“My name is Rich Henighan. I am a retired Nurse Practitioner. I volunteer with the Tennessee Health Care Campaign, providing enrollment assistance.
For 32 years, before my retirement, I provided Primary Care to low-income residents in Appalachian Tennessee. The Public Health Primary Care program was designed as a ‘safety net’ for people who could not get TennCare (Medicaid). As a ‘safety net’ the program had gaping holes. Funding was uncertain and many Counties did not offer the program at all. I was able to help patients with Primary Care needs – short term acute illness or stable chronic conditions. But those needing the care of a specialist for diagnosis or hospitalization and treatment were out of luck.
People need reliable health coverage that will pay for primary care and also diagnosis and treatment of more serious illness. When the Affordable Care Act first started, I trained with the Tennessee Health Care Campaign as a Certified Application Counsellor so I could help people in my community get affordable, quality health insurance. I volunteered weekly at the Sevier County Library and Senior Center helping people enroll on the ACA Marketplace or TennCare. Since the COVID-19 pandemic, I now offer the same service by phone enrollment. The work is rewarding when I am able to get someone enrolled, but I feel for those who don’t qualify.
For example, I just talked to a 63 year-old woman living in rural Roane County who has been working as a janitor, but chose to retire early to reduce her COVID-19 risk. She signed up for what she thought was some sort of insurance paying $400/mo but learned after 2-3 months it was a scam. So, as she says: ‘I never smoked or drank, I worked all my life and now I’m uninsured in a pandemic.’ She has a long-term relationship with a local Primary Care Provider and pays $90/ visit cash to see them now as a self-pay patient. They gave her the THCC enrollment hotline number.
She started Social Security this year but the amount she receives puts her just under the Federal Poverty level so she is unable to receive Advanced Premium Tax Credits for a Marketplace plan. She doesn’t see a way to earn any extra money during the COVID epidemic. Though below poverty, she is ineligible for any category of TennCare. So she, like hundreds of thousands of Tennesseans, falls into our state’s Coverage Gap, created by the refusal of our legislature and governor to allow expansion of Medicaid.”
