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Tenn.'s Retreat On Medicaid Points to Struggle

"I can't believe he is saying he tried everything he could when he knows that is not true," Smith, 39, said in an interview later at the seven-person graphics design firm where she works. "This is not his last resort."

As protests go, Wednesday's event was unremarkable. Fewer than 75 people braved the harsh wind, and a handful stretched out "dead" on the concrete, only to discover the governor and guests had slipped in through an underground parking garage.


Bart and Atha Comiskey would have spent $9,300 last year on medication were it not for TennCare, which charges a small monthly premium and copayments. (Peyton Hoge For The Washington Post)


Friday's Question:
It was not until the early 20th century that the Senate enacted rules allowing members to end filibusters and unlimited debate. How many votes were required to invoke cloture when the Senate first adopted the rule in 1917?
51
60
64
67


Although he avoided a confrontation, Bredesen is keenly aware of his detractors, even singling out some by name.

Lori Smith is one.

Unprompted, in an interview in the Capitol, Bredesen identified her as a "poster child" for liberal advocates and the media. He denigrated Smith, and many of the 30,000 TennCare clients deemed "uninsurable," for making "lifestyle choices" to work for small businesses that do not offer insurance rather than finding jobs with the state or large companies that do.

Told of Bredesen's remarks, Smith teared up, then fired back.

"With my illnesses, I don't have the luxury of getting other jobs" that would require 40 full hours each week, she said. Smith, who took a $12,000 pay cut to join the smaller, more flexible company, said she often arrives late, takes naps or misses work entirely.

"How long do you think [other employers] would keep me working 20 or 30 hours a week? I'm thrilled to be here," she said, seated behind her desk in a cozy office filled with candles. "Is he trying to tell me I'm irresponsible because I work here?"

For Smith and Bredesen, clearly, the battle over TennCare is personal and emotional.

The governor blames a small band of activists and public interest lawyers for saddling the state with inflexible legal consent decrees that restrict his ability to make less drastic cost savings.

The advocates and patients see in Bredesen a wealthy businessman with a "my way or the highway" attitude who raises the specter of bankruptcy when Tennessee's surplus last year was between $170 million and $600 million.

Even with such bitter feelings and management woes, TennCare achieved medical successes in the years since Senate Majority Leader Bill Frist (R-Tenn.), before his election in 1993, and then-Gov. Ned R. McWherter devised the idea.

Darla Nelson is Exhibit A. Suffering from depression, with two youngsters and no husband, Nelson "self-medicated" with prescription drugs and alcohol several years ago.

Today, the 39-year-old has been sober for three years, works at a day spa and is taking night classes to become a radiology technician, all thanks to TennCare, she said. Without TennCare, she worries she will not be able to afford the counseling and $100-a-month antidepressants that keep her steady.


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