Recent editorials from Tennessee newspapers:
Knoxville (Tenn.) News Sentinel on failure to expand TennCare:
Thousands of Tennesseans would have better access to health care and the state's economy would receive a boost if lawmakers would accept the federal government's offer to underwrite an expansion of Medicaid.
A report released last week by the White House quantified the benefits of expansion Tennessee is foregoing by not expanding its Medicaid program, which is administered as TennCare.
Compiled by the White House Council of Economic Advisers, the report offers more evidence that Gov. Bill Haslam and the Legislature's Republican supermajority are doing their constituents no favors by not expanding Medicaid.
The expansion, offered through the Patient Protection and Affordable Care Act, would cover people and families who currently do not qualify for TennCare and earn up to 138 percent of the federal poverty level — $32,914 for a family of four. The federal government is committed to paying 100 percent of the expansion costs through 2016, with the level of support gradually dropping until it levels off at 90 percent in 2020.
So far, 26 states and the District of Columbia have expanded their Medicaid programs, providing health care coverage to 5.2 million low-income Americans. Tennessee and the 23 other states that have not expanded Medicaid will have deprived 5.7 million people access to coverage. In Tennessee, at least 234,000 people — a number roughly equal to the combined populations of Knoxville, Oak Ridge and Farragut — have been blocked from receiving coverage.
In states that have expanded Medicaid, the report notes, the number of people with Medicaid coverage has jumped 15.3 percent since enrollment began late last year. Those covered through Medicaid are much more likely to see a primary care physician and to obtain preventive care, such as mammograms and cholesterol screenings. Health outcomes also would improve. In Massachusetts, adult mortality rates fell 2.9 percent after that state's health care reform, which was the model for the Affordable Care Act.
There are economic benefits as well. Expansion would reduce the number of Tennesseans facing catastrophic out-of-pocket medical expenses by 10,500, the report states. And the benefits are not restricted to individuals receiving coverage. Had Tennessee expanded Medicaid effective Jan. 1, the state would have seen $5.1 billion in new federal spending by 2016, as well as 21,700 new jobs. The state's gross domestic product would have increased by $3.8 billion.
The report makes it clear that Tennesseans are paying a price — both in terms of economic opportunity and the health of low-income workers. Hospitals, too, are feeling the pain. The Affordable Care Act slashed funding for hospitals providing indigent care because Medicaid expansion would reduce the number of uninsured patients visiting emergency rooms. The failure to expand Medicaid was cited by the owners of Haywood Park Community Hospital in Brownsville, Tenn., when they announced the closure of the facility earlier this year. According to the Tennessee Justice Center, at least 53 other Tennessee hospitals, employing more than 21,000 people are at risk of closing.
Haslam has proposed an alternate plan that would allow those eligible for expanded Medicaid to purchase health insurance policies on the federally run exchange, but the U.S. Department of Health and Human Services has not approved it. Other states, including Arkansas, Iowa and Michigan, have similar alternative programs.
The Legislature would have to sign off on any agreement. Given the Republican supermajority's antipathy toward President Barack Obama's health care reform law, approval would be unlikely. Still, lawmakers need to know how their inaction is harming their constituents, not the president. Expanding the state's Medicaid program, either through TennCare or an alternative program, remains in the best interest of Tennesseans.
The Post-Intelligencer, Paris, Tennessee, on drug-using moms:
Facing what has been called an epidemic of drug-dependent newborns, the state of Tennessee is cracking down on drug-using mothers.
State officials are alerting physicians to be aware of a new state law that allows women to be charged as criminals if they use drugs illegally during pregnancy.
Last year, the state counted 921 drug-dependent newborns, The Tennessean in Nashville reported. So far this year, the count is 463.
Physicians and state officials in Tennessee have won national recognition for their efforts. State officials have passed laws that encourage drug treatment for mothers at the same time that they threaten criminal punishment.
Doctors are not required to tell law enforcement that they suspect patients are abusing drugs, but they are required to notify the Department of Children's Services.
Mothers reported to DCS are not automatically prosecuted, but the law requires that cases be investigated.
The decision whether to prosecute will be made by local teams of DCS investigators, physicians and law enforcement officials.
It's tragic for a child to be born dependent on drugs. The state is right to get tough, but the emphasis needs to be on treatment.
Tennessee appears to be on the right track.
The Commercial Appeal, Memphis, Tennessee, on jobs growth in June:
Unemployment in the United States fell in June to 6.1 percent from 6.3 percent in May, the lowest rate since the fall of 2008. That's when financial giant Lehman Brothers collapsed, taking with it in house-of-cards fashion other Wall Street firms and a good chunk of the auto industry, along with a lot of other luckless companies.
That prompted an unprecedented government bailout that pumped billions of dollars into banks and businesses and continues even to this day, in much-diminished form, through the Federal Reserve's bond buying program. Now, thanks to the robust economic recovery, that program may be nearing its end.
The economy added 288,000 jobs last month and 2.5 million jobs in the last 12, the fastest annual growth since 2006. According to The Associated Press, the 200,000-plus monthly job gains over the past five months have been the best stretch since the 1990s tech boom — although we must hope this growth comes to a better ending than the subsequent tech bust.
Job gains were spread across the economy — factories, retailers, financial firms, restaurants and bars all added substantially to their payrolls. And employment got a boost from another surprising quarter — government hiring, which began to tail off in 2007 and began shedding employees every year from 2009 to 2013. Public-sector hiring has increased by 54,000 jobs so far this year, good news for hollowed-out local and state governments.
The first-quarter 2.9 percent decline in gross domestic product is increasingly looking like a weather-related anomaly. Economists polled by the British newspaper The Guardian seemed to agree that the world's largest economy is in good shape with strong underlying momentum.
There are two other anomalies that are perhaps cause for worry. Wage growth has remained at an anemic 2 percent a year during the recovery, well below the historical average of 3.5 percent. The U.S. economy depends heavily on consumer spending and 2 percent a year is not going to do much to help that. Some think wages will pick up along with the economy, a view that seems to have not yet caught on with employers.
The other anomaly is that workforce participation — the number of Americans working or actively looking for work — is stuck at a low of just over 62 percent. The problem is no longer purely economic; the jobs are there, and employers are hiring. It might be structural: workers stuck in the wrong place or with the wrong skills. Or it could be societal: Older workers who lost their jobs and are content to scrape along until retirement age and Social Security or desperate workers who are willing to work off the books.
A booming economy solves all kinds of problems and ultimately these may be two of them.