Recently, the Tennessee Senate Health and Welfare Committee voted against passing Governor Bill Haslam's healthcare proposal to expand Medicaid in the state. The Republican governor's plan, creatively titled Insure Tennessee, would have provided 280,000 low-income Tennesseans with federally funded health insurance.
The vote came just three days into the special session of the General Assembly called by Gov. Haslam specially to address the Insure Tennessee legislation. Haslam addressed the special session, and asked lawmakers to look past politics and "come up with an answer, come up with a plan that addresses Tennesseans' needs and do it in a fiscally responsible way." For Haslam, that answer was Insure Tennessee.
But the bill failed to even make it to the floor, dying in a committee to a 7-4 vote.
Created over a year ago, Insure Tennessee would use funds provided through the Affordable Care Act to help cover the health care costs of residents living 138 percent below the poverty line through vouchers and incentivizing healthy behaviors. Despite being created by the state, the plan was deemed as an extension of "Obamacare" by Republican opponents of the bill since the funds would be provided by the ACA.
With no other alternative in place or even proposed, nearly 300,000 Tennesseans remain without health insurance.
States that have expanded Medicaid have seen both health and financial benefits. In a study conducted in the two years after Oregon expanded it's own Medicaid system in 2008, the coverage led to an 80 percent decrease in extreme out-of-pockets expenses (costs exceeding 30 percent of income) due to an increase in preventive medicine. Failure to expand also negatively affects the state's health care providers. Hospitals could be put at a competitive disadvantage and dropped from insurers networks leading to a lost in business and higher costs for those with private insurance.
As for the health benefits, not expanding Medicaid coverage kills people. According to a 2012 study by Harvard School of Public Health, the mortality rate of those states who have already expanded Medicaid under the ACA is 6 percent lower than non-expansion states. For every 176 people added to Medicaid, one life would be saved. Doing the math, 27,000 of the five million uninsured in non-expansion states could die as a result of not gaining health insurance.
But for the Tennessee General Assembly, the potential lives lost, or saved, paled in comparison to the importance of ideology. Before the Senate committee convened to discuss the bill, House Speaker Beth Harwell told reporters that she didn't believe the bill had enough votes to pass the House. Minutes later, Insure Tennessee was killed in the committee.
Senator Richard Briggs, a Republican who voted in favor of Insure Tennessee, stated that he believed ideology was a part of why the bill failed. For number of Republicans in the Tennessee legislature, and around the country, keeping government "small" and "limited" is worth denying nearly 300,000 people health insurance and the health and financial benefits that come with it.
After the vote, Gov. Haslam expressed his disappointment and admitted that "didn't know what the next step looks like." Meanwhile, 280,000 Tennesseans continue to live in the stressful, unstable and deadly realm of the uninsured.