The Crisis in Rural Healthcare
A Policy Briefing for Tennessee Leaders
The Situation at a Glance
Tennessee faces a significant healthcare crisis, with consequences that fall hardest on our rural communities. The data below highlights the scale of the challenge and the urgent need for policy action.
Rural Hospitals Closed
16
Since 2010, the most per capita in the nation.
Tennesseans Uninsured
660,000
A crisis concentrated in rural areas and low-wage jobs.
Left in Coverage Gap
95,000
Too poor for ACA aid, but ineligible for TennCare.
Core Challenges
Two intertwined issues drive the health crisis: a systemic gap in insurance coverage and the resulting decline of local providers and facilities. Explore the data behind these challenges below.
The Anatomy of the Uninsured Crisis
Statewide, 660,000 Tennesseans lack health insurance. The chart reveals a critical policy failure: 95,000 of these individuals are in the "coverage gap," earning too little for ACA subsidies but deemed ineligible for TennCare. This group has no affordable coverage options.
For those with insurance, public programs are essential. Over 1.6 million rely on TennCare, and another 609,900 depend on ACA subsidies to afford their plans. The looming 2025 expiration of enhanced ACA subsidies threatens to move a huge portion of this group into the uninsured category, destabilizing the market and disproportionately harming rural families who have fewer employer-based options.
Actionable Solutions
Addressing this crisis requires decisive, evidence-based policy action. The following proposals represent the most effective strategies to stabilize rural healthcare, improve health outcomes, and ensure economic vitality for communities across Tennessee.
The Single Most Impactful Step: Provide additional appropriations to TennCare and ACA subsidy eligibility to reduce the number of uninsured Tennesseans.
- Economic Benefit: Creates jobs and stimulates local economies.
- Hospital Stability: Provides a critical financial lifeline to struggling rural hospitals by reducing uncompensated care costs, the primary driver of closures.
- Improved Health: Ensures access to preventive care, chronic disease management, and life-saving treatments, leading to a healthier, more productive workforce.