Lawmakers Approve Low-THC Cannabis Oil

Both the Tennessee House and Senate on Monday approved legislation allowing for the medical use of oils made from non-psychoactive strains the cannabis plant family.

The low-THC “cannabidiol” or CBD oils can aid in the treatment of intractable seizures, particularly in children, but without intoxicating side effects.

Knoxville Republican Becky Duncan Massey, the Senate sponsor, took pains to differentiate her legislation from efforts to legalize higher-level THC cannabis for treatment of other chronic conditions.

“It is not a medical marijuana bill,” she told members of the upper chamber during debate on SB280. “This does not in anyway legalize the smoking of marijuana.” Massey said CBD oil “has no street value.”

The bill passed 26-0, with several Republicans abstaining.

The legislation would carve out an exception in the state’s marijuana prohibition statutes for people, under a doctor’s supervision, to use cannabis oils containing less than one percent tetrahydrocannabinol, the chemical in marijuana chiefly responsible for producing mind-altered states.

Massey said patients will be allowed to have the medication if they have paperwork from the state indicating their diagnosis met the necessary qualifications. And while Tennessee doctors would write the diagnosis to allow their patients to access the medicine, they could not actually prescribe the oil, she added.

Massey noted that, “ironically,” other drugs used to control seizures have a lot more potential for abuse, addiction and physiological harm.

“Cannabis oil doesn’t work for everybody, but neither does traditional medicine,” Massey said.

The bill’s sponsors worked with many interested parties, including the Department of Safety, the Tennessee Bureau of Investigation and the American Academy of Pediatrics to craft a better bill, Massey said.

Last year the General Assembly passed a law allowing Tennessee Tech to grow, produce and administer CBD oil for a study of its effects. However, the federal government refused to sign off on the study, Massey said.

“They are not giving out permits at this point in time, so we were not able to do that,” Massey said.

While the measure seemed to have broad support, some Senate Republicans voiced concern about the current federal status of the substance, as well as the lack of federal oversight or regulations.

Senate Speaker Pro Tem Bo Watson questioned who regulates the production and quality of the drug if it’s “not regulated” by the federal Food and Drug Administration.

With “no governmental certifying body” to indicate the product meets certain standards, people might not know for sure what they are really getting, suggested Watson, a physical therapist from North Chattanooga.

But Massey countered that the states in which the medication is produced have their own state-level regulations in lieu of federal oversight and controls.

Senate Finance Committee Chairman Randy McNally, a pharmacist, also worried about how the federal government might view Tennessee’s move. He worried that Tennessee patients could be charged under federal law for criminal marijuana possession, since the U.S. Drug Enforcement Administration classifies all cannabis plant materials and extracts as Schedule I drugs having no legitimate use recognized by the government.

Massey acknowledged that while qualifying Tennesseans would not face state-level prosecution, they could still be subject to arrest and imprisonment at the hands of the feds.

Another pharmacist who moonlights as a state senator, Gallatin Republican Ferrell Haile, was more supportive of the use of CBD oils. He noted that many parents considering it for their children are likely in desperate straits and would be willing to risk the DEA’s wrath if it potentially means saving their child’s life.

Massey agreed kids may unnecessarily die without access to this medication. “Ultimately we’ve got to trust the parents” who’ve “tried everything” and “exhausted every hope they had” to do what’s best for children, she said.

In the House a short while after the Senate’s vote, Cosby Republican Jeremy Faison accepted the Senate version of the bill, and, after including an amendment to the bill that adds epilepsy to the treatable conditions for the medication, the lower chamber passed the bill with no debate, 95-0, with one member abstaining.

“This is a big deal for Tennessee,” said Faison on the floor after it passed. “The people of all over helped, from Mountain City to Memphis, and it was just a testament of all the work that they have done to see that much green on the board, and we didn’t have to speak about the bill.”

As the House version of the measure carried an additional amendment, the bill now returns to the Senate for the upper chamber’s approval.

Alex Harris can be contacted at Alex@TNReport.com.

‘Summer Study’ Planned for GOP-Crafted Medical Cannabis Proposal

Bernie Ellis never thought he’d see a medical marijuana legalization proposal he just couldn’t abide. Then he saw the one drawn up by Republicans in the Tennessee Legislature this session.

The 66-year-old retired epidemiologist turned stalwart medical marijuana activist told TNReport last week that a yet-to-be finalized distribution system outlined by Sen. Steve Dickerson of Nashville and Rep. Ryan Williams of Cookeville seems too restrictive and overly bureaucratic.

It’s definitely for the best that the plan has been sent back to the “summer study” drawing board for more work, said Ellis.

The Dickerson-Williams legislation proposed the creation of a tightly controlled medical marijuana franchise system to provide state-approved cannabis products to sufferers of serious illnesses whom the General Assembly deems worthy. Also part of the plan were steep bonding-fees and tracking requirements on a strictly limited number of producers and distribution points in the state.

Additionally, Tennesseans would have to meet several restrictions themselves, such as giving up their drivers license, if they qualify to register.

Dickerson, an anesthesiologist, told reporters last week that he’s looking forward to a “very thoughtful summer study.”

Ellis was relieved to see the legislation punted for the year because to him it seemed loaded with unnecessary regulation, laden with centralized planning and encumbered by punitive caveats for would-be enrollees.

The requirement that medicinal pot users give up the privilege of legally operating a motor vehicle seemed especially onerous and uncalled for, said Ellis. He pointed to a National Highway Traffic Safety Administration study released in February that, after factoring in age and gender, showed marijuana use does not cause a significant increase in risk of accidents.

Ellis also criticized the limited number of ailments covered. “If this law passed as currently written, we’d be the only state in the country to prohibit glaucoma and AIDS patients from accessing medical cannabis,” he said.

But Ellis stressed that taken in sum, even with its many imperfections, neither the bill nor the fact that this issue has once again been begged off for the year by the Legislature is bad news.

A key development this year over years previous is that there’s been a noteworthy elevation in “the dialogue around the evidence for medical cannabis,” said Ellis, who is accustomed to taking the long view with respect to drug-war reform.

Given that only in the past year have majority-party Republicans in the Volunteer State indicated a willingness to even discuss the potential medicinal benefits of the country’s most maligned plant family, Ellis is convinced the conversation is on the right track.

“This was just not the right bill — too many problems with it,” Ellis told TNReport.

Currently, 23 states and the District of Columbia allow the medical use of cannabis.

For the past year and a half, GOP lawmakers have been taking the cannabis plant with increasing seriousness, amid growing public support for making marijuana available to those who need it to treat debilitating health conditions.

Last year the General Assembly overwhelmingly voted to legalize industrial hemp. And this year, a bill legalizing the use of low-THC cannabis oil has been moving steadily through the legislature, and looks likely to pass.

‘Insure TN’ Not Coming Up Again, say TNLeg GOP Bosses

Despite two legislative pushes and many protests statewide, leading majority-party lawmakers at the Capitol agree that Medicaid expansion just isn’t happening in Tennessee this year.

Three prominent GOP lawmakers said Tuesday that the most recent attempt to revive Gov. Bill Haslam’s “Insure Tennessee” plan to expand Medicaid coverage for needy Tennesseans was pretty much dead on arrival. And they are in no mood to see the issue resuscitated yet again, as the Knoxville News Sentinel reported Monday is what advocates are pushing. The Tennessee Justice Center is petitioning the speakers of both the House and Senate to bring an “Insure Tennessee” authorization measure to the floor for a vote by the full Legislature.

But that’s just not happening, said Lt. Gov. Ron Ramsey and House Speaker Beth Harwell, both of whom were skeptical about the governor’s distinctive Medicaid expansion plan even before it was twice shot down in Statehouse committees.

In addition, House Majority Leader Gerald McCormick, the Chattanooga Republican who sponsored “Insure Tennessee” legislation in the February special session, told TNReport that he doesn’t support a direct-to-the-floor move, and doesn’t think there’s support to make it happen anyway.

Harwell said in a emailed statement that the House also had a requirement for two-thirds of the body — or 66 members — to vote in favor of bringing a bill directly to the floor. “I appreciate the passion on this issue on both sides. However, under our House rules, I am unable to bring this bill directly to the floor, and bypass the committee process,” she said.

And McCormick said it would be “impossible” to get two-thirds to support suspending the rules and bring it to the floor.

“I’m for Insure Tennessee, but I would be opposed to it based on parliamentary reasons. I think it needs go through the committee process before we do something as major as that,” McCormick said.

Ramsey told reporters Tuesday “Insure Tennessee” faces a similar situation in the upper chamber, where Republicans outnumber Democrats 28-5.

“It takes 22 votes to suspend the rules to bring any bill out of committee. I even told (activists with Tennessee Justice Center) that,” said the lieutenant governor.

And Knoxville physician Richard Briggs, one of the Republican co-sponsors of “Insure Tennessee” in the Senate, said Tuesday while he’d like to see it come up for a full floor vote, he’s under no illusions that’s going to happen given clear opposition to the plan.

“Insure Tennessee” was designed by the Haslam administration in hopes of getting a stamp of approval from the General Assembly to drawn down billions in federal Medicaid expansion dollars made available through President Barack Obama’s signature health care law, the Patient Protection and Affordable Care Act. The governor maintained, though, that “Insure Tennessee” wasn’t really “Obamacare.” Rather, it was a “market-based” approach to government-financed health coverage for the 280,000 or so Tennesseans who fall into the ACA’s “coverage gap.”

Following the second committee defeat of “Insure Tennessee” last month, many vocal supporters of the plan crowding the halls of Legislative Plaza were left angry, distraught and in some cases weeping. At one point a verbal altercation occurred between a protester and Sen. Todd Gardenhire, who called the man an “asshole” on video.

Gardenhire said the protester had been harassing him in the bathroom just prior to the altercation.

The Chattanooga Republican told TNReport that since the February “Insure Tennessee” rejection, he’s been the target of a wave of vulgar and harassing phone calls and messages. Gardenhire shared a voicemail from one detractor in which he was accused of Satan worship, labeled a “treasonous traitor to Americans” and asserted to enjoy performing oral sex on the Koch brothers.

Gardenhire said he’s also received death threats. After his second vote against “Insure Tennessee,” he received an email that said, “Hey F**kface. You better increase your health care coverage, because the next time I see you, you’re going to be in the cross-hairs.”

Gardenhire said he’s ignored most of the shabby treatment, but the email gave him “chills,” and he reported it to the Tennessee Bureau of Investigation.

Despite the drama and bad feelings and dashed hopes, Gov. Haslam stands by his decision both to bring the bill before the Legislature in the special session, and to get behind the long-shot attempt to resurrect it last month.

“You don’t ever feel bad about raising false hopes in the sense that you’re always trying to get the right thing done, and we felt like that was the right policy, and I still feel like that’s the right policy, so I think it’s worse to never try,” he told TNReport during a Monday press conference in Nashville. “If you think something’s right but to never try, that feels like a bigger error.”

And the General Assembly GOP leadership in both chambers don’t appear to outwardly harbor any ill will toward the Republican governor for throwing his lot in with superminority Democrats on such a major policy issue.

At a press conference last week, Harwell said the governor worked “diligently” for two years on finding a solution for Medicaid expansion that the Republican supermajority Legislature would find palatable.

“The governor’s intentions have always been honorable in this,” she said.

And Ramsey said Tuesday afternoon that Haslam made the choice to support the second coming of “Insure Tennessee,” even though “it was no secret” that “support was lacking.”

Ramsey also noted that because the “Insure Tennessee” resolution arose the second time through efforts by lawmakers acting independently of the governor’s office, Haslam hadn’t seriously damaged his partisan bonafides with Republicans in the Legislature.

Alex Harris can be contacted at Alex@TNReport.com.

TN House Passes ‘Right to Try’ Measure

A bill to grant Tennessee patients suffering serious and seemingly incurable illnesses the “Right to Try” experimental-phase treatments has passed the state’s House of Representatives.

House Bill 143 passed on a 94-0 vote Thursday.

Sponsored by Bristol Republican Jon Lundburg, the legislation seeks to permit sufferers of “advanced illness,” not thought to be reversible, access to any “investigational drug, biological product, or device…that has successfully completed phase 1 of a clinical trial but has not yet been approved for general use by the federal food and drug administration and remains under investigation in a clinical trial that is approved by the FDA.”

The Tennessee Senate’s version of the legislation is awaiting a full chamber vote.

The Beacon Center of Tennessee, a free-market think tank in Nashville, has been pushing for the legislation this year. In a statement after House passage of the bill, a statement issued from Beacon lauded how “lawmakers from both sides of the aisle fought for what was right, choosing people over party affiliation.”

“We are humbled to have been part of this bi-partisan effort in the House to allow terminally ill patients to access potentially life-saving medicine that has already been deemed safe by the FDA,” said Beacon Policy Director Lindsay Boyd. “This is a great example of what can happen when Republicans and Democrats come together on common sense legislation.”

Arizona’s free-market think tank, the Phoenix-based Goldwater Institute, has been pressing for similar laws in legislatures across the country — and sent advocates to testify on behalf of Tennessee’s version of the bill last month.

Last week Montana became the 13th state to enact such a measure, according to the Goldwater Institute, which on their website declares, “States should enact ‘Right to Try’ measures to protect the fundamental right of people to try to save their own lives.”

Tennessee’s chapter of Americans for Prosperity, also strong backers of “Right to Try” legislation, issued a statement praising the House’s action. ““Today we are one step closer in assisting those in dire need of healthcare options,” said AFPTN director Andrew Ogles. “Though this is a first step in fixing an issue within healthcare, it demonstrates that states can innovate and find solutions without the interference of the federal government.”

GOP-Backed Medical Marijuana Legislation Advances in House

A Republican-backed medical marijuana proposal cleared the House Health Subcommittee’s final calendar this week.

The bill’s sponsor, subcommittee Chairman Ryan Williams, a Cookeville Republican, explained the measure was “a best effort to consider options for those Tennesseans across this state who are facing terminal illness.”

The bill was developed in association with Ted LaRoche, a Murfreesboro attorney and managing member of TennCanGrow LLC, an “investment group” working to support efforts to make medical cannabis available in a restricted fashion to Tennesseans in need.

LaRoche, former legal counsel for the National Healthcare Corporation, said he would like to see Tennessee join the 23 other states that allow their citizens to treat serious or life-threatening ailments with cannabis — and, in time, combat veterans suffering from post-traumatic stress disorder.

In its current form, the bill would allow for “very limited, narrow” delivery mechanisms of medical cannabis, including the use of nebulizers, gel-tabs and time-release patches, and would not resemble recreational marijuana at all, Williams said.

The illnesses covered by the bill include terminal cancer in stages II through IV, Parkinson’s disease, multiple sclerosis, intractable seizures, epilepsy, Huntington’s disease, and damage to the spinal tissue resulting in intractable muscle spasms.

Williams’ measure would also strictly govern cannabis production.

For instance, for each grand division of the state there would be two grow facilities, and 33 dispensaries statewide where Tennesseans with these diagnoses would be able to use their Health Department-issued marijuana registration card.

Williams explained those dispensaries “will have to be licensed by the state of Tennessee. They will have to have performance and payment bonds,” as well as pay a “nonrefundable application fee.” He added that any companies who do participate in the new industry would also have to “provide seed-to-sale technology” to allow the tracking of cannabis from genesis to the end-result.

Williams later told TNReport the technology for “seed-to-sale” tracking is already in use by many food-producers, though it would be “new and newer to this industry.”

There was no subcommittee discussion following Williams’ explanation, and although the “Ayes” were voiced a bit half-heartedly, the proposal passed easily to the lower chamber’s full Health Committee.

This would not be the first time the Volunteer State allows cannabis for medical use: in the mid-80s, then-Gov. Lamar Alexander gave approval to medical marijuana legislation.

The issue polls positively among voters, with polls from both Vanderbilt University and Middle Tennessee State University consistently showing a large majority of Tennesseans favor moving forward on allowing doctor-prescribed marijuana.

But last week a medical marijuana measure annually brought by Nashville Democrat Sherry Jones was sent to summer study in the House Criminal Justice Subcommittee, due to committee-member concerns the panel hadn’t had the time to fully vet and consider the legislation themselves.

Jones told TNReport after the Health Committee hearing that while she wants to see medical marijuana legislation approved to help the Tennesseans “who are suffering needlessly,” she’s concerned this bill hasn’t been well thought out.

According to Jones, the bonding requirements and other restrictions on the industry side will limit those able to begin producing marijuana to “some out-of-state entity that already” produces cannabis and has the necessary cash-on-hand, rather than giving some Tennessee farmers a new cash-crop.

Jones also criticized the legislation’s requirement for the terminally ill to give up driving privileges in order to participate in the medical marijuana program. “You don’t give up your driver’s license for alcohol, or for morphine, or anything else, but you will have to for marijuana,” she said.

Williams later confirmed to TNReport that surrendering a driver’s license would be a condition of receiving a state-issued medical marijuana card.

According to Williams, most of the people diagnosed with these illnesses already aren’t driving. And “it gives law enforcement a comfort level,” because there’s been no tests developed determine if someone is driving under the influence of cannabis.

But Williams also said the number of dispensaries allowed under the law was just a starting point to get the discussion rolling, and not necessarily “set in stone.”

Should his bill pass the full Health Committee, Williams said it would next be heard by the Criminal Justice Committee, as it does also deal with criminal law.

At the national level, a bipartisan measure to allow states to craft their own cannabis codes without federal interference — sponsored in the Senate by Rand Paul, a Kentucky Republican and Cory Booker, a New Jersey Democrat — has been gaining support. In the U.S. House, Memphis Democrat Steve Cohen is co-sponsoring the measure.

And during the run up to the November elections last year, U.S. Sen. Lamar Alexander announced he was in favor of allowing states to dictate their own pot policies.

Cannabis Oil for Intractable Seizures Headed to Floor

Elsewhere in medical-related Cannabis news, a bill to allow Tennesseans to use a low-THC cannabis oil to treat intractable seizures is currently assigned to the Calendar Committee in both chambers, awaiting scheduling for full floor votes.

The measure — HB197/SB280 — is being carried by two Northeast Tennessee Republicans: Rep. Jeremy Faison of Cosby and Sen. Becky Massey of Knoxville.

The bill passed the Senate Judiciary Committee Tuesday with seven members voting in the affirmative, and two abstaining.

Voting for the measure were Committee Chairman Brian Kelsey, R-Germantown, as well as fellow Republican Sens. Janice Bowling of Tullahoma, Todd Gardenhire of Chattanooga, Doug Overbey of Maryville and Kerry Roberts of Dickson, as well as Memphis Democrats Sara Kyle and Lee Harris, the Senate Minority Leader.

The two members abstaining from the vote were Republican Sens. Mike Bell of Riceville and John Stevens of Huntingdon.

It passed the House Health Committee Wednesday on a voice vote, after being amended by the sponsor to expand the treatment to those with seizures from epilepsy, as well.

Alex Harris can be contacted at Alex@TNReport.com.

End of the Line for ‘Insure TN’

An attempt to revive Gov. Bill Haslam’s plan to use Obamacare funding to finance health coverage for nearly 300,000 Tennesseans has once again been shot down in a state Senate hearing.

Most of the Republicans on the Senate Commerce Committee proved in no mood to move a resolution to the upper-chamber Finance Committee that would have authorized Haslam to launch “Insure Tennessee” after the U.S. Supreme Court hands down a decision this summer on the legality of government subsidies in federally run Affordable Care Act insurance exchanges.

Senate Joint Resolution 93 was sponsored by Sen. Doug Overbey of Maryville and was defeated on a 6-2 vote. That means the issue is likely dead for the year — even though the House has yet to vote on the matter in any of its committees.

“Insure Tennessee” was previously killed in a special session Senate Health Committee on a 7-4 vote back in February. But earlier this month it was revived, and last week won passage in the regular session Health Committee — only to seemingly meet its end this week.

The House version of the resolution could come up Wednesday in the Finance and Banking Subcommittee, but it seemingly would face extremely long odds in the lower chamber, too. Like in the Senate, Republicans enjoy supermajority domination over Democrats.

Nevertheless, House Minority Leader Craig Fitzhugh, D-Ripley, released a statement after the Senate Commerce Committee vote in which he said, “(O)ur constituents deserve the right to be heard and 300,000 Tennesseans who get up everyday, go to work and pay taxes deserve the chance to have health care. This is a moral issue and we have a moral imperative to pick ourselves up and keep fighting.”

However, House Majority Leader Gerald McCormick, R-Chattanooga, said that with the Senate vote Tuesday, the House version of the resolution is more than likely “a dead duck.”

“I don’t expect there to be a whole lot of momentum. If there’s no chance of actually passing the thing, I don’t know that everybody will want to put a whole lot of effort into it, is my guess,” said McCormick, who sponsored the governor’s proposal in the special session and still considers “Insure Tennessee” a sound proposal.

Devised behind closed doors by the Haslam administration over the past two years, “Insure Tennessee” would have created a two-year pilot project system of vouchers and co-pays mostly funded through the Affordable Care Act. Eligible enrollees would have been Tennesseans in the so-called “coverage gap” who aren’t poor enough for TennCare but also don’t make enough money to qualify for Obamacare insurance marketplace subsidies.

The six members of the Commerce Committee voting “no” on the resolution were Chairman Jack Johnson of Franklin, Todd Gardenhire of Chattanooga, Bo Watson of Hixon, Steve Southerland of Morristown, Dolores Gresham of Somerville and Jim Tracy of Shelbyville. All are Republicans.

Voting “yes” were Ken Yager, R-Kingston, and Reginald Tate, D-Memphis.

Mark Green, a Republican from Clarksville, abstained from the vote, saying that as a physician he stood to gain financially from either a “yes” or “no” vote.

Politics of ‘Insure Tennessee’ Good for Republicans: Governor

Tennessee Gov. Bill Haslam expressed some tempered optimism Monday about a revival in the General Assembly of his “Insure Tennessee” plan, which lawmakers shot down during a special session last month.

“Insure Tennessee” is the governor’s tentative agreement with the Obama administration to expand government-financed health insurance to low-income Tennesseans who don’t otherwise don’t meet the requirements for getting subsidies coverage on the Affordable Care Act exchanges.

Haslam said his administration has been in contact lately with members of the Legislature to address their concerns.

A resolution is under consideration in the Senate Commerce Committee Tuesday that would grant the Haslam administration authority to finalize a deal with the federal government allowing a two-year Medicaid expansion pilot program. The proposal would allow the state to rake in $2.8 billion in U.S. taxpayer funding to establish medical coverage for around 300,000 people.

Under the proposal, the state would be on the hook for about $74 million, but Tennessee’s hospitals, which stand to reap huge financial rewards from the program, have indicated they’ll cover any of the state’s portion of the costs.

The governor emphasized that he’s under no illusions that his Obamacare-funded scheme is going to be an easy sell in the supermajority GOP-controlled Legislature. “It is hard on this one to get past the politics,” Haslam said.

“We’ve know all along that this would be tough, but I think what we are saying is give us a full hearing and listen to the real arguments instead of some of the political arguments that people are making,” said Haslam. “I still think ‘Insure Tennessee’ is the right thing for the state.”

The governor is sticking with his pitch that the political upsides of Mediciad expansion outweigh the pitfalls, even among Republican voters, who Haslam claims favor the plan.

Cough Syrup Suppression Measure Moves to Haslam

The Tennessee General Assembly are clearly not impressed with Three 6 Mafia’s ideas for how to use cough syrup.

Thursday morning the Tennessee House, in a near-unanimous decision, voted to place an age restriction on sales of cough syrup containing dextromethorphan for fear that adolescents were increasingly abusing the medication as prescribed by the Memphis-based rap group in the 2000 song “Sippin’ on Some Syrup.”

The Senate had earlier this year voted unanimously to slap an age-floor on purchases of drugs like Robitussin.

The vote on SB45 in the House was 92-1, with Lebanon Republican Mark Pody the only member voting in opposition.

The House agreed to the Senate version of the bill, which had been amended to change the penalty from criminal to civil, as well as to exempt “licensed health care facilities and prisons” and change the age-appearance at which an ID is no longer required to 30.

When taken in large quantities the medication produces a dissociative high similar to PCP or Ketamine.

However, its abuse can also cause fever, increased heart rate, vomiting, impaired judgment, slurred speech and hallucinations. And DM medications often contain acetominophen — Tylenol — high doses of which can cause liver failure.

According to House sponsor William Lamberth, the cough suppressant has substantial potential for abuse by minors looking for cheap, easy buzz. “I don’t have any facts or figures — that’s more anecdotal evidence — but it’s my understanding from doctors, pharmacists and everything else that it’s definitely a beneficial law,” he told TNReport earlier this year.

The measure is headed to Gov. Bill Haslam for his signature. Its effective date is Jan. 1, 2016.

Alex Harris can be contacted at Alex@TNReport.com.

‘Insure Tennessee’ Back in Action

The governor’s Medicaid expansion plan, which died during a special session last month, cleared the Senate’s Health and Welfare Committee on a 6-2-1 vote Wednesday evening.

“Insure Tennessee” is now headed to the upper chamber’s Commerce and Labor Committee, where most Capitol watchers, including Gov. Bill Haslam himself, predict it will hit rougher sailing.

The plan, which would be authorized by Senate Joint Resolution 93, aims to draw down billions of dollars in Affordable Care Act-related funding to expand government-financed insurance to people who make too much for TennCare, but not enough for Obamacare’s federal-exchange subsides. Somewhere in the neighborhood of 300,000 Tennesseans are anticipated to be eligible for “Insure Tennessee.”

Voting yes on the Health Committee were five Republicans, including SJR93 sponsor Doug Overbey of Maryville, Rusty Crowe of Johnson City, Ed Jackson of Jackson, Becky Duncan Massey of Knoxville and Richard Briggs, also from Knoxville.

Nashville Democrat Jeff Yarbro, the minority party’s caucus chairman, also voted in favor.

Bo Watson of Hixson, the Senate’s Republican speaker pro tem, as well as Randy McNally of Oak Ridge, voted against the bill. Republican Joey Hensley, a Republican physician from Hohenwald, abstained.

If the measure by chance slips through the Commerce Committee, McNally, also a Republican, would likely get another shot at shooting it down in the Finance Committee, which he chairs.

The House version of the legislation, HJR85, is scheduled for a hearing in the Insurance and Banking Subcommittee next week, where it too is expected to face stiff resistance.

In early February, during the “extraordinary session” of the Legislature, a handpicked special Senate Health and Welfare Committee killed the proposal in a 7-4 vote. At that time, Crowe — who voted in favor of the resolution this week — voted “no.”

When it was unveiled, Haslam called “Insure Tennessee” a “market-based” alternative to simple Medicaid expansion. The governor has promised any of the costs not covered by Washington, D.C. that are associated with extending coverage to the more than a quarter of a million newly eligibles in Tennessee would be covered by the state’s hospitals.

However, as amended, the measure would call on Haslam to hold off on implementing the plan until after the U.S. Supreme Court’s ruling on whether or not the subsidies provided by the federal government are legal.

SJR93 also requires a “lockout provision” for enrollees failing to pay premiums, as well as a demand of written confirmation from the Centers for Medicare and Medicaid Services that the Volunteer State can pull out of the program if the costs run too high.

While the resolution’s fiscal note indicates a cost increase to the state of about $7.8 million, TennCare officials explained those costs would be covered by certain “offsets,” as well as the additional funds from the state’s hospitals.

Haslam praised the Senate for taking up the issue again earlier this week at a Nashville Area Chamber of Commerce breakfast Tuesday, calling it “an encouraging sign.”

However, Senate Speaker Ron Ramsey remains skeptical, and told the Associated Press this week that he’s “not sure it ever gets to the floor, to be perfectly honest.”

When the the governor’s Medicaid expansion resolution was killed earlier this year, Senate Majority Leader Mark Norris of Collierville suggested that any future Medicaid expansion authorization would have to “pass on the floor of the House before the Senate will consider it.”

Alex Harris can be contacted at Alex@TNReport.com.

Divine Intervention Sought to Encourage TN Medicaid Expansion

A coalition of students, clergy and individuals took to Legislative Plaza Wednesday to pray, protest and sing gospel songs in support of expanding the Volunteer State’s Medicaid program to more Tennesseans of modest means.

The “Moral Movement for Health Care,” organized by Fisk University student Justin Jones, circled the plaza several times, praying for the Legislature as well as seeking God’s assistance in turning the hearts of conservative lawmakers.

A similar group also exists in North Carolina.

In an early February special session, the GOP supermajority-run General Assembly killed a proposal from Republican Gov. Bill Haslam to use federal Medicaid expansion dollars to provide “market-based” government-financed health insurance options to lower income Tennesseans not eligible for TennCare or Obamacare’s private-coverage subsidies.

Haslam told reporters earlier this week that while his administration is open to revisiting Insure Tennessee, he doesn’t anticipate pushing the matter to the forefront of political discussion absent clear indications the GOP-controlled Legislature is more amenable to passage than it showed in February.

“There has to be a path,” he said.

Haslam said he is in fact open to considering other politically viable policy ideas for enabling Medicaid expansion in Tennessee. But he tends also to believe his administration already “negotiated the very best deal that’s been done” among Republican-led states looking to develop unique arrangements with the Obama administration under which ACA Medicaid expansion funding can be drawn down.

“Everything that we could ask for we did, and we got everything, we think, in the end that they will give us,” he said.

A Democratic proposal still alive in the General Assembly proposes repealing the “Stop Obamacare Act,” guided to passage last year by Sen. Brian Kelsey of Germantown and Rep. Jeremy Durham of Franklin, that requires the Tennessee governor to win legislative approval prior to enacting any ACA-associated Medicaid expansion initiative. That barrier was imposed both as a barrier to Obamacare implementation and to prevent the sitting or a future governor from unilaterally encumbering state taxpayers with down-the-road TennCare cost increases.

House Democratic Caucus Chairman Mike Stewart of Nashville, who is sponsoring the repeal of the Kelsey-Durham legislation, told TNReport that in most states a governor has the power to “cooperate with the federal government” and make decisions to “get our tax dollars back” under plans like Insure Tennessee.

“I think we need to just get rid of this requirement and let Gov. Haslam go forward and bring Insure Tennessee into being,” Stewart said.

Stewart, said he anticipates bringing House Bill 1018 for a hearing next week in the House Health Subcommittee. Senate Democratic Caucus Chairman Jeff Yarbro, also of Nashville, is sponsoring a similar measure that’s scheduled for a TennCare subcommittee review on Monday.

If either measure fails in committee, not at all an unlikely outcome given Democrats’ woeful lack of seats in both chambers, the chances of Medicaid expansion in 2015 will sink to nil.

Yarbro also had a pair of resolutions — SJR94 and SJR105 — each of which would authorize Haslam to expand Tennessee’s Medicaid program by different degrees, but neither have been put on notice for a hearing.

A Republican proposal to reform TennCare to possibly cover individuals up to 138 percent of the poverty rate was taken off notice today by freshman GOP Rep. Eddie Smith of Knoxville.

Smith told TNReport Wednesday that his intent with HB1271 was for the state to look at how to “request a block grant from the federal government of the existing TennCare money,” so the state could have more flexibility in providing Medicaid services, and provide those services to more people.

But that’s an extremely complicated issue that Smith said the Legislature isn’t likely to tackle before adjourning for the year.