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Haslam Pitches Insure TN to Joint Session of General Assembly

Press release from the office of Tennessee Gov. Bill Haslam; February 2, 2015:

Governor’s plan provides health care coverage to more Tennesseans at no cost to the state

NASHVILLE – Tennessee Gov. Bill Haslam this evening addressed a joint convention of the 109th General Assembly as legislators began an extraordinary legislative session to consider his Insure Tennessee plan.

The proposal, a two-year pilot program to provide market-based health care coverage to more than 250,000 Tennesseans who currently don’t have access to health insurance or have limited options, does not create any new taxes for Tennesseans and will not add any state cost to the budget.

“Two years ago, the General Assembly made two requests of us,” Haslam said.  “First, to bring a unique and specific plan to Tennessee that met the needs of our citizens and was financially responsible for our state and the country, and secondly, to bring that plan back to the General Assembly for a vote.

“I have done both of those things.  This plan is overwhelmingly supported by Republicans and Democrats in our state.  Tonight, I am asking for your vote to help Insure Tennessee.”

After the U.S. Supreme Court ruled in 2012 that the federal government could not force states to expand their Medicaid programs, the governor went before the legislature the next spring to announce that Tennessee would not expand its Medicaid program.  He also said at the time that he didn’t think it made sense for Tennessee to reject federal dollars that Tennesseans are paying for, that are going to other states and that could cover more Tennesseans who need insurance, so he started to work on a third way – a “Tennessee plan.”

“After nearly two years of hard work, we have a Tennessee-specific plan that addresses health outcomes and cost,” Haslam said. “This is not Obamacare. If it was, it wouldn’t have taken this long to negotiate. We have done what you asked us to do and what we said we would do.  We found a unique, Tennessee solution,” Haslam said.

Citing his own opposition to the Affordable Care Act, especially for its failure to address health care costs, Haslam continued, “As a Republican elected leader, I feel like we owe the country answers as to what we would do about health care.  For too long, we’ve said what we don’t like – mainly Obamacare.  This is a chance to show what we would do.”

The plan would provide coverage to more than 250,000 uninsured Tennesseans earning less than 138 percent of the federal poverty level, valued at slightly over $16,000 a year for an individual and $27,000 for a family of three.

Five key areas of the governor’s plan include: a fiscally sound and sustainable program; providing two new private market choices for Tennesseans; shifting the delivery model and payment of health care in Tennessee from fee-for-service to outcomes based; incentivizing Tennesseans to be more engaged and to take more personal responsibility in their health; and preparing participants for eventual transition to commercial health coverage.

The governor announced his Insure Tennessee proposal in December and issued a proclamation last month to convene the “extraordinary session” of the 109th General Assembly to consider a joint resolution.  The special session, the first of the Haslam administration, began today at 4 p.m. CST.

Kelsey Releases Open Letter from County GOP Chairmen Opposed to Insure TN

Press release from Tennessee Sen. Brian Kelsey, R-Germantown; February, 2, 2015:

NASHVILLE, Tenn. – Sen. Brian Kelsey (R-Germantown) and Rep. Jeremy Durham (R-Franklin) today will accept a letter from a statewide coalition of conservative leaders and activists who oppose Medicaid expansion. Sen. Brian Kelsey stated, “Republican opposition to Obamacare Medicaid expansion is gaining momentum. These county party chairmen reflect the grassroots Republican opposition that is taking hold in the legislature.” Kelsey and Durham will discuss the open letter on behalf of the legislature at a press conference today at 10:30 am, scheduled for Hearing Room LP30.

Signatories to the letter include current chairs and party members from counties served by rural hospitals, such as West Tennessee Healthcare in Weakley County. Signatories also include persons recently included on a list of circulated by supporters of Medicaid expansion who did not intend to support the governor’s proposal. Party chairs signing the letter:

  • Rachel Welch–Chairman, Putnam County Republican Party
  • Gayle Jones–Chairman, Giles County Republican Party
  • Barry Hutcherson–Chairman, Chester County Republican Party
  • Chris Thompson–Chairman, Pickett County Republican Party
  • Dolores DiGeatano, MD–Chairman, Fayette County Republican Party
  • David Baldovin–Chairman, Moore county Republican Party
  • Sue Jackson–Chairman, Obion County Republican Party
  • Daniel Williams–Chairman, Carroll County Republican Party
  • Ben Nixon–Chairman, Warren County Republican Party
  • Harold Kemp–Chairman, Macon County Republican Party
  • Constance Hightower–Chairman, Hamblen County Republican Party
  • Debbie Baldwin–Chairman, Benton County Republican Party
  • Judi Swilling–Chairman, Claiborne County Republican Party
  • Jimmy Knight–Chairman, Union County Republican Party
  • Fred Ellis–Chairman, Lincoln County Republican Party
  • Ken Coppinger–Chairman, Rhea County Republican Party
  • Richard Swink–Chairman, Robertson County Republican Party
  • Ronald Wayne King–Chairman, Scott County Republican Party
  • Robert Dunham–Chairman, White County Republican Party

An excerpt from the letter reads, “As conservatives in our communities, we have worked hard to elect leaders we trust will uphold our values of shrinking government, imposing less taxes and costs on businesses and individuals, and embracing a free market.

“We reject ObamaCare’s Medicaid expansion. And we need you to stand strong on these principles in the coming special session.” A copy of the letter is attached.

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Dear Legislators:

As conservatives in our communities, we have worked hard to elect leaders we trust will uphold our values of shrinking government, imposing less taxes and costs on businesses and individuals, and embracing a free market.

We reject ObamaCare’s Medicaid expansion. And we need you to stand strong on these principles in the coming special session.

Although Governor Haslam originally opposed Obamacare, it appears he has chosen to abandon those principles now that he is safely in his second term. His proposal for Insure Tennessee is no more than expansion of Obamacare by another name.

Nearly 9 in 10 Tennesseans eligible for Medicaid expansion are working-age adults without dependent children to support, according to the Urban Institute. Instead of adding a whole new generation onto welfare programs like Medicaid, we need to get working-age adults working again. Our state deserves a clear path to jobs and prosperity―not an ObamaCare Medicaid expansion like Insure Tennessee.

We are also concerned about how this ObamaCare Medicaid expansion is funded. In particular, $716 billion will be cut from Medicare in order to pay for the Medicaid expansion and other parts of the law, according to The Heritage Foundation. Medicaid expansion breaks the Medicare promise we made 50 years ago. And if other state Medicaid expansions are any indication, Medicaid costs will skyrocket―putting Tennessee seniors at further risk.

We are all aware of the mess that TennCare created and the difficulty our state had when we had to end the program and kick 350,000 Tennesseans off the Medicaid rolls.

Governor Haslam’s “two year pilot program” reeks of the same issues that we had less than a decade ago. Tennessee should not make the same mistake again.

We reject the ObamaCare Medicaid expansion known as Insure Tennessee. On behalf of many local Republicans oppose this expansion, we urge you to do what’s right for Tennessee and stand strong against this proposal.

Sincerely,

Tennessee Republican Party Chairs

MTSU Poll: Few Tennesseans Aware of Haslam’s Medicaid Expansion Plan

Press release from MTSU Poll; January 31, 2015:

But support higher than opposition among those who have

MURFREESBORO, Tenn. — Two-thirds of Tennesseans haven’t heard much about Gov. Bill Haslam’s “Insure Tennessee” health care proposal, but among the third who have, support substantially outweighs opposition, according to the latest MTSU Poll.

The poll randomly surveyed 600 adult residents statewide a week before a special legislative session kicks off Monday to consider the measure. The survey’s margin of error is 4 percentage points.

“Gov. Haslam has gotten a notable head start in promoting the measure among Tennesseans,” said Ken Blake, director of the poll at Middle Tennessee State University. “But his opponents have a lot of maneuvering room left among the two in three Tennesseans who are still largely unaware of the measure.”

Conducted Jan. 25-27, the poll first asked Tennesseans how much they had heard about “a proposal from Gov. Bill Haslam called ‘Insure Tennessee,’ which is designed to provide health insurance for Tennesseans who earn too much to qualify for Medicaid but not enough to afford coverage on their own.” A follow-up question asked how they felt “right now about the governor’s ‘Insure Tennessee’ proposal.”

According to the results:

  • Thirty-three percent of Tennesseans have read or heard “a lot” (10 percent) or “some” (23 percent) about “Insure Tennessee,” while 66 percent have heard either “a little” (31 percent) or “nothing at all” (36 percent).
  • Among the 33 percent who have at least some information, 49 percent favor the proposal, 11 percent oppose it, and 40 percent are unsure or haven’t made up their minds.
  • Meanwhile, among the 66 percent who have heard little or nothing, 69 percent don’t know how they feel about it, while 26 percent expressed support, and 5 percent, opposition.
  • Overall, regardless of how much they have read or heard about the measure, 34 percent favor Insure Tennessee, 7 percent oppose it, and 59 percent remain uncertain.

Jason Reineke, associate director of the poll, emphasized the importance of accounting for how much Tennesseans know about the governor’s proposal when estimating their attitudes toward it.

“For obvious reasons, we try to avoid estimating public opinion about an issue before most of the public has become aware of it,” Reineke said. “But when the issue is the focus of a weeklong special legislative session, a public affairs poll like ours can’t simply ignore it. So we measured awareness first, then did our best to estimate support within high- and low-awareness groups.”

Reineke cautioned that people who knew little about Insure Tennessee before being polled probably answered based on whatever information they absorbed from the poll question itself. “Their opinions might change easily as they encounter additional information about the measure, including what is being said by the measure’s supporters and opponents.”

By contrast, people who had already heard or read something before being polled were more likely to express a previously developed opinion, Reineke said. ”Opinions expressed by these individuals probably will be relatively more stable over time, although any opinion can change at any time in response to new developments or information.”

Some demographic patterns are evident. For example, among Tennesseans who have heard a lot or some about Insure Tennessee, support is higher among those with at least some college education. Among those who have heard little or nothing, support is greater among minorities than among whites.

There is some evidence of higher support overall among Democrats and independents than among Republicans, but the pattern disappears after Tennesseans are divided according to how much they have heard about the proposal.

Find previous MTSU Poll results at www.mtsupoll.org.

Methodology

Interviews for the poll were conducted by Issues & Answers Network Inc., which completed 600 telephone surveys among a random sample of Tennessee residents aged 18 and over.

Data was collected using Tennessee statewide RDD sample with a mix of 80 percent landline and 20 percent cell phones. The average interview length was 13 minutes.

Quotas by gender and geographic region were implemented to ensure the sampled respondents were representative of Tennessee’s adult population. U.S. Census Bureau data were used to determine the gender distribution each of Tennessee’s Grand Divisions: East, Middle and West. The survey’s margin of error is +/- 4 percentage points, meaning that we are 95 percent confident that the actual result lies within 4 percentage points (in either direction) of the result our sample produced.

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Interactive graphic available here.

Haslam: If Insure TN Was Obamacare It Wouldn’t Have Taken 2 Years

Letter from Tennessee Gov. Bill Haslam; January 30, 2015:

Reaching Our Full Potential

On January 17, I was honored to be sworn in for my second term as governor. I see this job as being part of a historically significant relay race. I was handed the baton four years ago, and it’s my job to be intentional about advancing that baton during my eight years in office and handing it off to the next governor in a better position than it was handed to me.

One thing I can guarantee you that we are not going to do in the next four years is coast to the finish line. The decisions that we make are too important to the 6.5 million Tennesseans who are alive today and even more important for the generations that will follow us.

You can click here to read my inaugural address and here to see footage from the day.

Insure Tennessee

On Monday, the General Assembly will begin a special session to consider Insure Tennessee, a two-year pilot program to provide market-based health insurance coverage to more than 250,000 Tennesseans currently without access at no additional cost to taxpayers. Over the past two weeks, I’ve been visiting with legislators and providers across the state to discuss the plan, to talk about why it is so important to our state, and to answer questions and address concerns.

I believe the Affordable Care Act (also known as Obamacare) was bad for this country. It only addressed coverage for more people without doing the more difficult and important work of addressing cost.

Insure Tennessee is not Obamacare.  It wouldn’t have taken us nearly two years to negotiate with Washington to get the concessions we have if it was. This is a Tennessee-specific alternative to traditional Medicaid expansion that promotes better health outcomes and helps us control health care costs, which as an American I see as one of the biggest challenges our country faces. Doing nothing is not an option. Our approach is a critical first step to fundamentally changing health care in Tennessee.

***

I hope 2015 is off to a great start for you and your family. Please feel free to share your thoughts on this issue or anything else that’s on your mind.

Best,
Bill

Click here to see the 2014 timeline, highlights from our fourth year in office.

Overbey Sponsoring Insure TN, Looking Forward to Discussion

Statement from Tennessee Sen. Doug Overbey, R-Maryville; January 30, 2015:

“I accepted the opportunity to sponsor Insure Tennessee in the Senate after meeting with Governor Haslam this week and thoroughly discussing the program with him.  During our conversation, I became convinced that Insure Tennessee is uniquely crafted to meet our specific needs while utilizing conservative principles.  Insure Tennessee brings market principles and individual responsibility to the program.  The program is designed to control health care costs and improve access to many working poor Tennesseans who would otherwise have no access to affordable health insurance.”

“This program is especially important to struggling rural hospitals that lost funding under the Affordable Care Act for treating poor patients who cannot pay.  Unless it is approved, the loss of this funding could lead to the closure of some of our rural hospitals, meaning life and death for citizens in these areas to get to the nearest hospitals in a time of medical crisis.  Those closures would also put more stress on hospitals statewide, placing our healthcare system in jeopardy.”

“I look forward to talking with my colleagues as we begin the special session on Monday about this legislation and how Governor Haslam’s proposal will benefit the citizens of our state.”

Alexander, Hatch File Bill to Repeal Employer Mandate

Press release from the US. Sen. Lamar Alexander, R-Tenn.; January 29, 2015:

WASHINGTON – Today, Senate Finance Committee Chairman Orrin Hatch (R-Utah) and Senate Health, Education, Labor and Pensions (HELP) Committee Chairman Lamar Alexander (R-Tenn.) introduced the American Job Protection Act, S. 305, a bill to repeal Obamacare’s job-killing employer mandate.  Under the President’s health law, businesses with 50 or more equivalent employees are required to offer health insurance of minimum value or pay a penalty between $2,000 and $3,000 for each employee working 30 hours or more a week.  The Chairmen were joined by 26 senators in cosponsoring the bill.

“Obamacare’s burdensome employer mandate continues to hinder job-creation and growth, and the best action Washington can take is to repeal it entirely,” said Hatch.  “By doing away with the mandate, job-creators will be able to grow their businesses without the added concern of reaching an arbitrary and punitive threshold.  Repealing this job-killing mandate will put American small businesses back in a position to hire again. That means more jobs for the American people and more growth for the American economy.”

“The havoc Obamacare’s misguided employer mandate is wreaking in American workplaces was every bit as predictable as it was preventable, as Republicans warned over and over that an employer mandate would do exactly what it’s doing: businesses that employ many of our lowest-income workers are cutting jobs and many other businesses are reducing the number of hours their employees work to avoid the mandate’s high cost,” said Alexander. Until we have a Republican president and can repeal Obamacare, the responsible thing to do is repeal the employer mandate—one of several steps we can take to repair the damage Obamacare has done.”

Joining the Chairmen in cosponsoring the bill were Sens. Kelly Ayotte (R-N.H), John Barrasso (R-Wyo.),Roy Blunt (R-Mo.), Richard Burr (R-N.C.), Shelley Moore Capito (R-W.Va.), Dan Coats (R-Ind.), Thad Cochran (R-Miss.), Susan Collins (R-Maine), John Cornyn (R-Texas), Mike Crapo (R-Idaho), Deb Fischer(R-Neb.), Jeff Flake (R-Ariz.), Cory Gardner (R-Colo.), Chuck Grassley (R-Iowa), Jim Inhofe (R-Okla.),Johnny Isakson (R-Ga.), Mark Kirk (R-Ill.), Jerry Moran (R-Kan.), Rob Portman (R-Ohio), Pat Roberts (R-Kan.), Marco Rubio (R-Fla.), Tim Scott (R-S.C.), John Thune (R-S.D.), Pat Toomey (R-Pa.), David Vitter(R-La.), and Roger Wicker (R-Miss.).

The employer mandate went into effect in 2014.  Employers are subsequently experiencing the full negative effects of the mandate and are basing decisions about their businesses going forward around the mandate’s impacts.   A recent Gallup survey of small employers found that 11 times as many small business owners believe that the PPACA will increase their health care costs as opposed to those who believe that it will reduce costs.  Overall, approximately half of small business owners believe that the PPACA will be bad for business, compared to only 9 percent who expect it to have a beneficial impact. These expectations are forcing action: employers are holding back on hiring new employees or have slowed plans to grow their business.

The U.S. Chamber of Commerce’s Small Business Outlook Survey released in April 2013 found that the requirements of the health care law are now the biggest concern for small businesses. Of small business respondents, 77 percent say the health care law will make coverage for their employees more expensive, and 71 percent say the law makes it harder for them to hire more employees. As a result of the employer mandate, one-third of small businesses plan to reduce hiring, and will cut back hours to reduce the number of full-time employees.

Black: Obama Administration Decision to Limit Healthcare.gov Data Sharing ‘Welcome News’

Press release from U.S. Rep. Diane Black, R-Tenn. 06; January 23, 2015:

Washington, D.C. – Today Congressman Diane Black (R-TN-06) released the below statement on the news that the Obama Administration reversed its policy of sharing consumer data on Healthcare.gov. The Associated Press previously reported that “certain personal details — including age, income, and smoking habits — were being passed along, likely without consumers’ knowledge” to third-party sites. In a previous statement, Rep. Black said the revelations point to “inherent security flaws” in the Healthcare.gov website.

“While the Obama Administration’s decision to limit its data sharing practices on Healthcare.gov is certainly welcome news, it begs the question – why was this information shared in the first place? To what extent will the policy actually be ‘scaled back’ and what becomes of the information that was previously collected? Americans are already doubting the Obama Administration’s competence to handle their most personal information, particularly given the successful hacking of Healthcare.gov just last year. This data sharing policy, and the Administration’s sudden about-face in a classic Friday news dump only adds to the laundry list of questions my constituents have regarding the handling of the Obamacare exchanges,” said Congressman Diane Black.

Rep. Black added, “To add to the Obama Administration’s Healthcare.gov woes, this news coincides with the release of a government report finding that the Obama Administration did not bother to properly vet the contractors responsible for developing this website in the first place. With or without the Administration’s risky information-sharing practices in place, Healthcare.gov continues to be a stunning display of the Obama Administration’s haphazard approach to the rollout of this law.”

Kelsey Files Bill to Block TN From ‘Operating Any Obamacare Exchanges’

Press release from the Tennessee Senate Republican Caucus; January 15, 2015:

(NASHVILLE), January 15, 2015 – Senator Brian Kelsey (R-Germantown) and Representative Jeremy Durham (R-Franklin) today filed legislation that would prevent individuals and businesses in Tennessee from being assessed fees under Obamacare if the U.S. Supreme Court rules in favor of the plaintiffs in the case of King v. Burwell.  The Supreme Court is expected to hear oral arguments on the case in March which, in effect, challenges the administration’s regulations on citizens in states which did not set up state healthcare exchanges in conjunction with the federal act.

“This bill will stop the IRS from penalizing Tennesseans for not signing up for Obamacare,” said Senator Kelsey.  “It also prevents Tennessee from operating any Obamacare exchanges in the future.”

Plaintiffs in the lawsuit claim that the section of the law authorizing the government to distribute tax credits and assess penalties applies only when states choose to run their healthcare exchanges.  The law does not explicitly state that the tax credits and penalties apply when the federal government runs the exchange.  Tennessee is one of the 25 states that have chosen to force the federal government to run its exchange.  Senate bill 72 would prohibit Tennessee from running the exchange in the future if the plaintiffs receive a favorable ruling the case.  A decision on the case is expected by in June after the Tennessee General Assembly has adjourned.

“The Supreme Court could overturn half of Obamacare, and this bill will prepare our citizens for that,” Durham concluded.

A draft of the bill is available at: http://www.capitol.tn.gov/Bills/109/Bill/SB0072.pdf

TennCare Computer System’s Completion Date Still Unknown

Although he won’t speculate as to when the state’s new TennCare computer system will be completed, Darin Gordon, the program’s director, told members of the General Assembly he hopes a planned third-party audit will provide that answer.

Gordon gave testimony Tuesday to the Joint Fiscal Review Committee on the progress, or lack thereof, of the Northrop Grumman Corporation in developing the new “Tennessee Eligibility Determination System” for TennCare.

Tennessee has so far paid Northrop about $4.7 million of the $35.7 million it committed to the cybersecurity contractor in December of 2012, when they signed a three-year contract to develop the new system made necessary by the Affordable Care Act, Gordon said.

TEDS was supposed to go live in October 2013, and Northrop was last paid in January, Gordon added.

There are four “different tools” for the agency to ensure contractors comply with contract stipulations: penalties, liquidated damages, withholds and non-payment, in order of weakest to strongest. “We’re using the biggest tool that we have at this point to make sure that everybody is properly motivated to getting to where we want to be,” Gordon said.

Gordon said that Northrop, one of five firms to bid on the contract, made the lowest bid to produce the system. The next lowest was for $58 million, with the highest bid coming in at $109 million.

Wyoming, one of the other states to use Northrop to produce their system, is also “having challenges,” Gordon said.

Gordon told the committee that he had no idea as to when the system would be completed, because he’s “lost confidence in people’s ability to accurately predict” a timeline for completion.

Northrop is currently 99 percent done with its systems integration testing, the second phase of its five phases of implementation — but that doesn’t mean that phase is nearly done, Gordon said, because when issues with testing arise, developmental changes need to be made and the phase “can be at 99 percent for a longer period of time.”

The company is also about 80 percent complete with its third phase — user integration testing, but can’t start on the last two phases until the others are completed, Gordon explained.

“These are complex systems, there’s a lot of working in a very tight time-frame, and we want to make sure that what we do turn on, works,” Gordon said.

On Aug. 18, TennCare signed a no-bid contract with KPMG, an audit and advisory services firm, to run a 14-week audit of Northrop’s progress at a cost to the state of $1.2 million, Gordon told the committee. That report is expected to be ready sometime in late November or early December.

Following Gordon’s testimony, the committee also approved an extension of a contract with Policy Studies, Inc., the contractor who provides eligibility determination and processes application for the state’s children health insurance program. The contract, which is being extended through Dec. 2015 as a result of the delay in implementing TEDS. The contract extension is eligible for a 75 percent federal match.

The total cost to the state of the delay in getting the computer system on-line is not currently known, Gordon said.

The failure in bringing the new system online is one reason that TennCare is facing a lawsuit from the Southern Poverty Law Center, the National Health Law Program and the Tennessee Justice Center on behalf of several Tennesseans who have allegedly been denied coverage, though they claim eligibility.

“These system failures have serious impact on vulnerable Tennesseans and the health care infrastructure we all reply upon. It’s time for the state to spend less time blaming others and more time managing problems that have devastating consequences for our state,” said Michele Johnson, executive director for the TJC, in an e-mail.  Tennessee’s “lack” of a TennCare enrollment process “makes us unique in the nation,” she added.

The TJC filed the lawsuit because despite having met with TennCare officials since October of last year, “at some point it became clear that their willingness to problem-solve was not there,” and the Tennesseans they represent “couldn’t wait any longer,” Johnson told TNReport Wednesday.

Gordon was questioned by state Rep. Brenda Gilmore, a Nashville Democrat, about whether anything was being done to help hospitals cope with financial problems stemming from the inability to process emergency Medicaid applications because of the delay in TEDS implementation.

Gordon told Gilmore that because of the pending litigation the only information he could give was already included in his response to the federal Centers for Medicare & Medicaid Services, or in the briefs filed in the lawsuit.

However, the Gordon assured Gilmore that TennCare is in contact with the Tennessee Hospital Association “pretty much every week.”

Johnson told TNReport that she “thought it was interesting” the administration continued to say they couldn’t comment on anything related to the lawsuit because government agencies are required to “answer questions that the legislature has for their constituents.”

The next hearing in the federal case is scheduled for Friday.

Gordon noted to the committee that although TennCare has appeared before the legislature in the past, it wasn’t a result of computer system problems.

“Every state in the country all started from different starting points,” Gordon said. “Some had some modern technology already in place, and only had to adapt that technology to the new requirements. Other states, such as ourselves, had to start from scratch because our system was an old legacy system not capable of handling the changes that would be necessary to comply with the ACA.”

Additionally, the changes required by Obamacare have been “some of the most complicated” for the system since it began, Gordon explained.

Several other states — such as California’s backlog of hundreds of thousands of enrollees, or Oregon’s broken website and over-taxed Medicaid rolls — have had their own problems in developing a working system, Gordon said.

“These are complex systems, and are being implemented on a very quick runway, and so I think, if you look across the country, a lot of folks have had challenges with these,” Gordon said.

Haslam Optimistic New HHS Head Will Work With TN on Medicaid Expansion

Tennessee Gov. Bill Haslam said he expects discussions about Medicaid expansion in the Volunteer State will come up this week at the National Governors Association meeting in Nashville.

Sylvia Burwell, the new U.S. Department of Health and Human Services secretary, is expected to attend the NGA meeting, Haslam told reporters following a grant announcement in Dunlap Tuesday. She was appointed to the post June 9.

Despite the fact that it’s been about a year and a half since Haslam said he wanted to develop a special “Tennessee Plan” for accessing Affordable Care Act money to expand government-financed health insurance for the state’s lower income residents, there’s been little visible movement toward a compromise.

In the meantime, the Legislature has passed a law requiring that the General Assembly sign off on any agreement the Haslam administration reaches with Washington for it to take effect. Republicans dominate in the statehouse, and many have indicated they’re in no way whatsoever interested in facilitating any aspect of Obamacare.

Still, the governor said, new blood at HHS may mean novel approaches will be considered by those administering the ACA at the federal level.

“We’ve always had hope that there’s something to work out, or we would have just quit a long time ago,” Haslam said. “But I think obviously whenever you introduce somebody new into the process, you hope it’ll be somebody who can help get some of the logs unjammed.”

Haslam said he’s met Burwell previously when she was in a different position, but this week’s meeting in Nashville would be the first chance he’s had to speak with her since she was appointed head of the department that oversees the execution of Obamacare policies.

Former HHS Secretary Kathleen Sebelius, Obama’s first appointment to that role, resigned on April 11, in the wake of months of criticism over the problematic roll out of the Affordable Care Act federal health care exchange.

According to the Affordable Care Act, if Tennessee agrees to expand TennCare, the federal government will pick up the tab for the coverage through 2016, and provide part of the cost after that.

Haslam initially held out for a waiver from HHS that would allow him to establish a “third way,” and use federal money to subsidize private insurance to extend coverage to 175,000 uninsured Tennesseans.

An agreement was never reached between Sebelius and Haslam, but Haslam has continued to say that he is still working on finding a way to reach a middle ground between the Obama administration and Tennessee’s Republican super-majority in the General Assembly.

The Tennessee House Democratic Caucus sent out a press release last week referencing a recent report by the White House Council of Economic Advisors that “lays out the fiscal, economic and moral failure caused by the Haslam administration’s refusal to expand Medicaid in Tennessee.”

But there is concern among those opposed to expanding the state’s poverty health care program about whether the federal government can afford to do that, as well as what the state should do in the case that the money for the program is not forthcoming from federal officials.

Back in the mid-2000s, under Democratic Gov. Phil Bredesen, Tennessee had to remove more than 300,000 from TennCare coverage, due to rising costs and lack of funding, a problematic time that is often pointed to by opponents of Medicaid expansion.

Haslam was in Dunlap to award a transportation grant of $591,141 to the city for them to help connect nearby residential areas with the downtown education centers and business district.

The NGA meeting begins Thursday, July 10, in Nashville, and runs through July 13.