Just as I am, though tossed about
with many a conflict, many a doubt, …
Just as I am, poor, wretched, blind;
sight, riches, healing of the mind,
yea, all I need in thee to find
These are some of the verses of popular Christian hymn “Just As I Am.”
Across Tennessee, in Christian congregations large and small, rural and urban, it’s likely this song is being sung on Sunday morning.
The lyrics suggest an individual in crisis — perhaps a believer in need of guidance, or a lost soul facing spiritual or physical pain. The person is crying out for relief, offering nothing but to come forth “Just As I Am.”
It’s very likely that most of Tennessee’s 132 elected legislators are familiar with this hymn. All but three of them list a Christian religious affiliation on their legislative websites and of those, a vast majority are Protestant.
So, it’s also quite likely that on a given Sunday, a Tennessee legislator is sitting or standing in church, singing with his or her fellow parishioners, extolling the grace of a God who takes those seeking “just as they are.” It certainly wouldn’t be unusual for prayers to be offered for congregants who are sick or suffering in some way. Surely, the words of Just As I Am offer comfort — a reassurance that no matter what, there is hope.
It’s puzzling, then, that some 300,000 Tennesseans remain without the access to affordable health care that would be provided through Medicaid Expansion. While nearly 40 states have already expanded or plan to expand Medicaid, Tennessee has not. In fact, Tennessee’s Governor, Bill Lee, actively opposes the idea of expansion — a departure from his predecessor and fellow Republican, Bill Haslam.
Tennessee now leads the nation in rural hospital closures. Fourteen of our state’s hospitals in rural communities have closed in the last two years. There are now twenty one counties in Tennessee without access to an emergency room. There are reports suggesting at least six more rural hospitals are in danger of closing within a year.
Imagine standing next to your fellow church-goer and feeling the hope offered in the comforting words of “Just As I Am.” Imagine further that on the same pew is a Tennessee lawmaker — a lawmaker who has access to generous health benefits and also the ability to ensure everyone in the congregation has access to a basic level of health care.
Now, imagine that same lawmaker leaves church on Sunday and goes to the General Assembly on Monday and actively opposes extending the potentially life-saving help of Medicaid Expansion to his or her fellow believers. Unfortunately, that’s not difficult to imagine, because it is reality every single day in Tennessee. Since 2015, legislative leaders have been standing in the way of access to health care for 300,000 of their neighbors. Now, we have a Governor who has joined them in resisting the relief so many of our friends need.
In Tennessee, if you want health care, you may come just as you are, but if you live in Ducktown or Celina, there’s simply nowhere to go in your time of need. Your ability to access care depends on your ability to land a job with health insurance benefits or to afford a plan on the Affordable Care Act Exchange.
The hope so many Tennesseans sing about on Sunday is long gone on Monday morning. Forgotten in the wake of rhetoric about market-based solutions and block grants. Fancy buzzwords that leave too many behind. Legislators answer instead to the donor class and out-of-state funders who push them ever further away from a “love thy neighbor” policy outlook.
Just as I am, thou wilt receive,
wilt welcome, pardon, cleanse, relieve;
Sure, on Sunday you may receive welcome, pardon, and relief. But if your needs are physical, if your pain is acute, in too many Tennessee communities and for too many Tennesseans, there is no welcome at the hospital door. There is no relief from suffering simply because of a lack of insurance or because there’s just no hospital.
Tennessee may well be the last state in America to expand Medicaid — they may not expand it at all. If so, our policymakers will surely be the first in line on the day of moral reckoning to answer one simple question: Why didn’t you care for your brothers and sisters?
The answer, apparently, is that Just As I Am is only for Sunday morning.
Andy Spears is a writer and policy advocate living in Nashville.