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Get Covered NashvilleWHAT IS GCN?
A COLLABORATION OF AGENCIES WORKING TOGETHER TO MAKE THE ROLL-OUT OF THE ACA A SUCCESS – SHARING INFORMATION, ISSUES ANDSOLUTIONS AND OTHER COMMUNITY SUPPORT
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
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.
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)
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
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.
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…..
THE FUNDED AREA
THE AREA WE SERVE
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!
NOT SO FAST!!
In the Summer of 2012, The Supreme Court Ruledeach state could decide whether or not to ExpandMedicaid – this put a critical piece of the ACA in Jeopardy……..
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.
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 !
WHAT’S NEXT?•Will Haslam call another special session?•Next Legislative Session: 2016
Insure TN QUIZTrue or False
Senator Janice Boling:“Insure TN is only for able-bodied Persons, won’t help those with pre- existing conditions”
FALSE!!!!Insure TN covers all low-income Tennesseans, regardless of category or health needs.
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%.”
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.
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.”
FALSE !!!!Medicaid (TennCare in TN) is a federal program that is protected, and is completely separate from all provisions of the ACA law.
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.
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.
Keeping Insure Tennessee in playCall 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 [email protected].
Go to TJC website, sign the petition and get advocacy materials.
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
Help for the Uninsureduntil it passes:
Call HEALTH ASSIST:615-313-9972
1-800-269-4038Spanish: 615-227-7568
