Haslam rejects TennCare expansion under Affordable Care Act

Wednesday, March 27, 2013 at 12:31pm
032713 Haslam briefs press on Medicaid decision.jpg
Gov. Bill Haslam explains to reporters his decision to reject expanding the state's Medicaid program in lieu of pursuing an alternative plan if approved by the federal government. (Andrea Zelinski/SouthComm)


Updated at 12:55 p.m.

Gov. Bill Haslam is rejecting the federal government’s offer to pay for more people to receive Tennessee health care coverage on the state’s TennCare program but said he is instead researching a third alternative.

The option, which he said he is still working on, would use the federal dollars to buy private health insurance for some 175,000 low-income people, complete with co-pays.

“This isn’t the end of the story,” Haslam told reporters after breaking the news before a joint-session of the General Assembly that he would reject federal funds to expand TennCare right now. “We do think the Tennessee Plan, as I call it, is the right idea.”

For a full copy of the governor’s speech click here.

The program would sunset after a certain period of time, giving the legislature power to renew it or close the program down. His plan, as conceived, would also revamp the payment structure for providers so they are compensated for health outcomes, not just services performed, he said.

The announcement Wednesday effectively delays movement on any program, likely until at least next year, rejecting dollars extended under the Affordable Care Act to states to expand the state’s Medicaid rolls under the state’s TennCare program.

Democrats, who have been urging the governor to expand the Medicaid program, contend the governor’s announcement “delivered a ‘no’ dressed up as a year of delayed action and indecision,” according to a press release.

“This is a time when the people of Tennessee need clear, precise and bold leadership, and Governor Haslam offered none of that today,” echoed Rep. Mike Turner (D-Old Hickory), the House Democratic Caucus chairman. “It’s a failure of our moral obligation to protect the health and welfare of the most vulnerable among us. It’s a failure that will be paid with the lives of the working poor in our state — this is quite simply shameful.”

Republicans, many of whom clapped when the governor announced he would not expand Medicaid, said they are satisfied with Haslam’s decision.

“Governor Haslam offered a good solution, rather than expanding an unsustainable and broken program,” read a statement from the Senate Republican Caucus. “Hopefully, Washington will see our 20-year record of working through the problems we face with our healthcare system and agree to work with us on a plan that will truly be both beneficial to improving healthcare outcomes in our state and sustainable over the long run.”

Under the so-called Obamacare program, the federal government would cover the full cost of Medicaid coverage to Tennesseans up to 138 percent of the poverty level, equal to income of $32,000 for a family of four. The federal government would cover the full costs covered for three years, then scale back to paying 90 percent of the price tag in 2020.

Currently, the TennCare health coverage is largely limited to children of low-income families, pregnant women, the elderly and the disabled. Roughly 1.2 million people are now on the state’s TennCare rolls.

While the governor said he “fundamentally” believes people having health care coverage is better for citizens and the state than people not having coverage, he said he couldn’t stomach the idea of adding more people to the TennCare rolls then kicking them off when the federal government began to scale back how much it contributed.

“The whole idea of just take it for three years and cut the rolls just never felt right to me,” he said.

Haslam said his administration is still working with the U.S. Department of Health and Human Services to determine if Tennessee can work out its own plan.

The Tennessee Hospital Association, which has advocated for an expansion of Medicaid, said it is behind Haslam’s alternative health care plan and hopes the federal government can give the state the necessary approval to move forward soon.

“We are hopeful we will get the necessary assurances from the federal government that will allow the Governor to pursue the vision he outlined this morning and there can be a special session of the legislature in Tennessee to take advantage of the 100 percent federal funding available this year,” said THA President Craig Becker.


032713 Haslam prepared remarks.doc55.5 KB

14 Comments on this post:

By: pswindle on 3/27/13 at 11:23

What! He still wants federal money to buy private insurance. Private insurance is the most expensive of all. I hope the Federal Government rejects this. He is just putting more money into his friends pockets. What not give the new healthcare a chance? His friend Mitt had this healthcare in MA and it worked. I am being discussed day by day with this Governor and his Administartion. Remember, the Federal Govenment pays all for three years and then goes to 90%. What a deal. This shows how stupid TN has become.

By: Jughead on 3/27/13 at 11:45

Kudos to Haslem!!! Screw the Feds--reject ANYTHING they propose.

By: Rasputin72 on 3/27/13 at 5:55

I have to love a man of conviction like Haslam. Until the underclass is stopped from pro-cretion they should get nothing.

By: treehugger7 on 3/28/13 at 6:25

Garbage! Not that I didn't expect it, but I had high hopes that he would do the right thing. I don't know why, since he is unable to shake the right wing propensity of opposing anything that would actually help the people who need it the most. After all, he is a repug...may he rot

By: JKennedyMD on 3/28/13 at 7:14

If Haslam had bought into the PPACA's expansion of Medicaid as proposed by President Obama, the state would then be liable for the increasing cost of that expansion after 2016 without a guaranteed revenue source to pay for that expansion.

While some glibbly suggest that we take the full expansion for 3 years and then walk away, that's is not as simple as they suggest. Witness how difficult it was for Democrat Phil Bredesen to pare TennCare down, something that chicken-stuff Sundquist would not do.

As for buying private insurance, I suspect that Haslam will propose that these policies would be tied to Medicaid's fee schedule and "medical necessity" coverage policies, thus should be more restrictive and, thus, potentially less expensive than other private insurance. I agree that these policies should be equivalent to what one would buy on the Federal exchange.

In summary, I think that Governor Haslam is thoughtfully thinking this through and is holding the federal government accountable for what they will do as to not make this up as they go along, which is what we did when TennCare was implemented with its disatrous results. Thank you, Governor, for your leadership.

By: amoobrasil on 3/28/13 at 8:02

Jughead's comment is of the ilk one expects from "conservatives": it is emotional, devoid of fact, and contemptous of compassion and the good sense on which access to quality care by all human beings is founded.

By: BigPapa on 3/28/13 at 9:06

He did the right thing at this time. To jump right in and expand, and then either have to disenroll people or force MASSIVE tax hikes is a choice no governor wants.
Bredesen was really the only guy with the brains and heft to pull that off.

Sure people will scream and yell that folks will be dying in streets, but that's simply not true.

By: pswindle on 3/28/13 at 11:51

Hold on, Haslam! What large insurnace company is located in TN? Of course, Blue Cross, and that is the reason that Haslam wnats to make sure that Blue Cross ends up with the money without much care.

By: NewYorker1 on 3/28/13 at 1:28

"God bless America" Really? Do you actually think God would bless America with these republicans making these types of decisions? There are hardworking people in the US that is not given proper healthcare benefits from their employers. These people need affordable healthcare NOW. Three years of insurance is better than zero you freaken idiot.

I am truly disgusted by Haslam's decision. May Karma have mercy on you.

By: CoyoteCrawford on 3/28/13 at 2:20

Haslam turns down federal money to help the poor. Doesn't this expose a character flaw in this Republican governor?

By: pswindle on 3/28/13 at 3:56

But, he wants federal money for private insurance. Like his buddies at Blue Cross.. These buddies are good at election time.

By: yucchhii on 4/1/13 at 10:48

I may not care about the run around, beat around the bush type of comments and/or answers politicians give to the public, I just know that as time goes on, politicians, be it republican OR democrat show ultimately how FULL OF BULL THAT THEY ARE!! When I "SEE" that things are the way they "SHOULD BE", THEN I WILL BELIEVE!! The day I believe ANY politician democrat or republican, male or female..black, white Hispanic..whatever..is the day I start believing the supermarket tabloids and vice versa!!

By: yucchhii on 4/1/13 at 10:51

Well, all I know is...I'm just waiting for the REVOLUTION to start...which I don't think will be much longer..the way the politicians are carrying on...Naw, not much longer!!

By: susandavis on 4/25/13 at 12:12

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