One in 10 Tennesseans lack health insurance

From Southern Standard



NASHVILLE (AP) — A state report shows one in 10 Tennesseans, or about 580,000 people, lack health insurance.



That number does not include the 190,000 adults being cut from TennCare in an effort to reign in the costs of the $8.7 billion public health care program.



"The mistake we made was focusing on the 1.1 million people on TennCare and ignoring all of the other Tennesseans who are uninsured," Gov. Phil Bredesen said Wednesday in a speech to hospital officials gathered for the annual Hospital Alliance of Tennessee meeting.



The percentage of uninsured Tennesseans falls slightly under the most recent estimate of the national uninsured population. The Census Bureau estimates that in 2003, about 15.5 percent of U.S. citizens did not have health insurance.



Bredesen said he wants to find a way for all of the state's residents to have access to some form of medical insurance, and says the way to pay for it is to form partnerships among the government, insurance companies, health care providers, businesses, non-profits and recipients.



The cost of providing health care to people who cannot afford it ultimately either gets passed on to the insured through higher premiums or is paid by federal and state tax money.



"I really do believe that everyone does have to pay a little something for everything," he said.



The largest portion of uninsured people work more than 40 hours a week, hold only one job and work for small private businesses, according to the report completed by the Tennessee Department of Commerce and Insurance.



Sita Diehl, executive director of the National Alliance on Mental Illness of Tennessee said many people with mental illnesses are often considered an uninsurable pre-existing condition by insurance companies.



"I know several people with mental illnesses who are very, very capable, but because of their self employment or because they work for a small business, they are not able to qualify for private insurance," she said. "They are not poor enough or disabled enough to get on TennCare, but they're out in the cold."



Twenty percent of the uninsured work for employers who offer health insurance, but nearly a quarter of those workers said they were not eligible for their employer's coverage. Of those eligible, a quarter said the benefits were too expensive.



Gordon Bonnyman, executive director of the Tennessee Justice Center and an advocate for TennCare enrollees, said that while it's important to focus on the entire uninsured population, he feels the governor has created a bigger problem with TennCare disenrollments.



Bonnyman said the cuts resulted in the state forfeiting $1.2 billion in federal funds — money that could be used to provide more coverage to Tennesseans.



"Where are you going to come up with $1.2 billion to cover people?" he said. "It's fine to say you want to focus on all the uninsured. But you've got to pay attention to the federal money."



Part of the problem is an out-of-date Medicaid structure that doesn't address the needs of the country, Bredesen said. Medicaid was created in 1965 as a way to insure needy women and children, though the program now covers more than 20 categories of economic and medical conditions.



Bredesen said Tennessee is on the leading edge of Medicaid reform, with states like Pennsylvania, Florida and others beginning major overhauls. He said the National Governors Association intends to pressure the federal government to consider major changes to Medicaid.



"I think the program is deeply unfair," Bredesen said. "Our Medicaid house has grown too much by just tacking on another room. The way we have been dealing with it is coming to the end of the rope."



Medically uninsured Tennesseans span demographics

A look at the medically uninsured population of Tennnessee:



— 51.3 percent are between the ages of 41 and 65.



— 12 percent are black



— 2.5 percent are Hispanic



— 58.4 percent have a family income of less than $30,000.



— 11.2 percent live in West Tennessee, 10 percent in Middle Tennessee and 8.7 percent in East Tennessee.



— 20 percent work for employers who offer health insurance benefits.