Today I attended a summit organized by Nashville Organized for Action and Hope, or NOAH, an interfaith and multiracial organization working for a more just future. The meeting and its breakout sessions covered many fronts, but my particular concern was the Affordable Care Act and the State of Tennessee's response to it.
For the first time, I learned from Gordon Bonnyman, Junior of the Tennessee Justice Center just what Governor Haslam's proposed 'Tennessee plan" is and how it is loaded with 'poison pills' that are unacceptable under Federal law. Essentially, our governor has proposed to use Medicaid expansion funds to buy private insurance for the poor, a plan the Governor of Arkansas recently got approved. Haslam has added his own requirements, doubtless to make the plan acceptable to his divided base. These are:
- The Tennessee plan will not provide transportation to the place of treatment. This is a deal-killer under Federal law for very good reason. Transportation to treatment is a huge problem, especially in rural areas. At present, most of the doctors and hospitals that will take TN Care are in Nashville. If you're disabled - much less poor and disabled - that's a denial of medical service right there.
- The Tennessee plan won't pay for screening exams for 19 and 20-year-olds. Sure, you can wait two years if you're riddled with cancer or some other horrible disease.
- The poor will have to make a co-pay UP FRONT, otherwise our leaders fear these feckless people will misuse the access to healthcare. This is ridiculous on the face of it. Plenty of us who are not officially poor can't pull $50 out of our pocket at some point during the month.
Thus the poorest of the poor Tennesseans will have no access to healthcare unless and until our governor agrees to the Federal program.
Just as pernicious is the recent action of our Department of Commerce and Insurance, which has issued guidelines that for all practical purposes prevent volunteers from religious and social work organizations from helping people get access to affordable healthcare. Next Tuesday, enrollment in the Affordable Care Act will be available for those who have computer skills. There are many choices in the marketplace, because healthcare is a complicated and highly personal subject.
Almost everyone will seek help, but the Commerce and Insurance Department has set an impossible bar - fingerprinting, background checks, training beyond Federal requirements - and set them on impossibly short notice. Query: Does the Commerce and Insurance Department have the authority to regulate volunteers? We're going to court. Stay tuned.