Of the 119,000 Tennesseans who would qualify for state-funded healthcare insurance under a state Medicaid expansion, 28,000 are essential workers and 11,000 are parents with children at home, a new analysis from the Center on Budget and Policy Priorities found.

Tennessee is one of 12 states that has refused to expand its Medicaid program under the Affordable Care Act, which provides federal matching dollars to expand state programs to include low-income uninsured adults, aged 19 to 64, who would otherwise not qualify.

The expanded Medicaid programs are designed to provide health insurance to those who fall in a “coverage gap” — adults living below the poverty line who can neither qualify for healthcare market subsidies nor their state’s Medicaid program.

The analysis also found that Black Tennesseans are disproportionately impacted by the lack of an expanded TennCare program. Many who would qualify under a state expansion are living with disabilities.

The pandemic exposed both the critical need for essential workers and the risks they faced.

“When the pandemic hit, such workers were left with no access to affordable coverage even as they risked their safety providing essential goods and services,” the report said.

The analysis also found that Black Tennesseans are disproportionately impacted by the lack of an expanded TennCare program. Some 31,000 Black adults — or about 1 in 4 of all those who could be covered under a TennCare expansion — would qualify if state leaders expanded Medicaid. African-Americans make up 17% of the state’s population, according to Census data. Some 27,000 individuals who would qualify under a state expansion are living with disabilities, the analysis found.

The report urged states that haven’t yet implemented a Medicaid expansion to do so. It also urged Congress to act on a measure to create a “federal fallback” for states that do not. U.S. Senators Raphael Warnock and Jon Ossoff, both Georgia Democrats, have urged Congress to create a federal Medicaid “lookalike” program to provide coverage in non-expansion states.

TennCare currently provides health insurance coverage to approximately 1.5 million Tennesseans living in poverty, including pregnant women, children, caretaker relatives of dependent children and older adults, and adults with disabilities.