New State Rep from TN's Richest County Says We Can't Afford Federally Funded TennCare Expansion

Just a day after Gov. Bill Haslam did an about face on establishing state-run health insurance exchange in Tennessee as a part of the Affordable Care Act, the topic turned to whether the Tennessee legislature would expand our state's Medicaid program.

Former U.S. Senate Majority Leader Bill Frist — a Republican, gasp! — is publicly advocating for the expansion of TennCare. In a column published by The Commercial Appeal, he outlined the choice Tennessee legislators face:

What is optional is the Medicaid expansion, providing insurance to those who are uninsured presently and below 133 percent of poverty level. According to the state budget report, between 2014-19 this will add 180,000 people to TennCare at a cost of $200 million of state money.

The TennCare expansion would largely cover the working poor — those who are not offered health insurance through their employer and cannot afford it on the private market. For the first three years of the expansion (through 2016) the federal government would assume all of its cost, at least in part with our tax dollars paid by Tennesseans. In 2017, Tennessee would assume 5 percent of the cost and the state's share in the cost would gradually increase to 10 percent by 2019.

A plan that spends our tax dollars on health care for Tennesseans? Sounds reasonable given our state's poor health ranking, our 1 million uninsured residents, an infant mortality rate (7.9) well above the U.S. average, and the billions worth of uncompensated health care our medical professionals deliver each year.

State Rep. Jeremy Durhum (R-Franklin)

But since when have Tennessee Republicans been concerned with reason?!

Right on cue, the first bill filed for the 108th General Assembly is one that would bar the state from expanding Medicaid and take advantage of increased funding under health care reform (some estimates put that number as high as $2 billion a year worth of new money to pay doctors for treatment, hospitals, nurses, etc.).

The opposition to President Obama's landmark health law being implemented in the Volunteer State was predictable. Newly minted state Rep. Jeremy Durham (R-Franklin), a very close friend of bill-sponsor state Sen. Brian Kelsey, told TNReport.com that Tennessee just doesn't have the money.

“I feel we can’t afford to expand Medicaid.”

To the freshman lawmaker representing Tennessee's most opulent gated communities, I respectfully disagree.

Durham, a lawyer, lives in Tennessee's wealthiest county. The average household income is more than 70 percent higher than the rest of the state. Half of Williamson County's 69,000 houses are worth more than $336,000. By most measures, the people of Williamson County are doing pretty well.

I would welcome further analysis or correction on my tax expenditure projections. Email me.

And the richest Tennesseans are doing even better with billionaire Bill Haslam in the governor's mansion. In 2012, the 107th General Assembly passed into law $900 million worth of new tax breaks for Tennessee's highest earners over the next decade.

But even in Durham's Williamson County, an estimated 15,000 people — 8 percent of residents — have no health insurance. The reality of the matter is that no part of the state is immune to health care problems.

So it really comes down to a simple test of values. Vice President Joe Biden has an excellent quotation on the matter:  

"Don't tell me what you value. Show me your budget, and I'll tell you what you value."

What do we value?

• Do we build a stronger middle class and solid foundation for families to work their way into the middle class by giving $900 million worth of tax breaks to people who don't need them? 
• Are small business owners and rural communities better off if lawmakers fork over $1.6 billion worth of tax giveaways — every year — to big corporations in the city that may or may not be creating the jobs they promised? (Some of these companies may very well be living up to their promise to hire Tennesseans, but certainly, some are not. Our legislators could hold these corporations accountable and save money by creating an evaluation process that gauges the effectiveness of tax incentives and institutes a claw back provision for corporations that break their promise to taxpayers.)
• Do we spend $200 million to expand a cost-effective health program so that 180,000 people who work for a living can get care when they're sick and that doctors and hospitals get paid when they treat patients?

I'll definitely be writing more about the battle over whether to expand TennCare or not, but I'll end with this thought:

President Obama and Democrats fought for health care reform because we believe as a matter of principle, that every American should have genuine access to affordable, quality health care. In the wealthiest nation on Earth -- no illness or accident should ever lead to a family’s financial ruin.

Affordable health care our families can rely on is key to building a strong middle class. Tennesseans who work hard and play by the rules should have the security that comes with good health care.