students at blockgrant meeting


Memphis Law students joined scores of concerned citizens recently at a public hearing at the University of Memphis focusing on the proposed $7.85 billion Medicaid block grant amendment. Under the proposal, the state would receive the block grant to use on some of its Medicaid services, rather than receiving an unspecific but unlimited amount of funding based on claims filed.

Tennessee is one of 14 predominately Republican-controlled states that have not adopted Medicaid expansion as a rebuke to the Affordable Care Act -- a decision that has so far prevented 380,000 adults from receiving health benefits they would otherwise have, according to the Commonwealth Fund.

The governor has instead opted to attempt to receive a federal block grant to administer his own program. He has stated that the block grant would give Tennessee autonomy to improve the program and save money without compromising users' benefits.

University of Memphis law students enrolled in our Health Policy Practicum course, as well as students enrolled in the law school's Medical-Legal Partnership Clinic, provided public comment at the forum, with several more providing written statements, and one publishing a written op-ed in The Daily Memphian about the matter. 

Until this forum, TennCare officials avoided discussing Gov. Lee's plan in Shelby County, the state's largest urban area with the most number of TennCare recipients.

University of Memphis law student Eliza Jones said it was "inappropriate" that Memphis was not a "top priority" when scheduling public meetings about the block grant. Jones is a 3L

"Shelby County has more than 250,000 people enrolled in TennCare. That number represents 26% of our county's total population and 17.6% of TennCare enrollees, the highest concentration of TennCare enrollees of any county in Tennessee, by almost double," she said. "Shelby County is undoubtedly the most significant TennCare stakeholder of all Tennessee counties and this city should have been the starting place for any TennCare hearing concerning an issue of this magnitude."

Professor Katy Ramsey, director of the Medical-Legal Partnership Clinic, and several of her students spoke on-the-record with comments addressed at how this proposal would hurt various communities and poor individuals in Memphis and Shelby County.

"This is clear, people will die if this proposal goes into effect, and they will be our poorest, oldest, most vulnerable neighbors," said Rachel Ledbetter, a third-year law student in Memphis who spoke candidly that the state should be expanding Medicaid plans just as 36 other states have done instead of looking for ways to save money.

"This plan gives the state authority to cut services as they please without any accountability," she said.

"If you value the lives of Tennesseans and access to health care, then expand Medicaid in our state."

Professor Ramsey said it was difficult to imagine how the state would be able to achieve savings and reinvest them back in the state.

"The possibilities for significant cost savings are limited," Ramsey said. "One of the only ways would be to limit TennCare enrollment or benefits," adding, that it is "morally unconscionable" to limit or eliminate accountability rules that protect Medicaid.

"The state should be subject to more federal oversight, not less," she said, noting that 200,000 people once on TennCare have been dis-enrolled.

"I strongly urge the state not to move forward," Ramsey said. "The results would be devastating and irreversible."

The State of Tennessee will submit its block grant proposal to Washington, D.C. later this year.