The recently passed federal mega bill will have serious and far-reaching consequences for Tennesseans, the state budget and the state economy. Gordon Bonnyman, a co-founder of the Tennessee Justice Center who has spent his entire career as a lawyer advocating for people who are poor, particularly as it relates to healthcare justice, gives us a glimpse of what lies ahead in Tennessee.
Dr. Carole Myers: What can current beneficiaries of TennCare expect as a result of the mega bill?
Gordon Bonnyman: I think immediate effect will be fairly minimal. I don't think there's going to be any dramatic developments right away. Congress designed the bill so that many of the Medicaid impacts would occur after the next election for Congress next year. I also think that even after those effects begin to be felt, they will be, there won't be a single dramatic moment. I think what we will see is more red tape. The basic approach that's been taken is to use in states like Tennessee, is to use red tape, which we've shown in this state and elsewhere, can be very effective at reducing enrollment by eligible people just if you make the paperwork onerous enough, and you make the call waiting times long enough, and you make people resubmit the same information multiple times, you're going to wear out a lot of people, and they won't be able to complete the process. The effect is that it most disadvantages the people with disabilities; the people who are frail and elderly, who are least likely to be able to withstand all those those obstacles.
Let's look now, the mega bill includes pretty major changes in how Medicaid is funded by the federal government, and the implications are that the states will have a different role. Can you talk about how this will impact the state budget, please?
Again, I think we won't see any immediate impact. And in fact, our funding formula is not going to change, so we will not be subject to work requirements. A lot that's been written about what these changes involve will not apply to Tennessee. Unfortunately, unlike some of the claims that are being made by some of our elected officials, people will lose Medicaid coverage in this state. And people will los, much more quickly, their Marketplace coverage in this state. It's not that people will not be affected, but they will not be affected by many of the provisions that change the funding and our state budget won't be affected in the same way. What we will see is that over the next 10 years, an average of $70 million a year will come out of federal funding for the healthcare infrastructure in the state, and that will come out from just again the red tape of making it difficult for people to enroll, which means they won't have coverage, which means that when they go to the hospital, be it a rural hospital or an urban hospital, they won't have the means to pay. Those are revenues that will not flow into our health care system, and that's going to have a knock-on effect that's going to affect all of us who rely on that infrastructure.
