For the past 30 years, the League of Women Voters of the United States has worked for “a basic level of quality health care at an affordable cost [for] . . . all U.S. residents” [Impact on Issues, p. 128]; and the League of Women Voters of Tennessee specifically calls upon our state to expand Tennessee’s Medicaid eligibility [2020-2021 Yearbook, p. 15]. Needless to say, then, members of the League were delighted during last spring’s legislative session when legislators from both sides of the aisle began speaking positively about revisiting Medicaid expansion in Tennessee. The timeliness of that consideration seems apparent both in terms of the increasing health needs evident in our state and the incentives for expansion recently extended to states through the American Rescue Act.

The study "The Ambulance Is Our Emergency Room," released in March by the Tennessee Health Care Campaign and the Tennessee Justice Center, stated the growing health crisis in our state in indisputable terms. A 3-year participatory study conducted with Dr. Velma McBride Murry of the Vanderbilt University Medical Center, the study reflects in-depth collaboration with rural citizens and health care professionals concerning the detrimental impact the increasing loss of access to health care is having upon our population.

Tennessee is one of 12 states continuing to reject Medicaid expansion even as we have watched neighboring states (Arkansas, Kentucky and Virginia) reap the benefits of having done so. Consequently, rather than enjoying the improved health of our citizens and the stabilization of hospitals that other states are enjoying, Tennessee is second in the nation in the number of hospital closures, and it leads the nation in terms of hospital closures per capita. We have lost 18 rural hospitals since 2010; and over 75% of the state’s 25 remaining essential access rural hospitals are at high risk of closure. The health of thousands of Tennesseans is in jeopardy. This is particularly the case for the elderly and those on low incomes, who may have limited access to transportation.

Some 300,000 of our citizens have been unable to get insurance in the midst of the pandemic with some 16,000 of them living in Anderson and Loudon Counties. Many of these are essential workers, who are putting themselves at risk in order to continue feeding and caring for their families. Lack of insurance, leading to the lack of access to preventive care, takes an enormous toll both upon families and a region’s economy as costs of treatment rise exponentially when worsening conditions finally force people to seek care.

States that have adopted expansion are witnessing a significant decline in the racial and rural health disparities that plague our nation; and hospitals in states with expanded Medicaid are six times less likely to face closure. Add to this, the 900 million Federal dollars that will become available to our state, covering the cost of expansion for over 6 years, benefitting the lives of those gaining coverage and helping to alleviate the heavy toll the poor health of our citizenry takes upon our state.

It is hard to overestimate the importance of Medicaid expansion in and for Tennessee. Simple concern for our neighbors and for the wellbeing of our state should motivate us to contact our legislators strongly encouraging them to take this positive step. It would not be an exaggeration to say that our future depends on it.

~ From the Board of the League of Women Voters of Oak Ridge