In Tennessee, Tightened Access to Medicaid means Tough Choices

Healthcare is a luxury to some, especially in rural America. Basic medical care is unaffordable to those without adequate health insurance. Casey Britton, a TN resident, filed a 13-page Medicaid application and faxed it to the state before the March 31st deadline, but she received a notice on April 30th informing her that she no longer qualified. This also meant her two young sons, ages 2 and 5, would lose access to medical care.

32 states have expanded Medicaid after passage of the Affordable Care Act, commonly referred to as Obamacare. Virginia just voted to expand coverage, meaning only 17 states have refused to offer additional assistance to low-income individuals.

Tennessee went in the opposite direction and established work requirements for Medicaid recipients. The state follows in the foot steps of Indiana, Arkansas, and Kentucky. Governor Bill Haslam signed the bill, which requires adults with children under six to work, attend school, or volunteer part-time to continue Medicaid coverage. This is yet another move to restrict access to Medicaid.

Britton notes that qualifying for Medicaid is one hurdle, but accessing care is another. The rural area she lives in doesn’t have a pediatrician, meaning she has to drive 60 miles or use a walk-in clinic for her and her family’s healthcare needs. She takes care of her young children while her husband works in Nashville. She anticipates having more free time to find a job with her kids in school, but opportunities are limited where she lives.

The Trump administration supports work requirements for Medicaid, stating that people who work will get out of poverty and be healthier as a result. Advocates for health care are vehemently opposed and say that the move will lead adults to ignore chronic health conditions, skip preventative care, and result in more visits to the emergency room.

In 2016, 14.1 million children lived in poverty across the country. The percent of children in poverty in rural areas is higher than urban areas, with 24 and 19 percent respectively. The gap increased during the Great Recession and continues to widen, especially for single-parent homes and African-American children. In 2017, nearly 1.5 million children in TN were enrolled in Medicaid.

The Tennesee Justice Center predicts that over 480,000 low-income individuals could lose access to Medicaid under the new work requirements. The Kaiser Family Foundation reported that 60 percent of the 24.6 million Medicaid recipients across the country work at least part-time. Medicaid work requirements are set to go into effect in Indiana, Kentucky, New Hampshire, and Arkansas. There are 1.2 million residents receiving Medicare in Tennessee as of 2015.

Perry County, where Britton resides, has been struck by poverty as businesses re-located along the interstate, reducing job opportunities and growth. The Great Recession hit the county with a 29.8 percent unemployment rate.

It has since recovered and sits at 4.2 percent, but many residents left the area for Memphis or Nashville to get jobs. Jobs that are left pay low and don’t offer benefits such as health insurance. Rural poverty is a serious issue, notes Timothy McBride from the Center for Health Economics and Poverty at Washington University in St. Louis.

Lack of access to healthcare is spurred by the lack of reliable public transportation. Residents rely on friends and family members. Gas costs add up quickly, and fares can be exorbitant for some trips. Britton’s husband drives 90 miles one way to get to work, and getting to school by bus for the children takes an hour.

Policymakers ignore the reality of rural poverty and how these requirements are not compatible with daily living. Parents, such as Britton, go without to ensure their children are taken care of first.

Carlos Lopez is the director for Disabled Friends. He also handles the department of disability resources for MedicareFAQ, a learning resource center for all seniors and Medicare beneficiaries.

The Complete Health Care Guide for Disabled Seniors

Disabled seniors need specialized health care to keep them strong at their age. When you are a senior living with a disability, there are activities that become burdensome for you to accomplish. This is why you need specialized health care that gives you the opportunity to live a high-quality life.

Health care, in general, is vital to society. The evidence can be observed on how it continues to be versatile. There are several changes in health care ranging from compensation, regulation by the government and checks and balances by various state authorities. Stiff competition among leading private healthcare providers also brings into question the undisputable importance of health care provision.

The elderly and the disabled have for a long time been forgotten in terms of medical care. Previously, many of these adults have relied on traditional Medicare. Are you one of them? Have you relied on traditional Medicare?

Currently, there have been developed several scopes geared towards providing the required health care to senior adults with disabilities. These include Medicare and Medicare Advantage Plans, As a person with a disability and over 65 years of age, you have some health care options that should significantly add to the quality of your life. A Health Care guide will be most appropriate in guiding you on this topic.

The following guide will be crucial in helping you secure the best heath care option for your well being:

  1. Medicare
  2. Medicaid
  3. Private Insurance
  4. Program of All-Inclusive Care for the Elderly
  5. Senior Health Insurance Assistance Programme(SHIP)
  6. Eye Care Assistance Programs


This program may be categorically described as the traditional insurance program by the government. It aims at adults like you, above 65 years of age or one who has been disabled for two years. It is, however, important that you identify your best program. This is because different programs under this health care option have different regulations: including those that bar switching of Medicare plans.

The Medicare program is able to pay at least half of your health costs. For people above the age of 65, there are some pertinent questions you need to answer as you enroll for this program.

They include:

  • Will you have to pay back to the government for the benefits you receive?
  • What about specific drugs and procedures not covered under Medicare?
  • Can you opt out and enroll in another program?These are some of the pertinent issues that you need to ask yourself before taking any Medicare option.

The four parts of Medicare are as follows:

Medicare part A

Part A of Medicare covers the following sections:

Home health care
Nursing home health care
Inpatient medicare care

Medicare Part B

This is the second level of coverage under Medicare. Once you are signed up for this section, you can enjoy the following services:

Doctor and consultation services
Emergency Ambulance services
Mental check and care
Laboratory tests and x-ray services
Use of high-quality medical equipment

Medicare Part C

After taking the part A and B, you can be enrolled for Medicare part C. It covers the following services:

Provision of Medicare Advantage Plans
Private health Insurance

Medicare Part D

This is the final part you can take under Medicare. It mainly covers prescription of drugs as the major benefit. As a senior, you can use this part to claim or pay for your drug prescriptions.


Medicaid is a valuable option for seniors since it is geared towards availing funds for the financially unstable individuals, as well as the seniors. As long as you are above 65 years and are receiving Medicare, Medicaid will equally come your way with valuable financial boosts. For seniors, Medicaid will cover any payments and premiums usually charged under Medicare.

Medicaid, however, has some specific qualifications that you should attain to be enrolled. First, you should have less than $2000 in countable assets value. If you are to receive Medicaid as a couple, you should not have countable assets exceeding $101,500.

Private Insurance

There is a large probability that Medicare and any Medicare Advantage Plan may not have an insurance policy. This leaves you at the risk of losing support for any health issues not covered under the program. A private insurance will in this case come in handy to boost your risks.

Private insurers are more likely to offer you better cushioning against any emergencies and health finances. After you have a long term disability, these companies will examine your coverage issues and provide a suitable plan to keep your health finances in check.

Program of All-Inclusive Care for the Elderly

This is a nationwide program that targets elderly people who display an ardent need for home-based care. It provides medical and social services to seniors living in a community where (PACE) is located. High-quality health care is provided in the community as opposed to staying in a nursing home.

Other services you can get from PACE include:

Dental care
X-ray services and other laboratory tests
Drug prescription
Emergency response and ambulance services
Occupational therapy
Nursing home care

Senior Health Insurance Assistance Program

This is more of an information-based program. It aims at providing senior citizens (above 65) with details on medical bills, medical plans, and health insurance. As a senior, you may find it difficult to make rational decisions, and as such, the Health Assistance program will bail you out.

To receive any assistance, you need to show qualifications as follows:

Having attained Medicare assistance up to part D. This is because it is the level that provides money for drug prescription
Relevant information on disabled Medicare beneficiaries
Health Insurance Assistance
Medicare bill assistance

Eye Care Assistance Programs

A significant number of seniors have lost sight as they age. Some have lost it partially while others lose it entirely. It is, therefore, important that you get the appropriate health Insurance that covers the health and finances that are required to treat you. By the age of 65, it is estimated that around 1 in every three American citizens has some eye deformations. These can range from cataracts, and glaucoma among other complications. Eye care programs spread across the United States can help you overcome this situation or at least ensure your quality of life is enhanced.

Carlos Lopez is the director for Disabled Friends. He also handles the department of disability resources for MedicareFAQ, a learning resource center for all seniors and Medicare beneficiaries.