Mary Carol Akers looks in the trunk of her car before she leaves for work to make sure she has all the necessary tools for her job.
"You can see the oxygen tank, medications. I've got catheter kits and IVs, anything mother and baby might need," she says.
Akers makes a lot of house calls. She is a certified midwife serving Hardin and surrounding counties in central Kentucky. The retired Army lieutenant colonel has delivered babies at military hospitals throughout the world, and over the course of her career, she estimates she has delivered six thousand babies.
In the car with Akers on her way to a house call, she explains why some women choose not to give birth at a hospital.
"I think that one of the things about birth centers and midwifery is high touch and low tech, and high touch and low tech require a lot more work than putting them on the monitor and going to the desk to watch it from there," explains Akers. "I've also seen women go to the hospital with a birth plan in mind and be bullied out of it."
Previous naysayers are coming around to the idea of expanding TennCare. Even while criticizing the Affordable Care Act, they say pulling more poor people into the state’s Medicaid program could have some upsides.
Other Republican-led states have taken the leap, even as Governor Bill Haslam continues to weigh the pros and cons.
House Majority Leader Gerald McCormick says at first, all he could see was that after three years, the state would have to start picking up part of the tab.
“There are some other facts that have come to light since then that would offset some of those expenses. That’s why I have an open mind about it.”
Tennessee Gov. Bill Haslam says he will make up his mind on whether to expand the state’s Medicaid program by the end of the month. He says he’ll leave time for the state legislature to consider his decision.
There’s no pressing deadline except that the state legislature intends to wrap up work in April and Haslam needs lawmakers to sign off either way. If he does go along with the Affordable Care Act and expand the state’s Medicaid program, it could take a lot of convincing.
“If the decision is no, then their discussion is short I think. If the decision is yes, then I think they’ll need a decent amount of time to discuss that,” said the Republican Governor.
Two Republican lawmakers are still trying to advance bills that would bar the state from expanding Medicaid. They argue the state still can’t afford it even though the federal government pays the bill for the first three years.