Gov. Bill Haslam has said he will decide sometime next year whether Tennessee will expand its Medicaid program, but if he chooses to, he may face some stiff opposition.
Both House Speaker Beth Harwell and Lt. Gov. Ron Ramsey said they lean against an expansion and the leader of the House Republican freshmen — one of the largest freshmen classes ever — says he doesn’t think expanding Medicaid is such a good idea, either.
That all comes as the Obama administration announced that states will have to expand their Medicaid programs all the way, or not at all, as part of a key element of the federal health law aimed at extending government-subsidized insurance coverage to millions of Americans.
Even without an expansion under Obamacare, Medicaid in Tennessee “will grow every year as our state population increases,” Rep. Jeremy Durham, R-Franklin told TNReport.
“We don’t need to increase the threshold to what the Affordable Health Care Act says,” said Durham. “If we grow it that fast, we won’t be able to sustain it.”
Durham may only be a freshman in a sea that swept in 18 conservative newcomers to the House and secured that body’s supermajority, but he holds some sway. He is the new assistant floor leader for the House, the role that also serves as freshman class leader.
Durham also raised campaign money for his colleagues and campaigned with many of them leading up to Election Day.
“I feel we can’t afford to expand Medicaid,” said Durham, who reiterated the widespread GOP’s worry that while the federal government says it will cover additional costs to the state now, that may change in the future.
“Relying on federal funds that may or may not be there seems an unwise position to take,” said Durham.
In a speech before the Rotary Club of Nashville, Haslam announced that Tennessee would not run its own insurance exchange under the federal health care law. In doing so he sided with Tea Party activists and GOP lawmakers.
During that speech he outlined the difficult decision he faces in deciding what to do with Medicaid.
On one hand, the rising costs of Medicaid uses all the new revenue coming into the state’s coffers, meaning there is nothing to spend on other issues, such as higher education or prison overcrowding. On the other hand, he said that hospitals, and largely rural hospitals, would suffer because they rely on Medicaid dollars to keep the doors open.
“The expansion decision is a bigger and potentially, to be honest with you, a lot more difficult decision,” Haslam said.
Trent Seibert can be reached at email@example.com, on Twitter at @trentseibert or at 615-669-9501.