Rural hospital closures. Medicaid expansion. Maternal mortality.

Stage 01 · The standard Democratic pitch

“Healthcare is a right. We’ll expand Medicaid. We’ll save the rural hospitals.”

Health coverage for everyone. Health insurance people can actually afford. Lower drug prices. Protect Medicare. Expand Medicaid in Tennessee. Save the rural hospitals. Bring down the number of mothers dying. Treat mental health care like real health care. Finish the job the Affordable Care Act started.

I want every one of those things. I’m not going to argue against a single item on that list. But I am going to be straight with you about it - which pieces one new member of Congress can actually move, and which ones are stuck behind fights nobody has won yet.

Stage 02 · What actually happened

Tennessee still hasn’t expanded Medicaid. Rural hospitals keep closing.

Here’s what Medicaid expansion means. The federal government offered every state money to cover more low-income people under Medicaid - the public health insurance program. Most states took the deal. Tennessee didn’t. Fifteen years later, it still hasn’t. Hundreds of thousands of Tennesseans who would qualify for that coverage still don’t have it.

Tennessee has lost thirteen rural hospitals since 2010 - the second-highest rate of closures in the country¹. Our rate of mothers dying around childbirth is dangerously high for a wealthy country, and it’s far worse for Black mothers.

And at the end of 2025, Congress let the enhanced ACA subsidies lapse - the help that kept marketplace insurance affordable for about 22 million people. KFF estimated that subsidized enrollees who kept the same plan would see their premium payments more than double on average². The people hit hardest are early retirees, small-business owners, and middle-income households who don’t get insurance through a job - a lot of this district.

None of this is breaking news. It’s been sitting in state and federal reports for over a decade. Everyone with the power to fix it already knows.

Stage 03 · Why it hasn’t been delivered

The state won’t expand it. The Senate stalls reform. The drug lobby wins.

Expanding Medicaid is the state’s decision, not Washington’s. And the Tennessee legislature that keeps saying no is gerrymandered - the maps are drawn so those legislators don’t have to worry about the voters who’d punish them. So saying no costs them almost nothing.

At the federal level, most big healthcare bills need 60 votes in the Senate to pass. That’s the filibuster - a rule that lets a minority block a vote. There’s one narrow workaround, a budget process called reconciliation, but not every bill fits through it.

And drug prices? Reform gets watered down again and again by the drug-company lobby. Letting Medicare negotiate drug prices finally passed in 2022 - and even that took fifteen years of fighting, for one narrow win.

Stage 04 · What I can actually do in two years

Federal money, pressure on the agencies, and pressure on the state.

• Fight for federal money to keep rural hospitals open. Emergency funding meant to keep the doors open, not just pay down old debt. There are federal programs built for exactly this - they just need a member of Congress from a rural district treating them as a priority instead of an afterthought. That would be me.
• Bring federal money to Tennessee for mothers’ health. Specifically Tennessee. And track whether it actually works, with the results broken out by race. Federal programs to keep mothers alive already exist - Tennessee communities can go after them harder, and a member of Congress can push both the money and the attention.
• Use the seat to push the state to expand Medicaid. By turning down expansion, Tennessee turns down billions in federal money other states take. Right now, saying no costs state leaders almost nothing politically. My job would be to make it cost something - public hearings on every rural hospital that closes, county-by-county proof of exactly who would get covered, and public letters that force the Governor and state leaders to answer for it on the record.
• Restore the health insurance help that just got cut. At the end of 2025, Congress let the enhanced ACA subsidies lapse - the help that kept marketplace premiums affordable for about 22 million people. KFF estimated subsidized enrollees who kept the same plan would see their premium payments more than double on average. That hit early retirees, small-business owners, and middle-income households the hardest, exactly the people across this district who don’t get insurance through a job. The job here is direct - vote to restore that help, cosponsor the bill that does it, and name the members blocking it.
• Protect Medicare, and don’t let anyone gut it. Medicare works. The fight is keeping it that way - vote against every attempt to cut benefits or raise the eligibility age, and defend the one real win already on the books, letting Medicare negotiate drug prices. A House member doesn’t get to redesign Medicare alone. A House member does get to be a reliable vote against the people trying to hollow it out.
• Vote for lower drug prices every single time it comes up. Letting Medicare negotiate drug prices is wildly popular with the public and blocked by the drug-company lobby in Washington. The job is simple - keep voting for it, name the members who block it, and make that choice impossible to hide.