Our Healthcare System

Tennessee has lost more rural hospitals for its size than any other state in the nation. 32 more are at risk of closing or severely cutting their services. The legislative ban on using our federal health care funds starves those hospitals of revenues they urgently need. Most other states make full use of available federal funds. Research shows that states, like Tennessee, that refuse federal funding makes it six times more likely than their hospitals will close.

THE EFFECT OF HOSPITAL CLOSURES IN A RURAL COMMUNITY

Hospital closures threaten thousands of people’s jobs and the health care of everyone in the community. Hospitals are always among the largest employers in a community, and often they are the largest payroll. Hospitals are especially valuable because they provide jobs from entry level maintenance staff to high-level nurse, physician, and executive positions. Hospitals buy food and supplies and services locally. Their payrolls generate retail and service revenues, support real estate prices, and fill local government tax coffers that pay for schools and essential services. They are essential drivers of local economies in their own right. Research shows that the closing of a community’s sole hospital seriously depresses average per capita income, and significantly increases the unemployment rate in the community. 

When a hospital closes, doctors, nurses and other healthcare professionals move away. Without those health resources, it becomes impossible to recruit new jobs. The community’s young people leave in search of economic opportunity. A once vibrant and self-sufficient community fades away, threatening Tennessee’s cherished small-town way of life.

Hospital closures put financial pressure on neighboring hospitals, by increasing their burden of uncompensated emergency care. This creates a “domino effect” that leads to further hospital closings, a pattern that has already affected large areas of rural West Tennessee.

THE BURDEN OF MEDICAL DEBT AFFECTS US ALL

Uninsured medical debt is the leading cause of personal bankruptcy in Tennessee. Even a single visit to the hospital can spell financial ruin and destroy a family’s dreams for the future.

When an uninsured person is overwhelmed by medical debts she cannot pay, the unpaid costs of her care must be made up somewhere. Those costs are shifted to other patients’ bills and ultimately show up as increased insurance premiums for those who have coverage. This is known as the “hidden health tax,” and on average, people with private family plans pay $1000 every year in the form of this hidden “tax.”

Using federal health dollars to cover uninsured families would protect those families and reduce the premiums of everyone with coverage. 

Growth in health coverage drove down uncompensated care costs through 2016, according to the latest data from the Medicaid and CHIP Payment and Access Commission. These costs have fallen significantly since the Affordable Care Act’s major coverage expansions took effect. Although uncompensated care costs fell in all states, states that expanded Medicaid to many more low-income adults under the ACA saw more growth in coverage as well as larger drops in uncompensated care.

ACA expansion of Medicaid to low-income adults is preventing thousands of premature deaths each year. It saved the lives of at least 19,200 adults aged 55 to 64 over the four-year period from 2014 to 2017. In contrast, 15,600 older adults died prematurely because states like Tennessee have refused to expand Medicaid.

PREVENTIVE CARE SAVES MONEY AND SAVES LIVES

For Tennesseans with insurance, most of their preventive care is covered: yearly check-ups, mammograms, pap smears, screenings for depression, blood pressure, diabetes, and many vaccines are covered. But such medically important – and cost-effective – care is out of reach for families without insurance. They are six times more likely than people with insurance to skip routine visits and needed specialized care because of inability to pay.

It is estimated that bringing home our tax dollars to close the coverage gap would result in:

Bringing home our tax dollars would help our state become healthier, and would literally save lives. States that have accepted federal dollars to cover more of their citizens have seen a 6% decrease in all-cause mortality.

Our Economy

Bringing home our federal health dollars makes sense for Tennessee’s economy. By the legislature’s own estimate, that would bring $1.4 billion annually into the state. That’s $3.8 million every day!

Those funds would preserve existing jobs in rural hospitals and add 15,000 new jobs in every county and every sector of the economy, according to the University of Tennessee’s Center for Business and Economic Research.  That’s more than five times the number of jobs created by the Tennessee Department of Economic and Community Development venture capital program over its entire eight-year history.

RESOURCES

• The Effects of Medicaid Expansion under the ACA: Updated Findings from a Literature Review
• Protect Our Care research roundup
• Ohio’s 2014 Medicaid expansion extended health care coverage to more than 702,000 low-income Ohioans as of May 2016. For Group VIII enrollees, access to Medicaid has facilitated access to care, reduced emergency department utilization, improved self-reported health, and supported employment and job-seeking. – Ohio Medicaid Group VIII Assessment: A Report to the Ohio General Assembly
• Because of Medicaid expansion, Louisiana has added 19,000 new jobs, saved $317 million and covered 470,000 more people
• U-M study- A team studied information from more than 322,000 people in Michigan’s Medicaid expansion, and found the amount of medical bills in collections fell by 57 percent; a “16 percent drop in public records for financial events such as evictions, bankruptcies and wage garnishments” and a rise in individual credit scores.
• Full reports archive.