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UTK College of Social Work Online MSSW ProgramAbbie Mills, Priscilla Norman Fowler and Megan Salyer
AbstractImplementation of the Affordable Care Act and Medicaid Expansion is an active priority of the NASW-TN. In Tennessee, Medicaid expansion could benefit over 558,000 uninsured nonelderly adults who cannot afford health insurance (The University of Memphis, 2012). If Governor Haslam and The Tennessee General Assembly will reject Senate Bill 804 and House Bill 937 and agree to expand Medicaid, the federal government will pay 100 percent of the cost of Medicaid expansion for the first three years and no less than 90 percent of the cost of Medicaid expansion permanently. If Medicaid is not expanded in Tennessee, the economic impact could be devastating. It is estimated that 90,000 jobs will be lost and that Tennessee would experience a 13.3 billion dollar economic loss (Tennessee Hospital Association, 2013). However, this potential economic downturn can be avoided by expanding Medicaid. The projected increase in state and local sales tax revenue will stimulate the economy and more than pay for the costs of Medicaid expansion in Tennessee. Given the potential economic ramifications, Tennesseans can’t afford not to expand Medicaid.
The Affordable Care Act (ACA) & Medicaid Expansion
• Federal Law that helps to expand health insurance options to millions of uninsured Americans.
• Regulates private health insurance industry • Encourages states to expand their Medicaid
eligibility to cover individuals who live at 138% of the federal poverty level
• Tennessee has opted not to expand Medicaid
Primary goals of the ACA/Medicaid Expansion: • Access to quality healthcare for all Americans• Protections from abusive practices• Healthcare reform
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SB 804/HB937 “TennCare Fiscal
Responsibility Act”
Prohibits Tennessee from “participating in any Medicaid
expansion authorized under the federal Patient Protection and
Affordable Care Act.”
Strengths of SB804/HB937
Concern about the long-term financial stability of TennCare and ACA/Medicaid Expansion
Fiscal Responsibility
Tennesseans currently have TennCare and some provisions of ACA
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Limitations of SB804/HB937
Many Tennesseans are still uninsured under SB804/HB937
SB804/HB937 does not consider increase in sales tax revenue from potential economic growth due to Medicaid expansion
Rural Hospital Closure
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Image created by participants. Data Courtesy of Tennessee Justice Center. All rights reserved.
(By County)
Anderson: Methodist Medical Center of Oak Ridge Bedford: Heritage Medical Center
Bledsoe: Erlanger Bledsoe Bradley: Skyridge Medical Center Bradley: Skyridge Medical Center
Campbell : Jellico Community Hospital Carroll: Baptist Memorial - Huntingdon
Carroll: McKenzie Regional Hospital Cheatham: Centennial Medical Center at Ashland City
Claiborne: Claiborne County Hospital Clay: Cumberland River Hospital
Cocke: Baptist Hospital Cumberland: Cumberland Medical Center
Davidson: Metro Nashville General Hospital Davidson: Skyline Medical Center Madison Campus
Davidson: Southern Hills Medical Center Dickson: Horizon Medical Center
Fayette: Methodist Healthcare - Fayette Fentress: Jamestown Regional
Gibson: Gibson General Hospital Gibson: Humboldt General
Giles: Hillside Hospital Greene: Laughlin Memorial Hospital
Greene: Takoma Regional Hamblen: Lakeway Regional Hospital
Hamblen: Morristown Hamblen Healthcare Hamilton: Erlanger East
Hamilton: Erlanger Medical Center
HospitalsAt Risk of Closure
Image created by participants. Data Courtesy of Tennessee Justice Center. All rights reserved.
(By County)
Hamilton: Erlanger North Hancock: Wellmont Hancock County
Haywood: Haywood Park Community HospitalHenderson: Henderson County Community Hospital
Henry: Henry County Medical Center Hickman: Hickman Community Hospital
Humphreys: Three Rivers Hospital Johnson: Johnson County Community Hospital
Knox: Mercy Medical Center West Loudon: Ft. Loudon Medical Center
Macon: Macon County General Hospital Marion: Grandview Medical Center Marshall: Marshall Medical Center
McMin: Woods Memorial Roane: Roane Medical Center
Sevier: LeConte Medical Center Shelby: Baptist Memorial - Collierville
Shelby: Delta Medical Center Shelby: Methodist Hospital - North Shelby: Methodist Hospital - South
Shelby: Methodist University Healthcare Smith: Riverview Regional –North Smith: Riverview Regional –South
Sumner: Sumner Regional Medical Center Unicoi: Unicoi County Memorial Hospital
Washington: Franklin Woods Community Hospital
Hospitals At Risk of Closure
Areas for Change
Improve health outcomes Improve the quality of the workforce Strengthen Tennessee’s economy Assure all Tennesseans have quality health care
Vulnerable and At-Risk Populations
Tennesseans who are among the working poor Uninsured Tennesseans without children Elderly Tennesseans Veterans and their families Homeless Tennesseans Tennesseans with mental illness LGBT Tennesseans in partnerships Rural, impoverished Tennessee counties and
communities at risk of losing much needed emergency hospital services
Ways SB804/HB937 impacts these Tennesseans:
Limited access to healthcare Lack of access to preventative care Financial implications of emergency treatment Potential loss of life
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NASW Core Values
Service: We, as social workers put our own self interest aside to speak out for those who are uninsured. We expect nothing in return for our service. Knowing that our clients have access to quality healthcare is our only priority.
Social Justice:As social workers, we are committed to helping oppressed and overlooked groups of people get services they need. Medicaid expansion would give the priceless gift of health care to a group of people who have struggled for far too long.
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NASW Core Values
Dignity and Worth of the Person: Each person has inherent worth and no one should be left out simply due to poverty. Expanding Medicaid will give ALL Tennesseans fair access to medical care.
Importance of Human Relationships: Relationships suffer as individuals struggle with chronic illnesses and unpayable medical bills. Expanding Medicaid can help reduce the stress on families, helping to keep them healthy and strong.
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NASW Core Values
Integrity:Social workers strive to live up to our Code of Ethics in everything we do. We use our ethics fight injustice and stigma associated with healthcare reform in Tennessee.
Competence:Social workers stay informed about the policies of healthcare reform. After much research, we believe expanding Medicaid is the right thing to do for all Tennesseans.
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Policy Recommendations
1. Reject HB 937/SB804 to prevent Medicaid expansion from becoming unlawful in Tennessee.
2. Vote YES to HB290/SB604 to expand Medicaid in Tennessee.
3. Support Medicaid expansion to provide insurance coverage to individuals who earn a minimum of 138% of the federal poverty level (FPL).
4. Educate Tennesseans on the benefits of the Affordable Healthcare Act (ACA) to reduce stigma.
5. Create an infrastructure to support the delivery of healthcare services in Tennessee.
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558,044
“Of all the forms of inequality, injustice in healthcare is one of the most shocking and inhumane.”
- Dr. Martin Luther King, Jr at a Speech to the Medical Committee for Human Rights, 1966
