Affordable Care Act’s Impact on TN

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Michelle Johnson

By Michele Johnson, Executive Director of Tennessee Justice Center

Nowhere is the urban-rural divide greater — or more critical — than in the area of healthcare. While many of our urban hospitals are highly profitable, as many as half of Tennessee’s rural hospitals are struggling financially. The risk of their closing is a serious threat not only to health access in rural communities, but to those communities’ economic vitality. There has been limited coverage when a hospital has closed, but the scope of the broader crisis has remained hidden. We hope you will help us bring it out into the light and put it on the public agenda.

This topic could not be more timely or the need for informed editorial comment more urgent. As you know, Congress is preparing to repeal the ACA (aka Obamacare) and is debating how and when to replace it. House Speaker Paul Ryan has laid out a budget blueprint that calls for taking $1 trillion in savings from Medicaid (known in Tennessee as “TennCare”). Overhaul of Medicare is also on the Speaker’s agenda. Other federal programs specifically fund rural health and health care manpower development. As discretionary domestic spending programs, they face likely reduction or elimination in order to meet overall federal budget targets.

Rural hospitals and clinics are heavily reliant on all of these programs, and poorly considered changes by Congress can push many facilities into bankruptcy. Cuts in any one of these programs is a grave risk to rural health; taken together, the impending changes represent a tsunami that could devastate rural Tennessee.

Congress is expected to adopt the first major changes to federal health programs within a matter of weeks. There is little evidence that congressional leaders are aware of the vulnerability of the rural health care system, or of the need to carefully consider the potential impact of their decisions on rural America.

Because the story about what is going on in Congress is so big – and so important – we are submitting to you five separate editorials (DOWNLOAD HERE), of about 200 words each, covering different aspects of the issues that Congress is addressing. (Two of the editorials address Medicaid: the first describes its breadth and importance to rural TN, and the second describes congressional plans to cut Medicaid.) The articles all call on Congress to take rural communities into account when changing federal health laws and funding. They are listed in the order in which Congress is expected to take action on the topics addressed in the article:

• Congress, protect rural Tennessee — Provides general overview of rural health’s reliance on federal laws and programs, and the need for Congress to take rural communities into consideration when changing those programs.

• Don’t repeal Obamacare without a replacement – Supports Senators Alexander and Corker’s careful approach to ensuring that the ACA isn’t repealed without a replacement ready to take immediate effect.

• Preserve Medicaid, protect rural health – describes the rural Tennesseans who are covered by Medicaid (TennCare), and its role in funding the rural healthcare infrastructure.

• Don’t block grant Medicaid – addresses the specific plan by which Congress plans to cut Medicaid by $1 trillion over the next 9 years.

• Federal funding cuts threaten rural health – describes the special federal programs that target access barriers in rural communities.

Please help raise the awareness of Tennessee’s congressional delegation before it is too late. Consider running the articles that address this issue. This editorial kit was shared at the recent meeting of the Tennessee Press Association, but we are sending it to you today to make sure you receive it, and because the story continues to become more prominent.

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