Tennessee: GOP House passes fetal heartbeat law after state kicks 128,000 actual children off Medicaid

I'm lumping together three Tennessee-based stories here from the past month or so, but they're perfectly connected to each other:

March 7th, 2019:

The Tennessee House of Representatives passed a bill on Thursday that would ban abortion after a fetal heartbeat is detected, mimicking laws in other states that have been struck down by the courts and drawing the criticism of both advocates and opponents of abortion rights.

The measure, House Bill 77, would tightly restrict the window of time within which a woman could seek an abortion, because a fetal heartbeat can be detected as early as six weeks into a pregnancy. That is before many women even realize they are pregnant.

The bill, which is part of a category of anti-abortion measures called “heartbeat bills,” will now be referred to the State Senate, where abortion rights groups have said they hope to derail it. If it were to be passed by the Senate and signed into law, it would become one of the most restrictive abortion laws in the country.

Hours after the vote in Tennessee, the Georgia House of Representatives passed a similar bill that would outlaw abortions after a fetal heartbeat is detected. The state’s governor, Brian Kemp, a Republican, has indicated that he will sign the legislation, House Bill 481, if it passes in the State Senate.

The good news (such as it is): The bill ended up stalling out in the state Senate after all, and thus has been stopped until next year. But still. Meanwhile...

April 1st, 2019:

Tennessee erased insurance for at least 128,000 kids. Many parents don't know.

...Harrison is one of at least 128,000 children who, over a two-year span, were purged from TennCare or CoverKids, two Tennessee government health insurance programs for low-income families. It appears tens of thousands of these children have not acquired private insurance, so they likely joined the swelling ranks of the uninsured residents of Tennessee, already one of the unhealthiest states in the nation.

State officials said the sharp cuts are a consequence of TennCare and CoverKids pruning their enrollment...TennCare officials confirmed "many members" were disenrolled because they did not respond to renewal forms, but couldn't estimate how many were cut purely because of lack of paperwork.

That uncertainty, sources say, is causing havoc for poor families across the state. Some medical professionals say children have inexplicably lost coverage without their parents' knowledge, and social justice advocates allege the widespread disenrollment was largely caused by pervasive procedural errors inside TennCare.

...This story focuses on the two-year period between December 2016 and January 2019, during which 1 in every 8 children in TennCare was disenrolled. However, the current loss of insurance could actually be much higher because TennCare initially released data showing an additional 52,000 children were removed from the program in February — the biggest drop in any month on record.

After being questioned by The Tennessean, TennCare officials took this recent data offline and insisted it was incorrect, saying there had been no historic cuts in February. New enrollment data for February has not yet been made public.

Here's an important Twitter thread from the reporter at the Tennesseean who broke the story with more:

  • "The state says kids were cut for one of two reasons: They are either no longer eligible, mostly because their parents now make too much money to qualify, or because families didn't fill out proper paperwork. How many in each category? State officials say they don't know.
  • For conversations sake, lets say it's 50/50. That would mean that 64,000 children lost insurance, which they are legally entitled to, because a form didn't get filled out. Maybe the parents didn't understand it. Maybe the form got mailed to the wrong address.
  • Maybe the parents didn't understand the form (it's pretty dense.) Maybe their address was out of date in a government database, so they never got the form. Maybe it was lost in the mail. Are these good reasons for kids to lose coverage?
  • Also, it appears that the parents of many kids who lost insurance haven't been informed. Every day, families in this state find out at the doctor's office or the emergency room that their kid doesn't have TennCare anymore.
  • All the numbers in this story are bad, but in some places they are worse. In Memphis, about 27,000 kids lost coverage either TennCare or CoverKids. In Nashville, 17,000.
  • Cheatham County lost about 1,000. That might not sound like much, but it's more than 1 in every 5 kids in these programs. In just two years.
  • One final note: This is a hugely important issue and I want more journalists to cover it. Because of this, The @Tennessean has released all of the data we used for this story, free for anyone to use (with credit, please.) Get in there.

Kicking children off of Medicaid without telling their parents is disturbingly consistent with making abortion illegal before the woman even knows she's pregnant.

That brings me to April 12th, 2019 (today):

Tennessee House advances bill seeking to overhaul Medicaid

Tennessee would dramatically overhaul how it provides health care to its lower-income and disabled residents under a proposal the House advanced Thursday.

The bill cleared the GOP-dominated chamber on party lines, with 68 Republicans in favor and 21 Democrats against.

It's a proposal considered one of the top policy debates of the sessions, yet many in the minority party were visibly upset after being cut off from the debate and forced to cast a vote before all members had a chance to speak.

...The measure would require Gov. Bill Lee and the Department of Finance and Administration to submit a waiver within 120 days of the bill becoming law asking the federal government to send a fixed amount of money each year in the form of block grants. If the waiver is approved by the Centers for Medicare and Medicaid Services, it would then need the General Assembly's endorsement.

Ah yes...block grants. The perfect way of starving Medicaid and other low-income social services to death gradually instead of all at once:

Federal block grants are, by definition, an arbitrarily capped amount of federal funding that go to states in the form of a lump sum payment and fail to adjust for population growth, economic changes, public health crises, or natural disasters such as hurricanes, tornadoes, etc.

Thus, states with growing populations, such as Texas, or states often in the pathway of natural disasters, such as Texas, or states with a disproportionate share of low wage jobs, such as Texas, would be most negatively impacted by a federally-imposed block grant. As need increases due to any of these factors, block grants and federal assistance are, by definition, unresponsive and unhelpful. States would be left facing the full brunt of any calamity or crisis.