In early 2003, after he was inaugurated, Governor Bredesen began
negotiating with the Tennessee Justice Center in an attempt to settle 4
class action lawsuits that they had filed against the State. By the end
of the summer, they had completed negotiations and entered into
settlement agreements. Governor Bredesen had said at that time that
these settlement agreements had put the State in the drivers seat to be
able to manage TennCare. He made promises then that he would implement
reform. Throughout the rest of 2003 no reforms were implemented.



In
February of 2004, the Governor once again announced he was going to
reform the program and invited advocates to work with him to help
create a reform package. The Tennessee Justice Center and other
advocates across the state then began meeting to suggest reforms to the
Governor. In September of 2004, the Governor submitted a reform
proposal to the federal government, which included NO dis-enrollments.
Later that same month, the state claimed to have suddenly discovered a
$130,000,000 deficit in the TennCare program. Internal State documents
obtained by TJC reveal that the State actually knew about the deficit
since June, 2004. In addition, the MacKenzie report projected a similar
deficit as early as 2003.


In October 2004, internal state documents reveal that the state had
already decided that mass dis-enrollments were going to be necessary
and they knew they were not able to implement any of the proposed
reform packages because, operationally, their system was unable to
maintain information about the benefit limits that they had suggested
were necessary in September. On November 1st, internal emails from the
State reveal that the administration had a political strategy to blame
the Tennessee Justice Center for the problems with TennCare. On
November 10th, after the mid-term elections, for the first time, the
administration announced that they were going to make massive cuts to
the program.



In an
email dated November 19, 2004, from David Goetz, Commissioner of Finance
and Administration, to J.D. Hickey, Director of TennCare, Goetz states,
“To hell with the Tennessee Justice Center… We’re making a run at
reform, stop us if you can.” Immediately after that announcement TJC
made an offer to the State that they would stand down or cease
litigation for two years to allow the Governor to implement whatever
reform packages that he thought was necessary as long as those reforms
did not include terminations or mass dis-enrollments from
TennCare.  Publicly, the administration said they would continue
negotiations with TJC and consider their offer, while internal
documents reveal they had no intention of doing so and that they would
reject their offers without evaluating the costs.

An internal memo obtained from the Governor’s office, dated November
22, 2004, entitled, “Back to Medicaid Kickoff” confirms that the
administration was not negotiating in good faith. The most compelling
and damning evidence that the Governor had no intention of trying to
reach any settlements that might try and save TennCare is in the
confidential memo that reads “Prevent alternative proposals (e.g.,
savings, revenue generation, enrollment).”



In
December of 2004, the State offered TJC two offers. One was an option
that included 97,000 dis-enrollments from TennCare, the second option
included about 150,000 people being dis-enrolled from TennCare. TJC
rejected these offers as completely unacceptable. Publicly the State
said they offered TJC an option that included no dis-enrollments but
TJC adamantly denies they received such an offer.



In
February of 2005, the State filed with the Federal Government their
latest reform package which included hundreds of thousands of
terminations from the program, far greater than had previously been
suggested in the press or otherwise. There were also deep benefit cuts
such as a four prescription limit, and severe limits on how many times
you can go to the doctor.  Internal documents also revealed that
these very deep cuts are what the State calls “front-loaded”, which
means they are making cuts now, this year, even though the budget
situation doesn’t call for them. The documents reveal the reason for
making these cuts now is because they don’t want to have to make them
next year during an election year. The documents indicate the State’s
intention to “front-load” the bad news now in order to do “add-backs”
later. So their strategy is to make the cuts now so they can add back
some of the benefits next year in an effort to make it look as though
they are helping people, but the facts are they’ll be helping people
that they’re hurting now. On page 10 of the “Return to Medicaid”
report, it states, “front load bad news, allowing add backs later”.
Page 3 of the “Back to Medicaid” confidential memo confirms that
politics is indeed a major consideration of the overall strategy of the
cuts. It states, “build back enrollment through alternative programs
(e.g. CHIP) in year two”.



Sharon
Cobb, Tenncare advocate and documentary producer, was tipped off that
the Governor was in a bookstore which was across the street from a
large rally protesting these cuts. She asked the Governor, “What do you
have to say to me and people like me that will likely die without our
medications?” His response was, “I don’t want to blame… I won’t place blame on anyone who will have to die as a result of all this.” That’s right, that is literally what he said.



Indeed, many
people may die or become severely ill and/or disabled as a result of
these cuts. Those currently taking anti-rejection medication for organ
transplants will lose their medicine. Those with manageable high blood
pressure and high triglycerides will also lose their medications and a
certain amount of those people will go on to have a heart attack and/or
strokes. Many affected by these cuts are severely and chronically ill
and stand little or no chance of surviving beyond a few weeks without
their life saving medications.  These
cuts will be financially disastrous as well, resulting in overcrowded
emergency rooms, potentially forcing small hospitals out of business.

The question has been raised, Where is our defender of life, Senator
Bill Frist, who was quick to go to the floor on behalf of Terri Shiavo,
a woman in a persistent vegetative state, yet he remains silent on this
issue that affects so many more lives, particularly those of his own
constituents.

Where is he indeed!
 

To view the “323,000” documentary, visit Tenncare.org.



Starting
on June 20th, Tennesseans have engaged in the longest continuous
sit-in, in the State’s history. TennCare advocates continue to camp
outside of the Governor’s office within the capital building.
Initially, Governor Bredesen assumed he could get some political
mileage out of the situation by bringing them all McDonalds food to
eat. However, once the Governor realized that these citizens were in it
for the long haul, he forbade anyone to bring them food or drink, only
recently relenting due to public pressure. As of the date of this
article, they are still there.



Since
Thursday, July 28, and for three consecutive days, bells will toll
every four seconds in Nashville, Tennessee, in honor of the 719,000
Tennesseans who are losing their health care. On Sunday, July 31, at
8:30 p.m. Central Time, TennCare enrollees, advocates, friends and
loved ones will hold a candlelight vigil to witness the last tolling of
bells.


We are
urging advocates across the country to organize candlelight vigils in
solidarity with the Nashville vigil. If you decide to organize a vigil
or any other activity, please send an e-mail to Tennessee@familiesusa.org
to let them know what you are planning to do. They will post the
information on their web-page so others in your city/state can join
you. (Click here for information on those vigils)



Here in
Eastern Iowa, the Health Care forum of Progressive Action for the
Common Good will hold a candlelight vigil and bell ringing at 8:30pm on
Sunday, July 31st, at the Unitarian Church, 3707 Eastern Avenue, in
Davenport. The vigil will also be preceded at 7:30 by the showing of
the documentary, “323,000.” The ringing of the bells will represent the
99 counties in Iowa as a way of showing support and solidarity with the
people of Tennessee and the 719,000 TennCare enrollees affected by the
cuts.