Latest news with #TennCare
Yahoo
23-05-2025
- Health
- Yahoo
'Big Beautiful Bill' means a Code Blue for Tennessee health care
Vanderbilt University Medical Center has been hit by $250 million in federal budget cuts. (Photo: John Partipilo/Tennessee Lookout) The U.S. House of Representatives passed their 'Big Beautiful Bill' by a vote of 215-214. Every member of the Tennessee Congressional delegation voted yes, with the exception of 9th District U.S. Rep. Steve Cohen, a Democrat. And with that vote, they put thousands of Tennesseans at risk of losing their healthcare and their food benefits. Cuts to TennCare, our state's Medicaid program, will hurt vulnerable Tennesseans — people with disabilities, low income pregnant women, the elderly and children — who depend on this program for access to primary care, preventative care, prenatal and postpartum care and skilled nursing care. We also face historic cuts to the Supplemental Nutrition Assistance Program (SNAP) program, right as school lets out for the summer — a time when many kids go hungry. According to the Center on Budget and Policy Priorities, 57,000 Tennesseans with children stand to lose their SNAP benefits. This means children will get up and go to bed hungry all over our state. Healthcare workers in Tennessee have been sounding the alarm bells on a number of issues for years now: COVID public health measures and vaccine outreach, threats to reproductive healthcare, and, more recently, the NIH funding cuts and the resulting loss of grant money for medical research. Here in Middle Tennessee, one of our biggest employers, Vanderbilt University Medical Center (VUMC), has announced $250 million in federal budget cuts and has already begun layoffs as a result of the funding cuts to the National Institutes of Health (NIH). VUMC received $468 million in 2024 for medical research, the second most in the country according to Axios. Overall, Tennessee universities received $770 million in funding for research from the NIH last year alone. 250k Tennesseans could lose TennCare, private insurance under Congressional spending bill Statewide, the cuts have also affected the University of Tennessee Health System, Meharry Medical College and St Jude Children's Research Hospital. Meharry Medical College is an historically Black college (HBCU) in Nashville and it helps to fill the gap of underrepresented minorities in the healthcare workforce. In Memphis, St. Jude's is the hospital where parents can get treatment for their children with cancer and other diseases without fear of medically bankrupting their families. We have only just begun to feel the pain from the loss of the critical NIH funding source for these essential organizations. Eventually, medical research will slow, and breakthrough science, like the work that was done at Vanderbilt to develop the COVID vaccine, will be threatened. Now, it's time for health care workers and advocates to answer the call for healthcare again. We need to press that Code Blue button in Tennessee, gathering our colleagues together to fight the impending federal budget cuts that threaten Medicaid and SNAP. Inside the hospital, activating a Code Blue means there is a medical emergency and a patient in need of resuscitation. Here in Tennessee, our healthcare system is in dire straits. According to the Kaiser Family Foundation, 250,000 Tennesseans will lose their healthcare coverage as a result of Medicaid cuts and other changes to the Affordable Care Act insurance marketplace. This is on top of the already over 635,000 Tennesseans lacking any healthcare coverage in 2023, about 11% of the population in our state. Because of our high uninsured rate, Tennessee has had more rural hospital closures per capita than anywhere else in the country, which has led to maternity care deserts and factors into our dismal maternal mortality rates. This 'Big Beautiful Bill' will have far-reaching consequences for all Tennesseans, not just those who rely on TennCare and SNAP. Hospitals, especially rural ones, run on slim margins and will be at increased risk of closure due to the Medicaid cuts. According to Becker's Hospital review, over 41% of rural hospitals in Tennessee are vulnerable. Rural hospitals in our state closing will inevitably lead to further crowding in the tertiary care hospitals in our big cities. Wait times in emergency departments will go up for everyone. Appointments to see primary care and specialists will be harder to get. It couldn't be any clearer: when one person is denied healthcare access, it affects us all. There is a Code Blue in Tennessee. Our patients, neighbors, hospitals and communities need our help. We cannot let heartless politicians pull the plug and flatline our safety net just to give tax cuts to billionaires. It's time to gather all hands on deck to save our healthcare system that is teetering on the brink before it's too far gone to resuscitate. SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX
Yahoo
22-05-2025
- Health
- Yahoo
250k Tennesseans could lose TennCare, private insurance under Congressional spending bill
U.S. Capitol building in Washington, D.C. (Photo: Jennifer Shutt/States Newsroom) Proposed cuts in federal healthcare spending on Medicaid and the Affordable Care Act could force more than 250,000 Tennesseans to join the ranks of the uninsured, an analysis by the Kaiser Family Foundation found. Healthcare advocates are closely following House debate over a legislative package that would make significant changes to Medicaid and the Affordable Care Act (ACA) marketplaces. The reconciliation bill would cut Medicaid spending nationwide by at least $716 billion, representing the single largest cut in the program's history, a separate analysis by the Congressional Budget Office found. The bill would achieve those cuts in a variety of ways, including by introducing stricter enrollment and work requirements for the low-income and disabled Tennesseans who rely on TennCare, Tennessee's Medicaid program. The bill would also eliminate so-called premium tax credits that have helped individuals purchase their own health insurance on the Affordable Care Act marketplace. Together, the two provisions could cost between 190,000 – 310,000 Tennesseans access to TennCare or private insurance through the healthcare marketplace, according to Kaiser Family Foundation. Much, however, remains in flux about the final language of the omnibus federal spending bill as it heads to a vote on the House floor. The bill includes a significant increase in spending on immigration enforcement and an extension of tax cuts created during President Donald Trump's first administration. SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX
Yahoo
15-05-2025
- Business
- Yahoo
‘It doesn't make sense': TN hemp stores face uncertain future following near-ban on THCA
KINGSPORT, Tenn. (WJHL) – The Tennessee legislature dealt a crushing blow to hemp stores across the state after moving forward with a bill that would ban hemp products that contain more than 0.3% THCA. THCA turns into an intoxicant when burned. Adam Stallings and Ashton Smyth are business partners who own The Laboratory in Kingsport and several other locations in East Tennessee. Smyth said discussions are already underway to decide how the business can move forward. TOP STORIES: TennCare change would aid Ballad's rural hospitals 'I think we're going to grow more in clothing and artwork and other things like that,' Smyth said. 'In our Johnson City store, we sell some collectible items like trading cards.' Smyth said that they're going to lean into their TCHA drinks, which aren't included in the ban, as an avenue to keep people in the doors. He explained that they've been taking suggestions from customers as to what kinds of products they'd like to see in stores. Nonetheless, Smyth said that not having their top products will have a negative impact. 'We sell a lot of different things that aren't THCA, but at the end of the day, THCA is what gets people in the door,' Smyth said. Smyth and Stallings both lobbied in Nashville to help keep the multi-million-dollar hemp industry in the state. Although that push failed, Stallings said he isn't giving up the fight. CRIME: Unicoi Co. couple charged with aggravated child abuse Stallings is going as far as running for a spot in the Tennessee House of Representatives. 'We have to get people that are in there that are going to be a serious voice, that are going to listen to the people and be that voice for the people that will vote for the will of the people,' Stallings said. The future is unclear in Tennessee for The Laboratory and other stores that sell hemp products. Smyth said that tough conversations are in the future. One of those conversations surrounds whether to stay in Tennessee. 'This is where we want to grow and continue trying to put the effort here in the state,' Smyth said. 'Now, with how everything's going, we've really had to consider moving out of this state.' Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
Yahoo
14-05-2025
- Business
- Yahoo
TennCare change would aid Ballad's rural hospitals
JOHNSON CITY, Tenn. (WJHL) — A revenue boost that could guarantee Ballad Health's rural Tennessee hospitals stay open until at least 2028 is inching toward federal approval, but the tweak to TennCare reimbursement for hospitals isn't yet assured. RELATED: Tennessee, Ballad Health agree to changes in COPA terms The proposed change would hike TennCare hospital reimbursement rates to the average paid by commercial insurance and could net Ballad around $100 million a year. Without it, Ballad's commitment to keep its rural hospitals open — part of the 'Certificate of Public Advantage' (COPA) that governs the inpatient hospital monopoly — would end in 2026. The 2026 date is already an extension beyond the initial (2018) five-year commitment that would have lifted the restriction in 2023, and beyond a six-year pledge Ballad made a couple years ago. But it's earlier than the 2028 date the Tennessee Department of Health (TDH) wanted when it floated numerous changes to the COPA's 'Terms of Certification' early last year. 'I think that would basically wipe out what would be our annualized operating loss,' Ballad CEO Alan Levine said of the proposed change. 'Our operating loss for the first half of the year was $50 million, just about.' Hospital systems nationally are struggling in the post-COVID environment. Ballad, which has increased nursing salaries by about $200 million over the past several years, lost $34 million in fiscal 2023 and only avoided a 2024 loss thanks to a lawsuit settlement. Even with a just-released third quarter that was barely in the black ($543,338), Ballad has lost $44.9 million so far this fiscal year. 'We anticipate that the amount we would get from this state-directed payment model would probably help offset a good chunk of that $200 million (in salary increases),' Levine said. Financial reports back that up. Through the first three quarters of fiscal 2021, Ballad spent $622 million combined on salaries, contract labor and employee benefits. Through the same period of fiscal 2025 (to March 30), that total was $849 million. Kids with TennCare face major hurdles finding dentists With those realities and a TennCare reimbursement that pays about half of the cost and hadn't been increased in years, according to Levine, Ballad countered TDH's proposal last year. The system called for the state to approve an increase in the 'provider tax' on hospitals that could then be put into the TennCare program and matched 2:1 by federal funds, allowing for the reimbursement increase. 'You can't sit there and look at the state and say, 'oh, yes, by goodness, we're going to commit to keeping them open for five more years when in two years, I may have to go back to the state and say, 'I can't, I don't have the financial resources to do it.'' Levine said maintaining the area's rural hospitals was a primary reason Ballad formed in the first place through a merger of previously competing systems, Wellmont and Mountain States. Closing them, he said, would impact not just the communities they're in but the hospital system as a whole. 'We have three tertiary facilities, (Kingsport's) Holston Valley, Bristol and Johnson City Medical Center. If those rural hospitals closed, those three tertiary hospitals would get overwhelmed because you lose … access in those communities that keeps people in their community. 'If those access points are gone, you're going to end up with these three hospitals getting overwhelmed,' Levine said of the larger facilities. 'If people are concerned about wait times, they really have to be concerned about wait times if those hospitals get overwhelmed. So we have every reason, irrespective of the COPA, to keep those hospitals open.' The proposal gained state approval this year, but it also has to get two levels of approval at the federal Centers for Medicare & Medicaid Services (CMS) because TennCare is Tennessee's Medicaid program. Levine said that process is nearing completion. But Congress also has to approve the change, and the proposal has reached that stage just as Medicaid cuts are on the table during budget talks and 'wasteful spending' is on many lips in the nation's capital. The provider tax, which is used to some extent in every state save Alaska, has drawn criticism as a way for states to receive federal matching funds without expending their own money. Levine said the Tennessee request, which would increase the state's hospital provider tax to the legally allowed maximum of 6%, is a legitimate effort to address a problem for systems with high numbers of low-income and rural patients. Even if Congress changes the provider tax law, he said, it's looking like they would grandfather in existing arrangements, including the new proposal. 'I think the fact that Congress is going down that path with this bill and CMS is working with the state is a good sign,' he said. 'It shows that I think people understand the necessity for this. I think Congress has a tough job to do, and all we can advocate for is, look, we have to make sure we're making them aware of what the consequences are of whatever actions they take.' He said First District Congresswoman Diana Harshbarger helped lead a push that resulted in all nine Tennessee House members and both its senators signing a letter in support of the change. 'She's taken a lot of time to understand this, and I think one of the things that she's been doing — I don't speak for her, but what she's been doing is asking the questions and trying to make sure that whatever policies Congress implements, it doesn't harm our region.' Levine said if the change is approved, it won't be a 'windfall' for Ballad given the increased expenses from labor and the need to 'cross-subsidize' rural hospitals that consistently lose money. 'I think one thing most of your viewers would agree on is that we want to pay nurses as much money as we can to retain nurses, and that's what we've done. This is simply trying to get us back to where we're financially stable.' Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
Yahoo
07-05-2025
- Health
- Yahoo
Tennessee, Ballad Health agree to changes in COPA terms
JOHNSON CITY, Tenn. (WJHL) — Rules governing Ballad Health's state-authorized hospital monopoly have just undergone their biggest revision after more than a year of negotiations between Tennessee officials and Ballad. Homelessness increased in Northeast TN, according to 2025 PIT Count The Tennessee Department of Health released the fifth version of the 'terms of certification' today. Those cover everything from quality of care measures and access to care to capital spending, charity care, public input and how much Ballad can charge insurance companies. In a news release, the Tennessee Department of Health (TDH) said the revisions cover five key areas: prioritizing quality of care, overall system scoring, rural hospitals, charity care, and listening sessions with the public. News Channel 11 spoke to Ballad CEO Alan Levine during those negotiations. At that time, earlier this year, he said the final sticking points had more to do with language than significant differences. 'Fundamentally, we're all in agreement,' Levine said. 'We want to see access and quality of care be the guideposts for what we're doing here.' The Tennessee rural hospitals in Greeneville, Elizabethton, Rogersville, Erwin, Mountain City and Sneedville will now stay open at least two years longer than the previous commitment and four years longer if the federal government okays a statewide proposal to increase TennCare reimbursements. 'If you go to any rural community that's lost their hospital, first of all, mortality rates go up in that community,' Levine told News Channel 11 during a late January interview about the negotiations with TDH. 'The economy in that community suffers. Those are good paying jobs for that community. Access to physicians deteriorates dramatically because the hospital does support those physicians. So I think people in the rural communities are very concerned about the loss of their hospitals.' The terms of certification exist because Ballad operates under a 'Certificate of Public Advantage' (COPA) granted by the state of Tennessee, which enabled the 2018 merger of formerly competing hospital systems Wellmont and Mountain States. Because that created an inpatient hospital monopoly that the Federal Trade Commission (FTC) opposed, the parties had to seek what's called 'state action immunity' from both Tennessee and Virginia to avoid facing an FTC lawsuit. 'For more than a year we have worked with the Tennessee Attorney General's Office and Ballad Health to ensure the COPA continues to provide a public benefit in meeting Northeast Tennessee's health needs,' TDH Commissioner Dr. Ralph Alvarado said in a news release. 'Our effort and progress serve as a model for health care in Tennessee, the Appalachia Region, and the entire nation. It is vitally important we get it right.' TDH will prepare a narrative review for the assessment of Ballad's performance through the end of the company's 2025 fiscal year June 30, the release said. This is to allow Ballad time to implement the new, numerical COPA performance scoring process for the 2026 Fiscal Year, beginning on July 1. In a statement released immediately after the TDH release, Ballad called the changes 'thoughtful and reasonable.' 'Our goals are the same,' Ballad's release reads. 'At a time when 150 rural hospitals have closed throughout the nation, and 700 more have been identified as being in danger of closure, keeping rural hospitals open for our communities is at the core of why the COPA was created. Access to high quality care is a goal everyone shares.' This is a developing story. Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed. For the latest news, weather, sports, and streaming video, head to WJHL | Tri-Cities News & Weather.
