Tennesseans are dying waiting on our $1.4 billion for Medicaid expansion  | Opinion

• Dr. Kathryn Crawford, DNP, RN, is a registered nurse in Knoxville, adjunct instructor in the University of Tennessee College of Nursing and works on health policy with the Tennessee Justice Center.

Tennesseans are literally dying as our elected officials leave $1.4 billion per year for our health care sitting in Washington, D.C., instead of working in our struggling rural communities. While Tennesseans wait on our state’s leaders to expand Medicaid, our rural communities continue suffering. As a nurse, I see this play out first-hand. Embracing a woman as she decides to take her husband off life support is hard. Holding this same woman as she regretfully recounts how her husband waited to seek care because a trip to the doctor would have cost too much without insurance moves me to outrage. Because of our elected officials' refusal to expand Medicaid, Tennesseans are waiting to seek care, leading to deadly consequences.  

Tennesseans support Medicaid expansion  

Tennesseans overwhelmingly support Medicaid expansion. In a Vanderbilt poll, 66% of Tennesseans favored Medicaid expansion. Our elected officials are not listening to the will of the people. Depending on charitable care and safety-net hospitals, as Gov. Bill Lee has suggested, is not a plan. Tennesseans know we have a health crisis in our rural communities, and we want Medicaid expansion.  

Medicaid expansion has protective effects  

According to Vanderbilt and Harvard health policy researchers, Medicaid expansion has a protective effect for residents of Southern states.  Medicaid expansion is linked to a decrease in self-reported health declines and a greater likelihood of maintaining baseline health. Southern states, like Tennessee, that have not expanded Medicaid could improve the overall health of low-income residents, especially in our rural areas, by expanding coverage.  

Bipartisan support exists  

With bipartisan support, it’s time our elected officials get to work and make Medicaid expansion a reality for struggling Tennesseans. What is the holdup? We are tired of band-aid fixes for Tennessee’s widespread health coverage gaps. Both sides of the table need to come together in support of what’s right for Tennessee: Medicaid expansion. With Tennesseans' support of Medicaid expansion, it’s time our legislators’ actions reflect their constituents’ values.  

Tennesseans cannot afford to wait  

Contrary to the governor's idea that safety-net providers and charitable care are an adequate substitute for insurance, researchers found these are not associated with a decrease in health decline. Tennesseans already have access to safety-net providers and charitable care, but these do not have the same protective effects on health as insurance. We need real solutions, like Medicaid expansion, to address our widespread rural health crises. We cannot afford to wait another second. Tennessee’s leadership needs to get to work and bring these health care dollars home to our struggling communities now.

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Now is the time for Tennesseans to let their voices be heard in support of Medicaid expansion. The estimated 300,000 Tennesseans who would be covered by Medicaid expansion cannot wait another year for Tennessee’s elected officials to take our health seriously. While Tennesseans die waiting to seek affordable care, over $10 billion available for Tennesseans’ health has been left sitting in Washington, D.C.   

There is a glimmer of hope for Tennessee. President Joe Biden’s American Rescue Plan Act offers new incentives: expand coverage to thousands of low-income Tennesseans and Tennessee will get a $1.26 billion bonus, more than enough to cover the state’s 10% share of expansion costs. In response, Lt. Gov. Randy McNally took a bold step by stating he and others would take a serious look at Medicaid expansion. Tennesseans are desperate for bold action. Lt. Gov. McNally, Tennesseans have heard you and we are ready to usher in this new chapter toward a healthier Tennessee — one in which affordable health care is available to all. Call your legislators today and let them know Tennesseans demand Medicaid expansion and real health care solutions. 

Dr. Kathryn Crawford, DNP, RN, is a registered nurse in Knoxville, adjunct instructor in the University of Tennessee College of Nursing and works on health policy with the Tennessee Justice Center.