But, as is so often the case with Republican public health policies, both the lawsuit and TN Together are invariably too little too late. The $25 million that TN Together earmarks for treatment, for example, will treat 6,000 to 10,000 addicted Tennesseans, according to state estimates, while the number of Tennesseans who actually abused opioids in 2016 was 317,647. And approximately 82,000 of them were already addicted.

In 2015, Gov. Haslam tried to persuade the Republican supermajority in the Tennessee General Assembly to expand Medicaid in the state through a federally approved, budget-neutral compromise to the Affordable Care Act. In keeping with a long tradition of defying common sense, statehouse legislators said no. If they had said yes, Tennessee would likely be enjoying addiction news similar to Kentucky’s: “After expanding Medicaid,” notes the Center on Budget and Policy Priorities, “Kentucky experienced a 700 percent increase in Medicaid beneficiaries using substance-use treatment services.” That number coincides with a 90 percent drop in overdose hospitalizations of uninsured Kentuckians.

My senior English course in high school was a survey of British literature. Somewhere toward the middle of the unit on Romantic poets, a boy in my class raised his hand and asked our teacher why so many of the writers we studied were drug addicts and alcoholics. More to the point, he wondered, why should we be reading the work of people who were clearly moral failures?

I don’t remember that student’s exact words, but I remember our teacher’s response. “When someone is struggling with addiction,” she said, “remember that you don’t know how many times he resisted that temptation before he finally gave in. A person who resists 99 times, even if he gives in the 100th, is a stronger person than someone who’s never been tempted at all.”

I have thought of the beloved teacher’s words countless times over the past 38 years. It’s such decent, human advice: Before judging another person, consider all the kinder ways there are to interpret what might seem at first like a terrible moral failing. And the way to do that is to imagine what it feels like to be fighting their battles.

Here in Tennessee, our struggling neighbors won’t benefit from federal dollars through Medicaid expansion for the same reason Tennesseans won’t benefit from so many other things that citizens of other states can take for granted. Why? Because Republicans in the Tennessee General Assembly are consistently more committed to defying what they see as federal overreach than to helping their own vulnerable citizens.