TennCare Enrollees: Tammy Nix and Charles Sanders Nashville, Tennessee
Age: Mid Forties

Ms. Nix and her husband, Charles Sanders, are both on TennCare. Mr. Sanders is a paraplegic with 13 prescriptions and Ms. Nix is his full-time caregiver.

IMPACT
Ms. Nix will lose her TennCare in February 2006 and her husband will suffer and/or could die as a result of these limits.

STORY
Mr. Sanders was in a car accident several years ago. As a result of this accident, he is now a paraplegic and totally depends on his wife, Tammy Nix, for his care. Ms. Nix, a native Tennessean, is a parent and grandparent, works full-time taking care of two other people, and is the only breadwinner in the family. If the proposed cuts to TennCare are approved, Ms. Nix will lose her health coverage as of February 2006. In addition, her husband will be subject to benefit limits. These limits include a maximum of 4 prescriptions a month and this number will not meet Mr. Sanders medical requirement of 13 prescriptions, ten of which control his pain, his seizures and the spasms he experiences.

At present, Ms. Nix is not currently eligible for Medicaid. Mr. Sanders receives supplemental security income (SSI) but is not eligible for Medicare.

QUOTE
"If I lose TennCare, I don't know what I'll do. Honestly!”
To the governor: "I voted for you because I believed that you would be able to fix TennCare with your background and your expertise. I was hoping we would get more out of you than we have. I am disappointed. I think you have given up and ignored a variety of solutions.” 

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  TennCare Enrollee: Ginger Eades Murfeesboro, Tennessee
35 Years Old

Ginger Eades is on TennCare. She will be affected by the proposed benefit limits. This may impact her ability to attend school preventing her from achieving her goals and dreams.

Illness: Schizoid Effective Bi-Polar Disorder
Number of Visits: 20 – 30 doctor visits a year;
Number of prescriptions needed: 10 Prescriptions

IMPACT
Ms. Eades is unable to work due to her mental health disorder. If the proposed cuts are enacted and she is limited to four prescriptions a month, the cost of the remaining prescriptions will be several hundred dollars a month. Ms. Eades receives less than $800 per month in income. In addition the limit of doctor visits will impact her quality of life.

STORY
Ginger Eades is 35 years old and is a full-time student at MTSU majoring in Criminal Justice. Due to several diagnoses of mental health disorders, including Affective-Affective Bipolar Disorder as well as a variety of sleeping disorders, Ms. Eades is on both TennCare Select for her medical needs and Premier TennCare Select for her psychiatric needs. Her illnesses require her to take ten specific medications per month. These mediations cost more than $1000. Her income per month is less than $800.

QUOTE
“Just one of my anti-psychotic drugs costs $422 per month. I have been hospitalized 4 times and I am scared because I know that I cannot function without these anti-depressants. Who will pay if I need to be hospitalized?”  

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  TennCare Enrollee: Donna R. Capuson Millington, Tennessee
41 years old

I work as a substitute teacher and part time tutor. I also provide attendant services to my mother who had a stroke three years ago. An interruption of my treatment plan for my bipolar disorder will most likely result in my hospitalization and in a setback in my ability to work as well as provide care to my mother. I was last hospitalized about 5 years ago.

Prescriptions needed: 9 medically necessary prescriptions. I depend on 4 for bipolar disorder and 2 medicines for diabetes, 1 for high blood pressure, hypothyroid and other medical conditions.

Number of Visits: Minimum of 24 visits a year. I see a doctor twice a month. Some of these visits are for lab work related to my medication maintenance.

IMPACT
I will be severely hurt by the proposed loss of benefits. Due to the cutback in medications, I will not be able to work. The loss of income from my work will reduce my ability to pay for both the medications and the doctor visits that are necessary to maintain my treatment.

STORY
Donna R. Capuson is a 41 year old woman with diabetes, high blood pressure, hypothyroidism, and a bipolar disorder. She has a master of arts in teaching with certification to teach 1st through 8th grade. She works part time as a tutor and as a substitute teacher and is presently looking for full time employment for the fall of 2005. She provides personal care for her mother, who had a stroke three years ago. This care includes monitoring her mother’s medications, providing diabetes and pulmonary care, and personal attendant services. She is an active member of the choir at Temple United Methodist Church and participates in other fellowship activities.
Because her house has been mortgaged to pay the medical bills due to her mother’s stroke, Donna’s income is necessary for her to make the mortgage payments. Loss of this income will result in the loss of her home and will result in her mother’s going into a nursing home.

QUOTE “My fear is that my mother will be put in a nursing home and I will become homeless.” 

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  TennCare Enrollee: Don Duvall Jackson, Tennessee
50 years old

PARALYZED CARPENTER

Number of Visits: Several per month
Prescriptions needed: 8 Prescriptions.

IMPACT
According to TennCare Advocacy Program Mr. Duvall, a paraplegic, is on TennCare Standard and is in the category proposed to be cut. Mr. Duvall will die without health insurance. If he is able to be placed on Medicare or other, he will greatly suffer from the Benefit Limits to prescriptions.

STORY
Mr. Duvall has grown up all his life in a family of carpenters. In 1994, Mr. Duvall was helping his father fix his roof when he feel and became paralyzed for life. Nonetheless, Mr. Duvall has held to his dreams and is going to school at a vocational rehabilitation program with a major in Political Science and a minor in Communications. Mr. Duvall loves his dog. He is currently on TennCare Standard, a category proposed to be cut by the Governor. He requires 8 prescriptions to keep him functioning: 2 barbiturates for otherwise unbearable pain, one anti-seizure, one for cholesterol, acid reflux medicine, penicillin for infections and Bachliphin for his blood.

QUOTE
"Tenncare has been the biggest positive in my life because without it I would be destitute and I don’t know what I would do. My monthly check for $740 per month from SSDI can stretch as long as I don’t have to worry about my meds. If I didn't get all of my medicines I just wouldn't be able to function". 

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  TennCare Enrollee: Clemmie Greenlee and Mother, Mary Pointer Nashville, Tennessee

Social Worker on TennCare Medicaid, Serves 30 people on TennCare. Her mother is 62 and was cut from TennCare Medicaid on March 9th, 2005.

IMPACT
Ms. Greenlee will likely continue to be on TennCare Medicaid but her mother just received a letter saying she would no longer be on TennCare and requires major eye surgery to prevent her from going completely blind.

STORY
Ms. Greenlee is a TennCare Medicaid recipient with supplemental security income (SSI) and co-founder of Galaxy Star Drug Awareness, a social service agency that serves about 30 TennCare Enrollees who are dealing with and recovering from addiction.

Ms. Greenlee is an essential staff member of this vital community organization. Besides her Asthma, she is healthy. But she is concerned that she may get sick and not be able to fulfill her responsibilities because of lack of access to health care. Who will take care of her mother? Her mother just received a letter saying that she would no longer receive TennCare. Ms. Greenlee’s mother has Emphysema, an unhealed broken leg and is 95% blind. Her mother is in need of eye surgery to prevent her from going completely blind. Without TennCare her mother’s quality of life at age 62 is going to go down hill fast. Her eyes won’t wait until she is eligible for Medicare.


QUOTE
“If I get sick and can’t pay for my health care because of Benefit Limits, who will take care of the community organization that I founded? More importantly, who will take care of my mother? She is crippled and mostly blind. How do I take care of my family?” 

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  Mom Wants Taxes to Secure the Future When I was a little girl, I was told that if I worked hard I could have anything I wanted. Well, I do work hard and I can barely afford the things I need, let alone anything I want. Today families like ours are working harder and longer and finding ourselves falling further and further behind. We worry about paying our mortgages, feeding our families, and sending our children to college. We pay our taxes knowing that it is our duty as citizens to invest in our government. We have faith that our leaders are using that investment wisely.

Recently I have been very concerned that our tax dollars are not being used to secure a better future for our children. President Bush has proposed a budget that will devastate working families. While providing tax relief to the rich, the budget denies such relief to hard-working families like ours. Not only does the proposed budget deny relief to our families, it does not use our tax investment wisely.

I have talked with several people who think cutting government spending on social programs is not a bad idea. What many people fail to realize is that when funding is cut, it is not the poorest of the poor who will be affected the most; it is working families who will pay the price. When programs are cut the first people to be affected are people who have an income, any income, who are helped by these programs. For example child care, which will be greatly affected if the proposed budget passes, is most utilized by working families.

On average nearly 8,000 West Virginia children per month receive federally funded child-care assistance. These are children of families like ours who are working and struggling to make ends meet. This summer when our own state government suggested cutting child-care assistance, parents spoke out. Among them were parents employed by our state government, who would have to quit their jobs if they lost their child-care assistance.

The poorest of the poor families were not going to be directly affected by the cut in child-care assistance. Only working families like ours who were above the poverty line ($18,850 for a family of four) would lose their child-care assistance.

If Bush’s budget is passed, we will be asked to invest in a government that is not concerned with investing in our families. Programs that provide relief for working families will be hit the hardest. The programs to help our children succeed in school will be cut. The programs to assist us in sending our children to college will be cut. The programs that help us purchase homes will be cut. The programs that help make our communities safer for our children will be cut. The programs that help families during hard times will be cut. If this budget is passed, our state will lose 531.5 million federal dollars in state grants in aid for domestic discretionary spending during the next five years. This is not using my tax investment wisely.

Evelyn Dortch is a working mother of four and executive director of the Direct Action Welfare Group in Charleston.

WV Sunday Gazette-Mail (c) 2005 

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