Supporters of Republican Gov. Bill Haslam’s “Insure Tennessee” plan held a party in the Olive Branch Church in Mufreesboro last night. Yes, the church meeting room was packed, but there were probably fewer than 75 residents there.

Haslam has been trying to generate public support for his plan to expand Medicaid in the state since it was killed in a state Senate committee last March on a 6-2 vote. At the moment, 280,000 people in the state do not have medical insurance. Of the total, 24,000 are veterans.

Koch Bothers campaigned against expansion with radio ads, mailers

Many of those in the gap are not lazy. They have jobs, but aren’t earning enough after they pay for food and other necessities to buy health insurance.

"Thanks to Citizens United, the more bucks you have the more free speech you get
“Thanks to Citizens United, the more bucks you have the more free speech you get.”

The plan has been targeted by the Koch Brothers, who blanketed the state with mailers and ran a series of radio ads against it.

The message at last night’s forum was that while there may not be free lunch, expanding Medicaid is close to a free snack.

That’s important because the company running St. Thomas Hospital here spent about $70 million to give emergency room to people without insurance , who couldn’t afford to pay. The deficit this causes is reflected in your hospital bill.

Feds picking up whole tab until 2017 and most of it later

Under the Affordable Care Act, the federal government will pick up 100% of the cost of the expansion through 2017, 95% until 2022 and 90% after that. In addition, the state’s hospitals. which would be thrilled to be off the hook for all that emergency room care, have agreed to make up the difference after 2017..

Concern over the federal deficit

Unless the term “Obamacare” makes you foam at the mouth, the only reason not to expand Medicaid in Tennessee is concern over the federal deficit.

Charles Baum, a professor of economics at MTSU and a county commissioner, tackled the debt issue head on. He said there is no additional local cost to the Medicaid expansion because we’ve already paid the federal government. The issue is whether the dollars we have sent Washington will come back here or go to states like Kentucky that have expanded Medicaid under the federal guidelines.

Kentucky expansion a success

Kentucky has had one of the biggest drops in uninsured residents since its expansion.

As for the deficit, Baum said the best way to measure it is in relation to gross domestic   product. Right now that ratio is 1:1 against the $18.5 trillion national debt. That means the entire value of all the goods and services produced in one year would pay off the entire debt. In comparison, a basket-case economy like Greece has a 1:1.6 ratio of gross domestic product to debt.

Five hospitals in state have gone bankrupt, in part from caring for the uninsured

Baum added that unless the state accepts the offer to expand Medicaid it may be putting many of its hospitals in a bind. That’s because the government is expected to cut back on payments it now gives hospitals to help offset the cost of providing care to the uninsured. The message: Expand Medicaid, and this won’t be an issue.

Present system benefits no one

Karen Springer, president and chief executive officer of Saint Thomas Heath, said the present system is inefficient because patients without insurance are forced to go to the emergency room for things like a sore throat, a cough or the flu. Because they don’t get preventative care or education about maintaining their health, the ultimate cost is more than it would be with the Medicaid expansion.

Leslie Atkins, a nurse at York VA medical  facility in Murfreesboro, focused on the veterans without care that she serves. She said one of the most difficult things she has had to do is to tell a veteran he or she does not have VA coverage because the kind of cancer involved is not covered.

Not the Lord I talk to

“Anyone who thinks it is okay not to provide care is not listening to the same Lord I listen to,” she said. “This is a step to help our neighbors not be dependent. I’m not a bleeding heart. I’m for a hand up instead of a handout. … Kentucky is rocking and rolling (with Medicaid expansion). My dollars are going to Washington and coming back to Kentucky.”

Under the governor’s plan, the state could pull out of the Medicare expansion if it decides the program isn’t working as hoped. To date, 31 states have opted to expand Medicaid under the federal guidelines and none have chosen to withdraw. Those not participating range from Virginia down to Florida, westward across to Texas and up the Plains States to Wyoming and Idaho. The only two southern states in the program are Kentucky and Arkansas.

Here are the legislators to contact:

— State Sen. Bill Ketron (R.-Murfreesboro): Murfreesboro office (615) 896 5440; email

— State Sen. Jim Tracy (R.-Shelbyville): Nashville office (615) 741 1066; email

— State Rep. Mike Sparks (R.-Smyrna): Nashville office (615) 741 6829; email:

— State Rep. Dr. Bryan Terry (R-Murfreesboro): Nasville office (615) 741 2180; email: Bryan says on his website that he is striving to be the leading opponent of Obamacare.

— State Rep. Dawn White (R.-Murfreesboro) Nashville office (615) 253 0264; email:

— State Rep. Rick Womick (R.-Rockvale) (615) 679 3672; email: