As Republicans Rail Against Obamacare, Tennessee Rural Hospitals Hit Hard Times

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Rural hospitals in Tennessee have been laying off workers and cutting services “to the bone" thanks to our Republican supermajority’s refusal to expand Medicaid under Obamacare.

That’s according to hospital administrators surveyed by The Tennessean and the Jackson Sun in some solid journalism over the weekend. Many rural hospitals are thinking about closing maternity wards and ending cancer treatment, among other services.

Contrast that bad news with this happy Washington Post story from Kentucky, where the Affordable Care Act is running smoothly and enrolling people right and left.

“Cashiers from the IGA grocery, clerks from the dollar store, workers from the lock factory, call-center agents, laid-off coal miners, KFC cooks"—all have been signing up at a clinic in Kentucky's Breathitt County, one of the nation's poorest.

“Woo-hoo! I can go to the doctor now?” one man asked. “I’m serious. I need to go.” One woman cried when she learned she now qualifies for Medicaid.

Obamacare might seem like a political loser at the moment, with website flaws and broken promises dominating the cable news chatter. But in Tennessee, voters will clue in to what’s happening. Just across the border, Kentucky reaps the benefits of Obamacare (partly from federal taxes Tennesseans are paying) while our economy suffers along with our health. And it’s not just poor people who will go without. Rural hospitals serve entire communities—rich and poor.

At first, Republicans claimed expanding Medicaid would wreck state finances. Now that the true state cost is known—the supermajority gives away three times as much revenue in tax cuts every year—they've been forced to switch to their all-purpose fallback argument: Washington lies! They say the federal government won't live up to its word and will saddle Tennessee with greater obligations than allowed under the law.

Gov. Bill Haslam has been trying to dodge responsibility for this stupidity, claiming he’s looking for an acceptable way forward and casting himself as the reasonable adult in the room. Who does he think he's fooling? In knuckling under to his party's mouthbreathers, his failure of leadership is obvious.

When Lt. Gov. Ron Ramsey and House Speaker Beth Harwell were asked last spring whether the state's Medicaid decision would hurt rural hospitals, they shrugged. That's the way the free market works sometimes, they said. We think they should ask for new talking points on this topic.

Eventually, Tennessee Republicans will face a choice: Either admit they are wrong and agree to expand Medicaid or stick to their irrational opposition to all things Obama and lose their asses at the polls.

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