MURFREESBORO, TENN. (E.R. WEST) -- A new report says Tennessee has made impressive strides toward getting more of the state's children covered by health insurance, but one out of every 16 kids still has no medical coverage.
According to the annual Kid Count National Data book, the state now ranks 36th in the nation for child well-being, three spots up from last year.
Even though the Tennessee Commission of Youth applauds the state for its reduction, the potential lack of Medicaid funding might push it higher than the already 85,000 kids uninsured in Tennessee.
Dr. Amy Vehec is treating one of those children in what she dubs the castle room at Mercy Community Healthcare, a free clinic in Franklin. Her 10-year-old patient, Matt, waits calmly, his legs dangling from the examination table.
According to Matt’s mom Candy Morehouse, doctor’s visits are a part of their family’s routine. Matt was diagnosed with asthma and autism at an early age. However, she never imagined she would have to seek medical attention for Matt without insurance.
“We will continue to have to pay out of pocket for everything. Because Matt has special medical needs, we are at the doctors a lot,” Morehouse said. “We get hospitalized. Just last year, he was hospitalized for three days in critical care, and we are still paying on that and probably will be for a long time.”
With Candy’s husband losing his job and then becoming self-employed, the family has to self-insure themselves. She and her husband looked at several options, including those on the state exchange through the Affordable Care Act, but all those options were too expensive.
Instead, the family chose Medishare, a faith based insurance program that pays only for major medical expenses and nothing else.
“We still have to pay everything nearly $400 a month for insurance does nothing for us at all,” Morehouse said.
All of these reasons are why the family goes to Mercy. Morehouse had to find a place that would allow them to pay as they went and still provide what she considers quality healthcare.
“When you don’t have insurance and you don’t have a lot of money for health care, which is insanely expensive especially when you have chronic care,” Morehouse said. “This is our option, and for me I couldn’t think of a better option. I am thrilled to be here.”
Dr. Vehec sees a lot of insured kids like Matt from around the state. Some come from as far west as Jackson and as far east as the Cumberland Plateau. Others are closer by, even from Williamson County.
“It is difficult to be poor in a wealthy county because there is a lot of expectation and perception that there are folks in need here,” Dr. Vehec said. “But because the need is so great and correct me if I am wrong, we see people from 32 counties in the region.”
Uninsured patients make her job more time consuming. She’s constantly keeping up with most affordable prescription lists along with maintaining contacts in the community who are willing to help Mercy care for patients.
When you have a child with complex medical problems and they don’t have insurance, the health departments aren’t geared for those kinds of problems and provide for all of these other needs.
Vehec could soon start to see more patients than she is now. According to Rose Nacarrato, Kids Count director, Tennessee could spiral backward if the state doesn’t enlarge the state’s Medicaid program.
“As we go forward with other states expanding Medicaid and Tennessee not, we will lose position in the area with children without health insurance,” Nacarrato said.
According to Nacarrato, most kids in the state are qualified for health insurance. She attributes some of the kids’ lack of insurance to their parents’ knowledge about state programs. But that’s not the case for all kids.
“If their parents are qualified, that makes it more likely for them to sign up,” Nacarrato said. “That will be another way we will be hurt if we don’t expand Medicaid. Parents, adults are in that expansion group and if they are not included, they are less likely to sign up for their children.”
For now, Matt will remain one out of 16 kids in this state who is uninsured, with his family continuing their pay-as-they-go care. A number that may increase as the state debates the future of the Medicaid program.