Thread by @BrettKelman

The Tennessee government got 1,800+ public comments on its plan for a Medicaid block grant. I read them all so you don’t have to. This is a thread about health care, journalism and how a heap of public records dissolved my brain into soup. It will be more fun than it sounds. 1/

If you haven’t heard, @GovBillLee wants to convert TennCare to a block grant. The state would get more control over billions in federal money that funds insurance for poor families, kids and people with disabilities. It's complicated but important. 2/ tennessean.com/story/news/pol…

But lots of people are afraid the block grant will hurt, not help. They suspect state officials will use this new authority over TennCare to intentionally weaken or reduce coverage, cut costs and divert money elsewhere. 3/

Over a span of a month, the state was required to gather public comments on proposal. Last week, I got all the comments via a records request. They span 2,272 pages. I’ve posted an entire searchable PDF online if you want to read them yourself. (Don't.) 4/ documentcloud.org/documents/6535…

By my count, the government got 1,802 public comments. Of those, 1,716 comments were opposed. 5/

75 comments were neutral, which means they mostly asked questions. 6/

Only 11 block grant comments were supportive.

Eleven.

(Also, yes, I stole this Twitter gimmick from @Fahrenthold. Whatever. He can’t bogart legal pads forever.) 7/

Reading these comments was not complicated, but it was mind-numbing. Over two days, I scrutinized public records until my eyes stung. Before we go any further, I want to thank the people who kept their comments simple and precise. These two are saints. 8/

I screenshotted some comments I felt were representative of a larger theme. For example, a lot of people responded specifically to highly-reported statements by the governor that the critics of the block grant plan just don’t understand it. (“Balderdash!”) 9/

Also, state officials insist they won’t use the block grant to siphon money out of TennCare, but lots of people just don’t believe that. This comment is a good example of that sentiment. 10/

The public comments contain at least 1,000 form letters, but many of those letters have been customized like this.

“The below is a form letter. It doesn’t matter – you’re not gonna read it anyway.”

MAMM YOU DON’T KNOW HOW WRONG YOU ARE

11/

Here is one of the very few supporting comments, submitted by a person who appears to be an accountant. It appears he used a template from an opposition form letter and re-wrote the whole thing to be supportive. That is unnecessarily rebellious and I kinda love it. 12/

“If this passes, we're changing our party from Republican to Democratic.” 13/

IS THIS ENOUGH STAMPS? (This person was opposed.) 14/

The great institution of American journalism is ill-equipped to deal with sarcasm. Per the strict standards of my analysis, I had no choice but to score this as “neutral.” You be the judge. 15/

This poet appears to have encapsulated the entire Tennessee health crisis on a postcard. 16/

I’m stealing this perfect sign-off for my email signature. 17/

Despite the exceedingly negative public response, Tennessee isn’t backing off the block grant plan. TennCare officials have said they will submit their proposal to the feds ahead of schedule this month. 18/

An agency spokesperson told me Monday they believe these negative public comments are not representative of the opinions of entire state. They say supporters are much less likely to provide comment. Does that really explain why there are only 11 supportive comments? 🤷‍♂️19/

TennCare also said they might tweak the proposal in response to public feedback, but they won’t say how. Changes won’t be revealed until AFTER the proposal is submitted to the feds. 20/

This thread is silly, but I wrote a serious @Tennessean story that published today. It's one of many block grant stories our team has written in recent few months. Most are behind a hard paywall, so only subscribers can read them. Why? I'm glad you asked. tennessean.com/story/news/hea…

Journalism like this takes time and effort and sometimes it melts your brain just a little. We believe that has value. If you want to support reporting like this, please consider subscribing. We need you. You need us. Let’s brave this wild world together. offers.tennessean.com/specialoffer?g…

Thanks for reading.

I’ve got to get back to work.

“Respectfully, but pissed off”