Tennessee rankings among the 50 states

• *14.4% = Percentage of population not covered by health insurance in 2008
• *10.4% = Percentage of population lacking access to primary care in 2010
• *6th highest births of low birth weight in 2007
• *4th highest infant mortality rate in 2006
• *13th highest death rate by diseases of the heart 2006
• *9th highest teenage birthrate in 2007
• *13th highest estimated death rate by cancer in 2009
• ^48th: Poor Physical Health Days (getting worse since 2008)
• ^ 47th: Obesity (getting worse since 2008)
• ^46th: Infant Mortality
• ^46th: Cancer Deaths
• ^45th: Preventable Hospitalizations
• ^44th: Cardiovascular Deaths
• ^41st: Smoking Prevalence
• ^39th: Infectious Diseases
• ^47th: Prenatal Care
• ^41st: Poor Mental Health Days (getting worse since 2008)
• ^31st: Lack of Health insurance (getting worse since 2008)
• ^21st: Public Health Funding
  

* Morgan, Kathleen O'Leary and Morgan, Scott. CQ Press's State Fact Finder Series: State Rankings 2010. Washington, DC, 2010.

^United Health Foundation: America's Health Rankings 2010. No. 1 is best; No. 50 is worst.

TennCare and Taxes - Both are State Responsibilities

“Simply put, hospitals agreed to pay for the state’s proposed cuts through a fee that would not be passed on to consumers, rather than allow devastating cuts to threaten care to their patients and communities, as well as some hospitals’ very existence…. hospitals would take care of patients as they always have. Ultimately, however, the funding of TennCare is unquestionably the state’s responsibility…. Certainly, these are not the best of times for a state whose budget revenues depend almost entirely on retail spending by consumers… a state where unemployment now has exceeded 11 percent.” - Craig Becker, CEO of the Tennessee Hospital Association, Feb. 23, 2010.

We have heard Gov. Phil Bredesen say that Tennessee cannot afford health insurance reform. However, when you go beyond the political rhetoric and look at the numbers, it will make you say, "Tennessee cannot afford to walk away from reform."

By expanding TennCare to cover an additional 300,000 poor working adults, and creating organized health insurance market places (called exchanges), covering 350,000 near-poor adults, Tennessee would receive more than $2 billion dollars a year and only have to spend $135 million for health insurance reform. This is about 6¢ in state dollars for 94¢ in federal dollars.

So, where does Tennessee get the 6¢ to spend so that it can get the other 94¢ in federal dollars? This is a better deal than building the interstate systems with the state paying 10¢ and the federal government paying 90¢. A deal that would provide health insurance coverage for 650,000 Tennesseans is too good to pass up.

Revenue to take advantage of such a great deal and expand health care coverage is generated from state taxes. Yet, in Tennessee, who pays the bulk of the taxes? Are the taxes fair and equitable?

The primary way that Tennessee collects revenue is through sales taxes and much of these consumption taxes are on necessities should as food and clothing. So Tennessee's tax structure is designed in such a way that the poor and near-poor pay a much higher percentage of their income on necessities while those in upper-income brackets spend much less because many of the services that upper-income folks use, and lower income people do not use, are exempt from sales tax.

The Tennessee Health Care Campaign is working to get the 6¢ on the dollar to expand health insurance to the poor and near poor. However, it is not fair that the poor and near-poor have to pay such a higher percentage of their income (12%) while higher income folks are only paying about 4% of their income for state taxes.

In addition, Tennessee’s tax structure is inadequate. Since 2005 (long before the recession in 2008) Tennessee cut back its TennCare program so much that its recommended budget in 2011 is smaller than its budget was in 2005. People who were once on TennCare but who were cut off because of a lack of adequate funding for the program have lost their lives, their limbs, their sight, and their mental health.

In addition to the cuts in enrollment, there has been a steady cut in benefits, forcing thousands to go without care. The benefit cuts proposed for 2011 by the Bredesen administration are the most draconian of any state in the nation.

Tony Garr,
Executive Director of Tennessee Health Care Campaign