The Republican refusal to expand Medicaid in Tennessee and extend health insurance to as many as 330,000 working people will have dire consequence for patients, workers and hospitals, Chairman Roy Herron said in a column that appeared this weekend in The Tennessean.

The full column can be read below:

August 24, 2013

Republicans’ stand on Medicaid will be disastrous for local hospitals

Recently, a Tennessee Republican leader said he opposes extending health insurance coverage to 330,000 Tennesseans because, “It’s kind of like when my daughter says, ‘Hey Dad, we need to buy this dress, because it’s 50 percent off.’ It’s just the other 50 percent I have to come up with.”

He’s a good dad and he’s right about dresses, but on Medicaid expansion, he is 50 percent off and 100 percent wrong.

The accurate analogy is, “It’s kind of like when my daughter says, ‘Hey Dad, we need to buy this dress because it’s 100 percent off.’ It’s just the zero percent I have to come up with.”

The first three years of Medicaid expansion — to extend health coverage to 330,000 working people — are paid for with 100 percent federal funds. And even if we choose to continue in the fourth year and beyond, the cost is capped at 10 cents on the dollar.

Extending Medicaid will bring 1 billion federal dollars a year into Tennessee communities. Payments to hospitals and clinics will then go to doctors, nurses, administrative staff, janitors, medical suppliers, X-ray technicians, therapists, groundskeepers, nursing aides, cafeteria workers, secretaries, administrators, executives, information technologists, clerks, even counselors and chaplains. They in turn will spend their paychecks on goods and services, creating more jobs.

Study after study confirms that federal Medicaid dollars spur enormous economic activity. A University of Memphis study concluded that Medicaid expansion in Tennessee would produce 18,000 new jobs.

But right now, unfortunately, the opposite is true: Republicans are sending Tennessee tax dollars to New York and California and depriving Tennessee of needed funds, with disastrous consequences for local hospitals and our state economy.

Our Republican lieutenant governor admitted refusing the $1 billion “is going to hurt. In some cases there may be hospitals that have to close. But look, if you want to operate in a free market, things like that happen.”

The only problem is that my friend the lieutenant governor is blaming our free market for his governmental decision. Denying hospitals federal funds is not a free-market decision — it’s a political decision by this Republican administration and Republican legislature.

Similarly, the Republican House speaker told reporters last spring, “There are some rural hospitals that will be hurt; there’s no doubt about that. But the health care industry is a changing industry, and those that can’t keep up, they just simply can’t.”

That’s like pulling the oxygen mask off a struggling patient and then saying, “That’s life — and death — in the free market. If you can’t keep up, if you can’t keep breathing, then just die.”

It’s not just a question of keeping up. My friend the House speaker, instead of blaming hospitals for not keeping up, should accept responsibility for denying hospitals federal funding.

The speaker also said, “if (the prediction of hospitals struggling) was a little exaggerated, we’ll find out in the next six months.”

Four months later, Vanderbilt University Medical Center is cutting 1,000 jobs. Vanderbilt attributes the loss of hundreds of these jobs to the growing cost of uninsured care and the failure to expand Medicaid.

It’s not just a Nashville problem. Within 40 miles of my West Tennessee home, two hospitals are closing and converting into a “clinic” and “emergency center,” and at least two more hospitals are firing employees.

Almost half of Tennessee’s general medical and surgical hospitals have been losing money or have survived only with disappearing federal support. These 54 especially vulnerable hospitals employ more than 21,000 Tennesseans and support the jobs — and care — of tens of thousands more.

How many hospitals have to close? How many Tennesseans have to be fired? How many lives have to be lost?

The hospitals at risk serve both Republicans and Democrats. The workers and the patients at risk are both Republicans and Democrats. But whether the hospitals and the patients survive is up to our Republican governor and Republican legislators.

This ought not be a partisan issue. It ought to be about saving hospitals, savings jobs and saving lives.

Roy Herron, a former minister and former state Senator, is chairman of the Tennessee Democratic Party.

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