The Commercial Appeal

Medicaid expansion would help honor women’s suffrage in the United States

- Your Turn Michele Johnson Guest columnist Michele M. Johnson is the executive director of the Tennessee Justice Center.

One hundred years ago, the Tennessee legislatur­e approved the 19th Amendment, which recognized the right to vote for women. Capping 75 years of struggle, Tennessee’s action provided the crucial 36th state needed to ratify the amendment.

Three generation­s of women sacrificed to win the vote in order to achieve a better life for themselves and those they loved. They used the vote to win greater financial security for their families and improvemen­ts in public health. And now, as the world grapples with a devastatin­g pandemic, legislator­s should honor the suffragists’ legacy by acting swiftly to extend health care and financial security to hundreds of thousands of Tennessee women and their loved ones.

Expansion would benefit women, lead to racial healing

Tennessee was slow to do the right thing 100 years ago, but we got there. Tennessee is again lagging behind, but we can still catch up. We are one of only 12 states that fail to make use of federal Medicaid funds to extend health coverage to low-wage, uninsured workers.

Tennessee’s unused share of those federal funds amounts to $1.4 billion a year.

Over 300,000 uninsured Tennessean­s qualify, a number that could rise by another 86,000 by December, as employment-related health coverage ends for the tens of thousands who lose their jobs. Those states that have used the federal funds to expand coverage have seen fewer preventabl­e deaths, lower rates of medical bankruptcy and fewer rural hospital closures.

Federal funding for health care improves states’ capacity to deal with the pandemic. And because women are more likely to be working in low-wage, front line jobs that don’t provide health coverage, they have the most to gain from expanding Medicaid.

By expanding Medicaid, Tennessee’s lawmakers can also take an overdue step toward racial healing. The women’s suffrage campaign occurred at the height of the Jim Crow Era and was tainted by racism. White suffragists often shunned Black women and used racist appeals to convince white men to approve votes for women.

How to end long-standing health disparitie­s

Expanding Medicaid is a concrete way to honor Black women who fought for women’s suffrage. The vital contributi­ons of courageous Black women, who were among the most consistent advocates for women’s suffrage, have gone unrecogniz­ed for far too long. And sharp racial health disparitie­s that existed in their time persist today, making an urgent demand on our state’s conscience.

Black Tennessean­s are 40% more likely to be uninsured, three times as likely to become infected with COVID-19 and twice as likely to die from it as white adults. Black women are three times more likely to die from a pregnancy related complicati­on, and Black babies are more than twice as likely to die before their first birthday. While States that have expanded Medicaid have significantly reduced racial disparitie­s in coverage and have saved lives, improved access to health care and strengthen­ed families’ financial security.

Our neighbors in Missouri just became the fifth Republican state in which voters have approved Medicaid expansion through a ballot initiative. Tennessee’s constituti­on does not provide for ballot initiative­s. We must therefore rely on the governor and our legislator­s to adopt this important reform, just as women had to rely on the leadership of the governor and legislator­s 100 years ago to achieve women’s suffrage.

We are counting on our elected leaders to make sure that Tennessee once again does the right thing.

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