Beyond Medicaid Expansion: Promoting Innovation and Access in Healthcare
Tennessee is on the right track for health care reform, but work is needed to maintain this success in 2027. This past legislative session saw a major reform through phasing out certificate-of-need laws for acute care hospitals and other important services. Removing government barriers to access is likely to increase the number of providers and services across the state. Research has suggested that a complete removal of certificate-of-need would have brought up to 63 hospitals to Tennessee, with 25 being in rural areas.
Repealing certificate-of-need laws will make substantial progress toward improving accessibility and affordability for Tennesseans. But this has not quelled calls to expand Medicaid to able-bodied, working-age adults. Medicaid expansion under the Affordable Care Act has been a nearly annual debate since Insure Tennessee was introduced and voted down in the 2015 session. In the decade since, there is now data to see how other states have experienced expansion and if it had a declining effect on the number of Tennessee hospitals.
That is why Beacon looked into the data in Beyond Medicaid Expansion: Promoting Innovation and Access in Healthcare. State data showed the number of hospitals has not gone down as many expansion proponents claimed it would, but it has had a modest increase. Formerly shuttered rural hospitals have reopened, with innovative micro-hospitals and freestanding emergency rooms filling a healthcare access gap for many rural Tennesseans. Coupled with the recent certificate-of-need reforms, Tennessee has a better healthcare future thanks to sound public policy and innovation, not the federal government.