild, depending where you go (less competition = higher cost – hello Ballad Health!) the “equivalent of paying $14 PER GALLON for a tank of gas”

 

Governor Lee To Sign Anti-LGBT Adoption Bill That Targets His Own Sister

You’ve probably heard that yesterday the TN Senate started off the legislative session by passing a bill which targets LGBT people and allows state-supported adoption agencies to discriminate against LGBT people.

The bill will now head to Governor Lee’s desk, and Lee has said he will sign it.

What you may not know is Governor Lee’s own sister is married to a woman, and therefore is a part of the LGBT community targeted by his party’s bill.

Here’s @ScoopNashville’s tweet about Cynthia Lee’s wedding:

And here’s Cynthia Lee with Bill’s wife Maria outside his campaign headquarters in Franklin:

Tennessee is #1 in medical bankruptcies, #2 in rural hospital closures, gets an “F” in education funding, and has the maternal mortality rate of a third world country… yet this is what the TN GOP and Bill Lee are focused on?

Here’s how they voted — GREEN means they voted for the bill. Red against.

Cynthia and her wife deserve to be treated just like everyone else in America, and should not be targeted and made to feel less than by our laws.

This adoption bill is especially ugly because it would have the effect of robbing loving homes from children who might otherwise not be able to find one.

If you agree Governor Lee should VETO THIS BILL, Holler at him HERE.

 

INTERVIEW: KEEL HUNT – Tennessean Columnist & Former Special Asst. to Lamar Alexander

Holler co-founder Justin Kanew interviews KEEL HUNT, Tennessean columnist and former Special Assistant to Lamar Alexander who recently spoke out about the need to speak up in the time of Trump in this poignant column: “I’m Done Being Quiet”.
PODCAST on iTunes. (13 mins)
CLIP:  “I think it’s fear that leads to silence.”
Full FACEBOOK LIVE interview.

VIDEO: IMPEACHMENT EVE IN TENNESSEE

Patriots braved the cold at rallies across TN on the eve of an historic vote to #DefendOurDemocracy. ‬

‪This is about country, not party. Nobody is above the law. That’s what makes America Great. 🇺🇸

SHARE on Twitter or Facebook.

TN Dems Call On Rep. Curcio & Speaker Sexton To Keep Their Word, Hold #ExpelByrd Hearings

Tennessee still has an admitted child sex abuser sitting in a State Rep seat.

Now that the Attorney General has said expelling him would be constitutional, it’s time for Tennessee Republicans to stop harboring him.

HOLLER AT THEM HERE:

Rep.Michael.Curcio@capitol.tn.gov 615-741-3513 

speaker.cameron.sexton@capitol.tn.gov 615-741-2343

TN HEALTH CRISIS: Gov. Lee’s Finance Commish Answers Medicaid Expansion Questions (Very Poorly)

There’s been a lot going on, so it has taken us a bit to get to this, but a few weeks back The Tennessean had Governor Bill Lee’s finance commissioner Stuart Mcwhorter on their podcast to answer questions about the Rural Health Care “Task Force” they’ve assembled to try to address the nightmare that is rural health in Tennessee, where we’re #1 in MEDICAL BANKRUPTCIES and RURAL HOSPITAL CLOSURES PER CAPITA, at the bottom in infant and maternal mortality and opioid deaths, the list goes on.

Just last week we learned in 2017 alone there were 52 mothers who died preventably from lack of Tenncare, making it clear not expanding Medicaid is nothing short of policy murder.

Natalie Allison of The Tennessean asked Mcwhorter the questions. Understandably, The Tennessean had quite a few of them considering reporters were kept out of the closed-door task force meetings.

Below are some excerpts. You can listen to the whole interview HERE.

We’ll pick it up where Natalie asks Mcwhorter a very straightforward question:

NATALIE ALLISON: So obviously rural hospital closures is something we’ve heard a lot about from people who live in those areas who are concerned with that. The other thing is what you just mentioned – the number of uninsured people in the state. So what kind of feedback were you guys hearing on how the state can address that?

MCWHORTER: It’s the #1 question we got. And I think in light of the fact that we have a number of uninsured Tennesseans, you want to understand what the causes of those things are. Some of it is a lack of workforce opportunities. We were really making sure we were bringing that discussion into the fold, around economic development incentives for companies to relocate to rural parts of the state.

Notice that Mcwhorter immediately takes the question of stopping rural hospital closures and getting people insured to employment- anything to steer the conversation away from government-based solutions and towards “free market capitalism”, but even that is a bogus premise since Mcwhorter is already talking about how the government can encourage it through tax incentives (and what he would later refer to as “seed funding”).

TRANSLATION: They don’t mind government intervention as long as that intervention goes to corporations, rather than directly to us

This answer is also problematic for another reason: PEOPLE ARE HURTING NOW.

Again, we just found out over 50 mothers DIED from not having expanded Medicaid in 2017 alone. So while Lee & Mcwhorter assemble their “task force” and talk vaguely about economic incentives, 1 mother is dying unnecessarily each week.

This is nothing short of POLICY MURDER.

Another point: Mcwhorter is heralding employer-based insurance as the solution because they want to keep us reliant on our employers for insurance, because when we’re reliant on them, we’re compliant. Take GM canceling the insurance of striking UAW workers, for example.

As long as we depend on them for our health care, they know it will be much harder for workers to push back against our corporate overlords.

Mcwhorter continues:

MCWHORTER: If you aren’t employed and don’t have the skills, we tie in a lot of what we’re discussing with the governor’s initiatives around vocational education and focusing on some of the trades and technical education. But it starts even before that. You start really getting into some of the – I go back to the social determinants…

This is where it starts to get weird.

MCWHORTER: …if you can’t get a child immunizations, or early childhood reading, or things you really want to focus on when a child is born in the state, those things continue to compound over time, and won’t allow people to either get a job or get out of their circumstances. So we really try to get to the root causes of some of these issues.

As a reminder, the question is: How do we stop hospitals from closing and get people insured so they can see doctors.

Think about how far afield we’ve gone here. To address a question about hospitals closing NOW and people being uninsured NOW, Mcwhorter is talking about children being vaccinated and learning how to read, and how that may lead to them not having insurance as adults – because it makes them less employable.

Again, a mother is dying every week. This obvious deflection is not helping them NOW.

Stuart goes on:

MCWHORTER: And if they’re employed, hopefully they have access to their employer’s insurance. If they’re not employed, what can we be doing to train and educate so they can get employed.

They don’t want us reliant on government, but boy do they ever want us begging our bosses for our lives.

Also, a key word here was “hopefully”. We have a five-alarm health care fire in Tennessee, where again we’re #1 in MEDICAL BANKRUPTCIES and RURAL HOSPITAL CLOSURES PER CAPITA, and Bill Lee’s health care task force mouthpiece is saying “hopefully” if we address some of these issues today’s kids may get employer-based health insurance in 25 years or so.

It gets worse.

Mcwhorter then goes on to blame mental illness for why some people don’t have insurance.

Yes, seriously:

MCWHORTER: And if you’re still up against other issues that prevent that (meaning getting a job) – and a lot of it is mental. We’re all aware of what’s going on around the state with that. We’re trying to address the mental disorders, the opioid crisis, all the things that contribute to that as well.

Aside from the obviously insulting implication that the hundreds of thousands of low-income folks who are falling into the Medicaid gap are either mentally ill or addicted to opioids, there’s a glaring flaw in what Mcwhorter is saying here: Studies have found Medicaid expansion is critical for fighting the opioid crisis.

There’s a reason opioid deaths are going up in our state while they go down in the states around us – it’s because we didn’t expand Medicaid.

We’ve rejected $7 BILLION and counting. You think that wouldn’t help us deal with the opioid crisis and other issues? Of Course it would. That’s not politics, it’s math.

Natalie Allison then speaks again for the first time since asking the original question, and asks Mcwhorter directly about Medicaid expansion (thank you Natalie):

NATALIE ALLISON: There are people who for years have been saying EXPAND MEDICAID, EXPAND MEDICAID. I have a feeling that’s not going to be the strategy you all are gonna be recommending to the governor as part of this task force, since he’s made it clear that’s not something he’s going to do. Is that safe to say?

MCWHORTER: I think it’s safe to say. A couple things. One is – he said that. The way I interpret that is this is a long-term plan with a long-term solution we need to look at. It’s a heavy lift. It’s a lot of hard work. It’s easy to look at something that’s immediate – i.e. Medicaid Expansion – but I think there’s a deeper issue here that we really want to look at.

(Did we mention one mother is dying each week that didn’t have to die while Mcwhorter and Lee “look at” deeper issues with their “task force”?)

MCWHORTER: Now I say all that to say, the legislature did pass a law around the Block Grant. If we don’t negotiate something, that goes away. Does Medicaid Expansion come back? I don’t think it comes back just in the context of Medicaid Expansion. But I think the same principles that are around Medicaid Expansion… I mean the goal around Medicaid Expansion is to provide access, coverage to more people. That’s what our goal is. We’re trying to do the same thing, it’s just getting there is going to be a little different.

Why? You’re literally saying Medicaid expansion does the things you want to do. The tool is sitting there. Why not use it?

Politics, that’s why. Plain and simple. Also, it’s worth noting that the Block Grant Mcwhorter is talking about is A) Illegal probably, and B) DEEPLY unpopular. Nearly 1800 people spoke up about it at the public hearings last month, and a whopping NINE were in favor of it.

Back to the conversation – Natalie Allison picked up on Mcwhorter seeming to say Medicaid Expansion’s principles are what they want to accomplish, so she presses him on it:

NATALIE ALLISON: So you just said something really interesting – you said you might take the principles of Medicaid Expansion and apply that to whatever other solution you all would use as your Plan B. Can you talk a little bit more about that? And clarify whether Medicaid Expansion would be totally off the table for your recommendations?

MCWHORTER: I guess what I’m saying with the principle applies is the ultimate outcomes. The goal of
Medicaid Expansion is to provide more access – more insurance to more people – the Governor doesn’t disagree with that. We also have to be fiscally responsible. And so we have to look at the right balance.

“Fiscally responsible”? Is rejecting $7 Billion that would help our state “Fiscally responsible”? Who is that helping?

They love talking about running the state “like a business” – what boss wouldn’t be fired for rejecting an injection of $7 Billion?

If what Mcwhorter means is the state would’ve had to match 10% of the expansion dollars – our state’s own hospitals said they would COVER THE DIFFERENCE because they need the funds so badly, and wanted to stem the tide of hospital closures.

No, Governor. Rejecting Medicaid Expansion is the opposite of “fiscally responsible”. It’s both fiscally and morally irresponsible.

Our state is suffering. Our mothers are dying. There’s a reason our last Republican governor Haslam called not expanding Medicaid one of his biggest regrets.

Meanwhile Governor Lee and this Republican Supermajority, who we’ve just learned have been sitting on $730,000,000 in TANF block grant funds intended to help poor people, now want to get their hands on billions in Medicaid block grant dollars intended for poor people’s health care.

Downright terrifying.

After 5+ years of blocking Medicaid Expansion, you’d think they’d have better answers than this.

Employer-based coverage is sometimes adequate — IF it’s offered. Tennessee leads the nation in minimum wage jobs. Those workers should be able to go to the doctor too.

After 188 Days of Protest, KINGSPORT TN Citizens Fight Anti-Free Speech Ordinance

Kingsport has protested the gutting of their hospital by a shady state-sanctioned monopoly Ballad Health for 188 DAYS. The city just passed an ordinance directed at them, and even threatened to charge their leader with “Felony Vandalism” for damage to the grass.
Watch the VIDEO from their heated meeting last night below, and holler at the mayor Patrick Shull and the city officials like Vice Mayor Colette George HERE.

Here’s the back story, from Daily Kos.
‪And here’s Ballad CEO ALAN LEVINE on 60 Minutes defending HMA pressuring doctors to admit people to the hospital unnecessarily FOR PROFIT. (AKA “MEDICARE FRAUD”)‬

Spoiler: Levine was lying. HMA ended up paying $260 MILLION in fines for DEFRAUDING the government.

‪Hey when nobody goes to jail, it’s worth it right? Now he’s in Kingsport sharing his *expertise* with them.‬