1. Get Covered Nashville
WHAT IS GCN?
A COLLABORATION OF AGENCIES WORKING TOGETHER TO MAKE
THE ROLL-OUT OF THE ACA A SUCCESS – SHARING INFORMATION, ISSUES AND
SOLUTIONS AND OTHER COMMUNITY SUPPORT
2. Who is Eligible for TennCare/Medicaid?
To be eligible must meet 2 Requirements:
1. Very low income (below the poverty level)
2. Meet a category requirement:
- Child under 21
- Pregnant
- Disabled
- Parent of child under 18
3. Recent History of Disenrollments
- In 2005 Governor Bredesen terminated adults on
TennCare Standard…..
-over 323,000 Tennesseans with pre-existing conditions lost their
coverage.
- Access TN, a high risk plan was implemented, but the premiums
ran $800-$1200 per month, more than most people made each
month.
-In 2009, the long-standing Daniels’ lawsuit was settled..
-an additional 150,000 Tennesseans on disability lost coverage.
4. How Detrimental Is This?
• For Most of us, a serious diagnosis means:
- Treatment
- Disruption of normal routines
- Concern and possibly fear
• For someone without insurance, even a minor diagnosis means:
- Choosing between food or utilities and medication (minor dx)
- Losing one’s home and life savings to pay for treatment (major
dx)
- Diagnosis means a death sentence (major dx)
5. Typical Circumstances of the
Uninsured
• Emergency Room Care
• Go without Rx’s if you can’t afford them
• Try to ignore symptoms
• End up in ICU due to not receiving the needed
care
6. WHAT DOES HEALTH ASSIST DO?
• Screen all callers for TennCare, CoverKids, Marketplace or Medicare
Programs
• Free or Low Cost Medical Home for Primary Care
• Free or low cost Prescriptions through Rx assistance programs
• Help Callers with specialty needs, find specialty care, surgeries,
treatment through available charity programs
We want callers to maintain their health and prevent
ER/Hospital stays until they are eligible for some type of
healthcare coverage.
7. Case Examples
• Client with seizure disorder, couldn’t get anti-
seizure meds
• Diabetic client, couldn’t afford to go to the Dr.
• Young client with Lupus
Not having health insurance is costly in lives, in jobs,
and in care for all of us…..
10. MARCH 23, 2010:
The Affordable Care Act Became
Law!
• For those of us doing this work,
• For those in serious medical
need,
• For Hospitals at risk
It was a long time coming,
but the wait was finally
over!
11. NOT SO FAST!!
In the Summer of 2012, The Supreme Court Ruled
each state could decide whether or not to Expand
Medicaid – this put a critical piece of the ACA in
Jeopardy……..
12. Between TennCare & Subsidized Ins.
Medicaid (TennCare) excludes adults – no matter
how poor – unless they are parents, pregnant or
approved by SSA for disability.
ACA’s premium tax credits and cost-sharing
protections only available above the poverty level.
13. INSURE TN
• Turned down in Special Session – unfortunately turned down based
on misinformation.
• Thanks to Jeff Yarbro, it was revived for a short time in the regular session, only
to die again, due to politics, continued to use excuses.
• Working on educating those in the gap, people in the community
and getting support and information to lawmakers for the Regular
Legislative session.
Understanding and Facts = SUPPORT !
17. TRUE OR FALSE?
Rep. Jeremy Durham:
“When the federal govt. no
longer covers 100% of the
cost, we will have to take
money from school children
to pay the 10%.”
18. FALSE !!!
The State will pay nothing,
this is cost neutral. The TN
Hospital Association has
agreed to pay all costs not
covered by the Federal
Government.
19. TRUE OR FALSE?
Senator Kerry Roberts:
“If we pass Insure TN but drop it,
if it doesn’t succeed, all those
on TennCare now will lose their
coverage.”
20. FALSE !!!!
Medicaid (TennCare in TN) is
a federal program that is
protected, and is completely
separate from all provisions
of the ACA law.
21. What Happens when it goes
back before the legislature?
Hurdle #1: will be the committee that killed it in
last session: The Commerce Committee, with our
own Jack Johnson. It must pass that committee to
remain alive to go to the floor. Others on Commerce
Committee: Jim Tracy, Delores Gresham, Bo Watson and
Green.
Hurdle #2: The Senate, it is believed it can pass in
the house.
22. Insure Tennessee: the Talking Points
Keeps Federal dollars set aside for
Tennessee
Provides peace of mind for Tennessee
families
Improves health of Tennesseans, creates
jobs, strengthens our economy
Ensures health and financial security
Preserves local hospitals that we all use.
23. Keeping Insure Tennessee in play
Call 615-763-4773 to be connected to your
State Representative and State Senator.
Join Monday night calls at 7:30 Central.
Sign up by contacting Katie Alexander at
kalexander@tnjustice.org.
Go to TJC website, sign the petition and
get advocacy materials.
24. WHAT CAN WE DO?
Saturday, May 30th, 8:00am Central -- THCC Annual Meeting: Come
to the annual THCC meeting to discuss Insure Tennessee and
enrollment.
Monday, June 1st, 7:30pm Central -- TJC Statewide Call: Join us for
our bi-weekly call
Join monthly action – get involved!
Check the TN Justice Website
25. Help for the Uninsured
until it passes:
Call HEALTH ASSIST:
615-313-9972
1-800-269-4038
Spanish: 615-227-7568
