{"id":59,"date":"2026-06-09T14:06:46","date_gmt":"2026-06-09T14:06:46","guid":{"rendered":"https:\/\/rachelfortn.com\/blog\/?p=59"},"modified":"2026-06-09T14:06:47","modified_gmt":"2026-06-09T14:06:47","slug":"tennessee-turned-down-27-billion-then-it-lost-more-hospitals-than-any-state-but-texas","status":"publish","type":"post","link":"https:\/\/rachelfortn.com\/blog\/tennessee-turned-down-27-billion-then-it-lost-more-hospitals-than-any-state-but-texas\/","title":{"rendered":"Tennessee turned down $27 billion. Then it lost more hospitals than any state but Texas."},"content":{"rendered":"

Let’s talk about Healthcare.<\/p>\n

Tennessee has lost sixteen rural hospitals. That’s more than any state but Texas.<\/p>\n

One of them was Haywood Park, in Brownsville. It closed in 2014. The building sat empty for eight years. For most of that time, if you had a heart attack in Haywood County, the closest ER was in Jackson or Memphis. That’s thirty or forty minutes away.<\/p>\n

Most of those hospitals closed because of a choice made in Nashville. Not in Washington. So let me be clear about whose job this is.<\/p>\n

Growing Medicaid – we call it TennCare here – is the state’s choice. Not a congressman’s. Back in 2010, a federal law set up a deal. The federal government pays 90 percent of the cost to cover low-income working adults. The state pays the other 10 percent. In 2015, Tennessee hospitals even offered to pay the state’s share. That way taxpayers wouldn’t owe a dime.<\/p>\n

The legislature said no. Tennessee is one of ten states still saying no.<\/p>\n

Here’s how a hospital ends up closing.<\/p>\n

Rural hospitals don’t make much money. A lot of their patients have no insurance. By law, the ER has to treat them anyway. So the hospital pays for that care itself. Do that long enough and it runs out of money and shuts down. Medicaid covers those patients. That’s what keeps a small hospital alive. Hospitals in states that grew Medicaid are far less likely to close. Hundreds of studies show it.<\/p>\n

Two research groups, the Robert Wood Johnson Foundation and the Urban Institute, did the math. They found Tennessee gave up about 27 to 31 billion federal dollars over ten years by saying no. That’s money Tennessee families already paid in taxes. Now it pays for hospitals in other states.<\/p>\n

The first worry was real, and I’ll say so. Some lawmakers didn’t trust Washington to keep paying its 90 percent. They didn’t want the state stuck with the bill if the feds backed out. That’s fair to think about. But the 2015 plan would have ended on its own if the federal money stopped. The way out was already built in. They said no anyway.<\/p>\n

Then Washington made it worse.<\/p>\n

A new law, H.R.1, was signed in July 2025. It cut Medicaid by close to a trillion dollars over ten years. About 137 billion of that comes out of rural areas. It also ended a bonus for states that finally grew Medicaid. North Carolina grew its program right before the deadline and got a billion dollars. Tennessee waited. That door is closed now.<\/p>\n

The same law set up a 50 billion dollar fund to help rural hospitals. It sounds big. But it’s split across all fifty states over five years. The rules say only 15 percent can go to actual hospitals and patient care. And the cuts it’s supposed to cover never go away. It doesn’t come close.<\/p>\n

So what can one House member really do?<\/p>\n

I can’t grow TennCare. That’s Nashville’s job, and I’ll tell anyone that to their face. But I can do something. I can vote against the cuts that hurt rural hospitals. I can fight to send Tennessee’s share of that 50 billion dollar fund to the counties that need it – Lake, Lauderdale, Obion, Haywood – instead of letting it spread thin. And I can use the seat to say, out loud and often, that the state is leaving money on the table while people drive forty minutes to an ER.<\/p>\n

If you vote for a Republican, this crisis will only get worse.<\/p>\n

Haywood Park opened back up in 2022. A private company took it over for almost nothing and put millions into fixing it. It’s one of the only rural hospitals in the whole country to come back after closing.<\/p>\n

Most of them never do. The fix isn’t waiting eight years for a buyer to show up. It’s a state that takes the deal. And someone in the seat who’ll fight for the people who can’t drive forty minutes.<\/p>\n

\n

Sources<\/h3>\n
    \n
  1. After a decadelong spate of closures, one rural Tennessee hospital reopens (NPR)<\/a><\/li>\n
  2. It’s a first: a rural hospital reopens in Tennessee (WPLN)<\/a><\/li>\n
  3. Medicaid Expansion 101: federal funding estimate (Sycamore Institute \/ RWJF-Urban)<\/a><\/li>\n
  4. Medicaid expansion has never been about money (Tennessee Lookout)<\/a><\/li>\n
  5. The Future of ACA’s Medicaid Expansion: What do Changes in HR1 Mean? (Georgetown CCF)<\/a><\/li>\n
  6. Unpacking the Rural Health Transformation Fund (Georgetown CCF)<\/a><\/li>\n
  7. Why Rural Hospitals Face a Funding Crisis (Commonwealth Fund)<\/a><\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

    Let’s talk about Healthcare. Tennessee has lost sixteen rural hospitals. That’s more than any state but Texas. One of them was Haywood Park, in Brownsville. It closed in 2014. The building sat empty for eight years. 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