Republican Cuts to Medicaid Put Tennesseans' Health and Coverage at Risk

Living Blue in a Red State

[Note: This Substack post has been prepared to also run as an Opinion Piece in the Crossville Chronicle, the local newspaper. Given that the Senate version of the 2025 Budget bill may be voted on tomorrow, the post will require some modifications prior to publication approval.]

In recent months, the “Hands Off” rally and the “No Kings” rally took place in Crossville, Tennessee in front of the Courthouse. The events were peaceful and, based on unofficial counts, some 350 people attended each of the events.

These rallies, which were coordinated with similar rallies across the country, were held to bring to the attention of residents of Cumberland County the negative effects of numerous policies of the Trump Administration that are supported by Rep. John Rose (R) of the 6^th Congressional District.

Ater the rallies, local on-line social trolling stated that the attendees were outside agitators who were paid to attend; that the focus was on “…supporting illegal illegals, open borders, and murderers; and that those who participated hate America.

Nothing could have been further from the truth. The participants were from Crossville and surrounding towns. All were there of their free will and no compensation was provided. After the “No Kings” rally two full carloads of food that were donated by rally participants were delivered to a local foodbank.

The Trump Administration policies that will most adversely harm residents of Cumberland County are proposed cuts to Medicaid, known in Tennessee as TennCare, and CHIP (Children’s Health Insurance Program) that are contained in the President’s “One Big Beautiful Bill” (OBBB). The bill passed the House of Representatives on May 22 by a largely party-line vote of 215-214-1. Rep. Rose voted for the bill.

These proposed cuts are not because America can’t provide for our most vulnerable; they are to help pay for the multi-trillion-dollar tax breaks for the wealthiest of Americans that are contained in the bill.

As passed, the OBBB would cut federal Medicaid payments by $880 billion over a 10-year period. These cuts would lead to stricter eligibility requirements, benefit reduction, or coverage losses for the 72 million Americans who rely on Medicaid for their health care.

According to the Kaiser Family Foundation, 1.5 million Tennesseans, representing 19% of the state’s population, are enrolled with TennCare, the state government body that administers Medicaid. In Tennessee, Medicaid covers 1 in 8 adults aged 19-64, 2 in 5 children, 4 in 7 nursing home residents, 1 in 5 Medicare beneficiaries, and 3 in 10 working-age adults with disabilities.

The Federal Government currently pays 65% of the cost of traditional Medicaid in Tennessee, with the state share being only 35%. So, who specifically would suffer in Tennessee if dramatic cuts were to be made to federal Medicaid payments as contained in the OBBB? This was recently answered in a document from the United States Senate Special Committee on Aging:

· Cut care for children. Around 42% of children are enrolled in Medicaid or CHIP. Around 43% of kids with special health needs, such as a physical or behavioral disability, depend on Medicaid.

· Block access for pregnant women and newborns. Nearly 38,000 births (46%) per year are covered by Medicaid.

· Curb health care access for people with disabilities. Medicaid covers over 316,000 people with a disability.

· Create barriers to behavioral health services. More than 96,000 Medicaid beneficiaries were treated for a substance use disorder in 2021.

· Cut coverage for Medicare beneficiaries. More than 253,000 dually-eligible Tennesseans rely on Medicaid to help pay their Medicare premiums and co-pays.

· Disrupt nursing home care. Cuts to Medicaid could disrupt care for 57% of nursing home residents who use Medicaid to pay for nursing home care.

One can feel the expected pain at a county level by looking at data from the Georgetown University McCourt School of Public Policy. Accordingly, Cumberland County, with an approximate population of 63,500, has a total Medicaid rate of 20%. The adult coverage rate stands at 13.8%, the senior Medicaid coverage rate is 14.0%, and the childhood Medicaid/CHIP coverage rate is 48.6%. These are not just statistics, they represent friends, neighbors, and family members.

SUMMARY

Those who participated in the recent rallies apparently care more about the pain that will be experienced here in Cumberland County by vulnerable people from OBBB than Rep. Rose who wrote on X on May 22 that he voted for it because: “Tennesseans are fed up with reckless spending and crushing national debt. They want a President equipped to deliver on his promises.”

[NOTE: As of today, Sunday, June 29, the Senate version of the OBBB can be expected shortly. If that is the case, additional information will need to be provided on any further changes to the Medicaid issue prior to publication.]