DAY SIXTY: Interview with Mary Hall, TennCare Recipient 

By Emma Goldman

Mary Hall is a heart transplant patient who received a new heart in 2002 after doctors discovered a tumor in her old heart. Mary is also a TennCare recipient. Recently she received a letter denying her health insurance under TennCare including the denial of medications which keep her body from rejecting her heart. Mary's medications cost her $25,000 a year and she cannot afford to pay for these medications. TennCare has notified Mary that she cannot appeal this decision. Mary has ten grandchildren and is due to be cut off her medications July 31st and will die soon after if her situation is not resolved. 

Why are you here at the Governor's Office?

I feel like I have got to do something because they are cutting my TennCare, my meds off and there are so many other people that are being affected. I am here for them too.

What is your condition?

I am a post-heart transplant patient. I take a lot of medicines and have very expensive check ups and without TennCare I am going to die.

How long have you been on TennCare?

I have been on TennCare since September of 2002. That is when we found out that I had a tumor in my heart and I lost all my insurance and my job. I received a donor organ on April 26th, 2003. 

How much do the medications that keep you alive cost?

$25,000 a year. 

Has TennCare been paying for those?

Yes they have been paying for everything.

Are you eligible to go on Medicare?

I am on Medicare, I got on Medicare in November but mine will only pay for doctor's visits and so forth, I don't have any idea what it is going to do about medicines. I feel just like we are kind of in limbo because nobody knows anything. We call our legislators and they don't really know anything because they are kept in the dark too. 

Have you been down here as part of this protest going on?

I just got in this morning and am planning on staying till sometime tomorrow evening.

Have you had a chance to meet with the Governor or Deputy Governor about this?

No, Mr Bredesen doesn't want to see me, but he wants to take my medicine.

You are meeting with Senator Frist aren't you?

Yes I am meeting with a representative of his this afternoon.

What are you going to tell Senator Frist?

The best I can remember is that when Senator Frist was a doctor he was a heart transplant surgeon and he needs to remember his heart transplant people here and he needs to remember who got him into Washington and he did a fantastic job with Terry Schiavo but what about the Mary Halls and so forth here in Tennessee that need help?

What do you think Senator Frist' representative is going to say to you?

If it is like the generic emails I got back then not a lot of anything but I am hoping he will tell me that 'yes, let's sit down and talk about this and work out something.'

Governor Bredesen said about two months ago that he was going to be certain that TennCare was still going to cover the sickest of the sick, do you think that is true?

No I don't, because I am one of the sickest of the sick and without my medicines my body will reject my heart and I will die just like any other transplant patient who has received a liver, lung, cornea, whatever, and without it I am going to die just like people that are on kidney dialysis, I know three people that rely on kidney dialysis that are already cut completely.

Did you receive a denial letter from TennCare?

Yes I did, I received a very negative letter that let me know that I am not even entitled to a fair hearing. They are going to cut my meds July 31st.

What specifically did that letter say about your right to appeal?

The letter said that I won't get a hearing if the only reason for my appeal is that I am appealing something that TennCare won't cover anymore. It also says that I won't get a hearing if my doctor or physician says that my care is medically necessary but TennCare won't cover it anymore. It also won't hear an appeal if I don't have any way to cover the medicine or care that TennCare won't cover anymore. These are all the reasons that I am not allowed a hearing. 

So basically what this is saying is that TennCare won't cover the medications that will keep you alive, and that you have no right to appeal this decision?

Exactly, I am not allowed a fair hearing with them but I am allowed to lose my medicines and die. 

How do you feel about that?

It is hard to say, I have fought so hard to stay alive with this new heart and now it is like they are going to shut the door and I am going to die. I don't think they realize they are really killing us. They have sentenced us to death and we didn't do a criminal offense or capital offense and we didn't mean to get sick like this, I didn't mean to get sick, I have been working all my life. I did fire and rescue. I did search and rescue. I was on the Sheriff's department as a reserve officer. I am a grandmother with ten grandchildren. I want to stay around and see my grandchildren get married but if they take me off my meds and I am cut and I can't afford my medicine then I won't live till Christmas. 

http://www.tnimc.org/