Health issues back in spotlight for Tennessee lawmakers
And although consensus on how to tackle big issues may vary, concern for the health of the state's residents touches both sides of the aisle.
"Health care has become one of the top issues in the state as well as the
Health and social services make up the largest portion -- 45 percent -- of the state's budget, followed by education at 29 percent, yet
But with many stakeholders and concerns on the table, here are a few issues to watch this season in the wake of week one:
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Medicaid
From protests calling for its expansion on Tuesday to the Trump administration's go-ahead Thursday allowing states to issue work requirements for able-bodied enrollees, it's hard to escape chatter about the health insurance program Medicaid, better known in the state as TennCare.
Medicaid, along with the
"The legislature has blocked Gov. [Bill] Haslam from using federal health funds, funds that Tennesseans send to
Zechman was one of several health care organization representatives who called on lawmakers to reconsider Medicaid expansion in a teleconference on Tuesday.
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But
"I think there's a lot of concern about the impact it would have on the health system, as well as the budget," he said. "The devil's in the details."
Provider shortages, transportation issues, economic challenges and higher rates of chronic disease create significant health challenges for rural Tennesseans, who make up about 22 percent of the state's population.
Since 2010,
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Champions of Medicaid expansion blame the closures on costs of providing uncompensated care to high volumes of uninsured, would-be beneficiaries, but
"A lot of the rural hospitals, it's very difficult for them to survive in today's environment and that's partially due to the patient mix they see," McNally said, adding that because they have a high percentage of Medicare and Medicaid patients "it's difficult to survive."
He and Watson, also a
"A lot of the cost of running a hospital in the 21st century is operational efficiencies that require a level of sophistication that many of the rural areas don't have," added Watson, noting that a rural hospital chief executive officer may simultaneously have responsibilities that in a larger facility would be handled by a chief financial officer, chief operating officer and even chief nursing officer.
Chronic Disease and Addiction
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When looking for areas of bipartisan agreement, lawmakers are united in the belief that many of the state's health issues are a result of "preventable" conditions.
High rates of chronic diseases, such as obesity, diabetes, hypertension, stroke, cancer, heart disease and depression, plague the state, and are often caused or exacerbated by controllable behaviors, such as lack of exercise, tobacco use, substance abuse and other damaging lifestyle choices.
"We've got to look more toward the preventative health, because as Chairman Watson is seeing, health care is becoming such a huge part of our budget that if we don't do something it's going to be unsustainable," Sen.
Sen.
"The one that I think we're really going to have to start focusing on, that legislation can have an impact on, deals with this opioid crisis that we have in this state," he said.
To date,
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