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Alexander Makes First Move to Repeal Individual Mandate

Lamar Alexander has filed a bill to repeal the portions of President Barack Obama’s signature health care legislation that require all Americans purchase health insurance or pay a fine.

Tennessee’s senior U.S. senator, who chairs the Health, Education, Labor & Pensions Committee, joined Finance Committee Chairman Orrin Hatch and 20 other Republican senators in filing the “American Liberty Restoration Act” on Wednesday.

In a press release, Alexander questioned how the federal government can “continue to enforce the individual mandate” when “the law doesn’t clearly ensure that millions of Americans are allowed to receive subsidies to help cover the cost.” He added that the ACA “outlaws plans that fit family budgets.”

“Millions more Americans are in for sticker shock when they see how much they owe the IRS in April because of Obamacare. We need to focus on making health care plans affordable to Americans,” Alexander said in the release.

For 2014, the first tax year affected by the individual mandate, individuals without health insurance will have to pay a penalty of $95 or 1 percent of their income — whichever is more. In 2015, the fine will go up to $325 or 2 percent of their income.

In his State of the Union speech this week, Obama appeared to double-down on statements made in the wake of the Republican takeover of the Senate in November when he vowed to veto any attempt to undo key pillars of the Affordable Care Act.

“We can’t put the security of families at risk by taking away their health insurance, or unraveling the new rules on Wall Street, or refighting past battles on immigration when we’ve got a system to fix. And if a bill comes to my desk that tries to do any of these things, it will earn my veto,” Obama said Tuesday night.

Back in November, the president told reporters he would “draw some lines” when it came to future legislation dealing with Obamacare passed by the GOP-controlled Congress. He said he would not sign a repeal of the law or support any other “efforts that would take away health care from the 10 million people who now have it and the millions more who are eligible to get it.”

“In some cases there may be recommendations that Republicans have for changes that would undermine the structure of the law, and I’ll be very honest with them about that and say, look, the law doesn’t work if you pull out that piece or that piece,” he said.

One of the areas of the law Obama vowed to stand firm on was the mandate that all Americans purchase health insurance. While the president said he understood that even with provided federal subsidies some Americans may still not be able to afford their insurance, the mandate is “a central component of the law.”

“The individual mandate is a line I can’t cross because the concept, borrowed from Massachusetts, from a law instituted by a former opponent of mine, Mitt Romney, understood that if you’re providing health insurance to people through the private marketplace, then you’ve got to make sure that people can’t game the system and just wait until they get sick before they go try to buy health insurance,” Obama said in November.

The concept of the individual mandate was first discussed in the late 1980s by conservative economists and pushed by Republican-leaning groups — including the Heritage Foundation and the American Enterprise Institute. It was supported by GOP congressmen in the early 1990s as “a less dangerous future than what Hillary [Clinton] was trying to do [with ‘Hillarycare’],” said former U.S. Rep. Newt Gingrich in December 2011.

The mandate was in part conceived of in response to the 1986 Emergency Medical Treatment and Active Labor Act, which required any hospital accepting Medicare funding to provide emergency care for anyone in need, regardless of ability to pay. Thus were created concerns of a “free-rider” problem in which medical-industry experts and economists worried people would intentionally go without insurance, knowing that a hospital had to provide them free care.

But just as conservatives haven’t always opposed the individual-mandate concept, liberals haven’t always been on board with it.

As recently as 2008, Obama criticized Hillary Clinton over her support of the mandate. “If things were that easy, I could mandate everybody to buy a house, and that would solve the problem of homelessness. It doesn’t,” he said at the time.

In 2011, Republican Tennessee Gov. Bill Haslam signed a bill passed by the Tennessee Legislature in response to the ACA which declared Tennesseans should “be free to choose or to decline to choose any mode of securing health care services without penalty or threat of penalty.”

The General Assembly will convene an “extraordinary session” of the legislature on Feb. 2, to discuss Haslam’s “Insure Tennessee” proposal to expand health insurance coverage for low-income Tennesseans.  Next Tuesday, Jan. 27, the Senate Judiciary Committee is scheduled to hold a hearing on “the legal issues raised by the governor’s proposed Obamacare Medicaid expansion plan.”

State Sen. Brian Kelsey, a Germantown Republican and chairman of the Senate Judiciary Committee, also filed legislation earlier this month to prevent the IRS from assessing any fines on Tennesseans who haven’t signed up for health insurance. The bill would also prevent the state from operating any healthcare exchange.

TNDP: HHS Report Shows ‘Obamacare’ Costs Lower than Expected

Press release from the Tennessee Democratic Party; Sept. 26, 2013:

NASHVILLE, Tenn. — As Republicans attempting to defund the Affordable Care Act march the country toward both a government shutdown and also a default on our obligations, the Tennessee Democratic Party touted new data from the U.S. Department of Health and Human Services showing that Obamacare is working and will cost consumers less than anticipated.

“The new report found that health care rates in Tennessee will be affordable, especially with new help available for around half of Americans buying health insurance. The report found that here in Tennessee, a 27-year-old making $25,000 a year will pay $103 per month and a family of four making $50,000 could pay $128,” said Roy Herron, chairman of the Tennessee Democratic Party. “The Affordable Care Act can help working families, but Republicans in Washington are trying everything to take affordable health care away, even if it means hurting our economy by shutting down the government and not paying our nation’s bills.”

The report found that in addition to lower premiums, Tennessee consumers will be able to choose from 59 plans and pick the one that works best for their family. These health care plans have no lifetime caps on care, end discrimination against those with preexisting conditions, and bar insurers from charging women more.

In contrast, the U.S. House of Representatives last week passed a bill with the support of Republican Congressmen Phil Roe, Jimmy Duncan, Chuck Fleischmann, Scott DesJarlais, Diane Black, Marsha Blackburn and Stephen Fincher to shut down the government unless Obamacare is defunded and all those hard-fought protections ended.

To view the report with a breakdown of how the Affordable Care Act is helping Tennessee, click here.

Haslam Rejects Federal Dollars This Year, Offers ‘Third Option’ on Medicaid

Gov. Bill Haslam announced the state will not expand TennCare this year as called for by the federal health care law. The governor instead outlined what he called “a third option” for helping Tennesseans get coverage.

Haslam said neither a flat-out refusal to enlarge TennCare based on problems with the law nor an open-armed embrace – “expanding a broken system” – was the right path for Tennessee.

Under Haslam’s proposal, which he says the federal government will not agree to, payments to health care providers would be based on quality of care rather than just volume of services provided, and patients would have co-pays “so the user has some skin in the game when it comes to health care incentives.”

The state could also backtrack if the expansion of TennCare, the state’s version of Medicaid, wasn’t working.

“Our plan would have a definitive circuit-breaker or sunset that could only be renewed with the General Assembly’s approval based on when the amount of the federal funding decreases,” Haslam said Wednesday, speaking before the General Assembly.

Haslam also offered a critique of the law (Patient Protection and Affordable Care Act of 2010).

“To me, the scandal of the Affordable Care Act is that it doesn’t significantly address cost or alignment reform,” Haslam said. “And that’s what Washington does – it looks at a complex problem, realizes that some people aren’t going to like the changes, and as a solution, decides to spend more money.”

Read the full speech here.

 

Haslam Looking to AR for TN Medicaid Expansion Ideas

Gov. Bill Haslam’s health policy specialists are probing into what Arkansas is doing with respect to increasing Medicaid coverage as part of federal Affordable Care Act reform initiatives.

During a press conference last week in Nashville, Tennessee’s Republican chief executive said his administration is “learning some things” from policies being pursued under Obamacare by Arkansas Gov. Mike Beebe, a Democrat.

Beebe appears to have secured approval from the Obama administration to funnel federal dollars earmarked for Medicaid expansions into private insurance for those eligible. According to the Washington Post’s “Wonkblog” today, other states considering such an approach are Florida, Ohio, Louisiana and Maine and perhaps even Texas:

We still don’t know the final details of the Arkansas agreement — or whether there is a final agreement. There are questions about whether this option will be more expensive than a traditional Medicaid expansion (the public program tends to cost a few thousand dollars less per enrollee).

What we do know, though, is that there are some very strong opponents of the Obamacare law — ones that have pledged never to expand Medicaid — who suddenly find this option palatable. It has the potential to grow the Medicaid expansion by millions of Americans, edging closer to the pre-Supreme Court version of the health-law’s coverage expansion.

One of the key differences between Arkansas and Tennessee is that The Natural State is partnering with the federal government on creating subsidized health-insurance exchanges. The Volunteer State is not.

Republicans in the Tennessee Legislature are divided between those who want to inoculate Tennessee against Obamacare to the greatest extent possible, and those who’re inclined to defer to Gov. Haslam to prescribe policy treatments that best suit the state’s unique conditions.

“Nobody likes the idea of just a sort of blanket Obamacare expansion, but that’s not what the governor is looking at,” said Mark Norris, the Tennessee Senate majority leader. “He’s real curious about what is happening in Arkansas, with their initiative to use Medicaid dollars for private insurance.”

Norris said he doesn’t anticipate Haslam making any decisions that could potentially put state government over a financial barrel. “He’s doing his due diligence. He’s doing what a good governor ought to do,” said the Republican from Collierville.

Norris added, “I have enough respect for the separation of powers and the three branches of government, and this particular governor, to wait and let him reach his own decision before we jump in and try to preempt something that he may never do anyway.”

However, this week a number of bills sponsored by lawmakers with no patience for the Patient Protection and Affordable Care Act are potentially coming for votes up in both House and Senate committees.

Senate Bill 666, sponsored by Dolores Gresham, R-Somerville, is scheduled for a hearing in the Commerce and Labor Committee Tuesday. The legislation, according to the official summary on the Legislature’s website, prohibits insurers doing business in Tennessee from participating in any health coverage exchange in the state operated under Obamacare. The bill’s companion measure, House Bill 476 by Republican Vance Dennis of Savannah, is slated for discussion in the lower chamber’s Banking and Insurance subcommittee on Wednesday.

Brian Kelsey, chairman of the Senate Judiciary Committee, told TNReport he favors the uncompromising approach taken recently by the Florida Legislature. Last week the GOP majority there put the brakes on Republican Gov. Rick Scott’s bid to expand his state’s Medicaid program.

“I think that was absolutely the right decision, and my hope is that all of us involved in the issue in Tennessee will also make the right decision to reject the Medicaid expansion,” said Kelsey, a Shelby County Republican. “I don’t think the votes are there to expand Medicaid in either the (Tennessee) Senate or the House, but time will tell.”

Kelsey’s Senate Bill 804 is up for a hearing Tuesday in the Commerce and Labor Committee. The House’s legislation that prohibits Medicaid expansion, HB937, could be discussed Wednesday by lawmakers on the insurance subcommittee.

House GOP Caucus Chairman Glen Casada anticipates Republican lawmakers flatly opposed to Medicaid expansion will start pressing their case in earnest on the Hill this week. In the House of Representatives “there are probably a lot of (Republican) members who are leaning ‘no,’ but they will give the due deference to Gov. Haslam to listen to what he has to say,” said the Franklin Republican.

Nevertheless, Casada said, “I think you will see the House and Senate acting quicker than what the governor is prepared to act.”

Tea Party Marshaling Anti-Obamacare Muster

Members of the Nashville Tea Party are planning a rally outside the state Capitol at noon Wednesday. Their hope is to put GOP lawmakers and Gov. Bill Haslam on clear notice that grassroots conservatives want Tennessee to disavow state-level cooperation and support for the federal health insurance exchanges outlined in President Obama’s healthcare overhaul.

“We’re calling it the ‘Just Say No’ rally, and we’re trying to send a message to the governor,” said Ben Cunningham, leader of the Nashville Tea Party. “We’re encouraging him to just say no to a state-run exchange and let the federal government own this disaster.”

Cunningham said he expects people from all three of Tennessee’s Grand Divisions to attend.

The Patient Protection and Affordable Care Act mandates that states choose between creating a state-run exchange where individuals may purchase health insurance eligible for federal subsidies or allowing the government to create a federally run insurance exchange.

Either way, those exchanges are supposed to be up and running by Jan. 1, 2014.

Haslam continues to say he has not made a decision on what course his administration will formally set — even after the federal government extended the deadline to make a decision to Dec. 14. Haslam and other state officials have complained that the federal government has failed to answer key questions as to how state-run exchanges would work.

Many governors, such as Rick Perry in Texas and Jan Brewer in Arizona, have said they will not set up a state-run exchange.

Tennessee tea partiers “would like Gov. Haslam to join with those governors and say, ‘No, we’re not going to be a branch office of the federal government,’” said Cunningham. He said a petition to that effect is circulating and “is getting a very good response.”

“If they (the federal government) want to implement this program, have at it, but our experience in the past with Medicaid, with education funding, is always a bait-and-switch situation where they fund much of the expenditures on the front end, and then the states are left with huge expenses on the back end,” Cunningham said. “There is some indication now that the phone calls and the emails that the governor is getting are overwhelmingly against a state exchange.”

The governor has indicated that while he opposes Obamacare in general, and he thinks the health exchanges are a bad idea overall, he’d prefer it if the state run them rather than the feds. However, high-ranking Republicans in both houses of the state’s General Assembly have indicated that support is lacking among the majority party for the state taking on that responsibility.

Trent Seibert can be reached at trent@tnreport.com, on Twitter at@trentseibert or at 615-669-9501.

Little Statehouse GOP Support for State-Run Insurance Exchange

Gov. Bill Haslam now has another month to decide and declare whether Tennessee intends to manage its own so-called medical insurance “exchange” as outlined in the controversial 2010 federal health care law.

After prodding from the Republican Governors’ Association, the Obama administration agreed late Thursday to give states more time to decide if they want to manage their own government-run health coverage marketplaces, or hand the duty over to the federal government.

“It is clear that putting in place the new programs you championed will be an enormous strain on state governments and budgets, as well as the federal government,” the governors wrote. “From the financial obligations and complex technicalities to ensuring the healthcare workforce and infrastructure will be in place to meet the new demand, the timeframe and many of the provisions in the (Patient Protection and Affordable Care Act) are simply unworkable.”

States now have until Dec. 14 to make their respective Affordable Care Act health-exchange decisions.

“We are hopeful in the coming weeks we will receive answers from Washington to the many questions we’ve asked in our effort to have a full picture of the future of exchanges in Tennessee,” Haslam said in a statement issued Friday morning.

Haslam has for a while been saying he favors the state running its own exchange. Haslam indicates he believes it would be better for insurance companies doing business here to answer to Tennessee regulators, and that a state-run exchange would better serve the unique features of the state’s health care system.

“Ultimately our citizens, through insurance companies, are going to pay for the cost of running that exchange,” Haslam said on Tuesday. “Who do we think can run it cheaper, us or the federal government? I’ll bet on us every time.”

But members of Haslam’s party in the Tennessee Legislature are anything but enthusiastic about the prospects of doing the federal government’s bidding with respect to the ACA.

In the wake of the president’s re-election, Tennessee faces a difficult policy decision  surrounding the subsidized insurance marketplaces mandated under Obamacare, the governor said this week. The three options include the state setting up and running the exchanges, letting the federal government do it or pulling together some kind of a hybrid model wherein state and federal bureaucracies share responsibility for creating or managing a system.

“Let me be clear, I oppose the Affordable Care Act,” Haslam said today. “Unfortunately, the Supreme Court upheld a majority of it this summer, including the provision that states are required to either participate in a federal exchange or establish their own.”

Both parties’ leaders in the Legislature agree, as far as it goes, that the state is indeed better suited to run the Tennessee exchange than the federal government.

“Government closest to the people governs best, and that should be a guiding principle as we implement the new health care law,” Senate Minority Leader Jim Kyle, D-Memphis, said this week. House Minority Leader Craig Fitzhugh, D-Ripley, told TNReport.com he believes a state-run health exchange system “would give us a little more control, and I think Tennessee would probably like to have that.”

However, GOP lawmakers, who overwhelmingly control both chambers of the Tennessee General Assembly, are expressing doubt that the federal government can be trusted to honor the integrity of whatever systems states develop on their own.

The key details about how the exchanges are theoretically supposed to operate have yet to trickle down through the federal regulatory pipeline, which has only added to the sense of uncertainty, and Republican legislative leaders believe the unpredictability is just getting started. A prevailing sentiment among GOP state representatives and senators is that Obamacare planners in Washington clearly anticipate keeping the states on short leashes, and that federal intervention into the state-run systems will be commonplace as the administration attempts to micromanage.

Republicans suspect that when all is politically said and done, the “state-run” exchange will be so laden with federal red tape, mandates and market manipulation that Tennessee would be better served steering clear and letting the feds drive from the outset.

Glen Casada, chairman of the House Health and Human Resources Committee, said that over the past few months he’s reversed his opinion on who should run the health insurance exchanges. Casada, R-College Grove, said he used to think states ought to handle them, but no longer.

“I just cannot see a reason to implement a state exchange when the (U.S.) Health and Human Services Department will not commit to us on what we can do exactly, and for how long,” Casada told TNReport Wednesday. “If the feds came out and were very clear on what we could and could not do, with guarantees that we could keep doing what we wanted to do, you would probably see some Republican House members interested (in a state-run exchange). But under the current criteria it looks like we have to operate under, I don’t think you are going to find too many in the House Republican caucus interested.”

Skepticism and frustration pervades the upper-chamber GOP caucus, too.

“The federal government has put the state of Tennessee between a rock and a hard place on the issue of health care exchanges,” said Senate Speaker Ron Ramsey, R-Blountville. “The Obama administration has refused to answer questions and provide information necessary to make decisions by its arbitrary deadline.”

Ramsey, the state’s lieutenant governor, added that the Haslam administration is going to need a stamp of approval from the Tennessee General Assembly if it decides that setting up a state-run system is the best way to go.

“No state exchange can be implemented without the consent of the Legislature,” said Ramsey. “This issue is not going away. The Republican majority will continue to do what we must to keep all options open to minimize the impact of this insidious federal law on the citizens of Tennessee.”

Sen. Mike Bell, chairman of his chamber’s Government Operations Committee, said he has no plans right now to support any sort of state-run exchange — and thinks he’s by no means alone in the caucus.

Bell, R-Riceville, said he is “still holding out hope” that Republicans in Congress can roadblock funding for Obama’s health care law “and thereby delay or possibly even kill it at the federal level.” Bell said resistance by the states could also force the feds to abandoned their plans.

“The very weight of the responsibility for setting up that bureaucracy to run 20 or 30 state exchanges will be so heavy the federal government won’t be able to do it,” he said. “I hold out hope — now, it’s a faint hope, but I hold out hope — that there’s something that still could stop this.”

House Democrats on Friday jabbed at Haslam to quit stalling and set a course for the state.

“The Governor has had ample time to decide whether or not he wants to establish a Tennessee plan for a Health Insurance Exchange,” Fitzhugh said in a caucus release. “Now is not the time for more delays, now is the time to create an open process that brings all interested parties to the table, Democrats, Republicans, consumer advocates, insurance companies, small businesses and others, to start deciding what this Tennessee Health Insurance Exchange will look like.”

Medicaid Expansion’s 5-Year Price Tag: $200 Million

An expansion of taxpayer-financed health insurance for the poor as prescribed by Obamacare would cost the state nearly $200 million through 2019, the state’s top TennCare official said this week.

And in each year after that, the expansion would cost $100 million or more, TennCare Director Darin Gordon said during a state budget hearing for his agency. The Haslam administration is deciding whether to enlarge the state’s Medicaid program by lifting eligibility to as high as 138 percent of the poverty level — or about $31,800 for a family of four.

The administration is also weighing whether the state should run its own insurance exchange, an online comparison tool to buy and receive subsidized health insurance, or allow the federal government to run an exchange for Tennesseans. The deadline to decide is Friday.

Both questions stem from the Patient Protection and Affordable Care Act, signed into law two years ago. Its major provisions kick in in 2014, but states are in the process of planning implementation now.

The question of state-based or federal exchanges largely turns on whether the state wants to retain control over what plans would be on the menu and the costs of administering the exchange, though officials said questions still surround the nuts-and-bolts requirements for an exchange.

Under a federal exchange, “they’re going to decide what the offering is,” Gov. Bill Haslam said, “so they could have the ability to just pick the national insurers, the six or seven folks that offer national coverage. And regionals and everybody else would never be on the menu.”

Beyond health care reform, Gordon outlined $164.8 million in cost increases to state taxpayers for fiscal year 2014. More than two-thirds of that amount is based on inflation and expected enrollment in TennCare and CoverKids, a state health insurance program for children 18 and younger.

This year, the Health Care Finance and Administration agency has a $9.6 billion budget, with $3.05 billion coming from state taxpayers. The agency oversees TennCare and certain other health insurance-related programs.

GOP Leaders Still Undecided on Obamacare

Top Tennessee state leaders are more undecided than ever about how to approach two major decisions tied to the federal health care overhaul.

Gov. Bill Haslam met with Lt. Gov. Ron Ramsey and House Speaker Beth Harwell in Ramsey’s legislative office Thursday morning to discuss the pros and cons of embracing key pillars of the health care law. The policy decision is also a political one, with GOP leaders contemplating how closely they should attach the deep red state to President Barack Obama’s healthcare reforms.

For months, the three leaders have hinted that if they must usher in the Patient Protection and Affordable Care Act passed in 2010, they would want to do it, as Ramsey puts it, “the Tennessee way.”

For example, they had said they like the idea of running a so-called health insurance “exchange,” a government-controlled “marketplace” for people and businesses to comparison shop for health care plans. If Tennessee decides against running the “exchange,” the federal government will manage it instead. The state has until Nov. 16 to decide.

“I don’t want to turn it over to the federal government and allow them to do it, and yet at the same time, I think this thing is doomed to disaster eventually, and do we want to put our fingerprints on it? So, it’s a catch-22 situation,” Ramsey told TNReport after the meeting.

Haslam, who has leaned toward running the exchange, said he, too, isn’t so sure.

“I think there are certain advantages to running something ourselves,” Haslam said. “We definitely have not made a decision on that.”

The other issue is whether to expand TennCare, an option that arose after the U.S. Supreme Court upheld Obamacare as constitutional but determined that states cannot be forced into expanding their Medicaid programs. The expansion would cost the state $1.5 billion over five years, according to a Commercial Appeal review of federal data.

“It’s a pretty complex decision,” Haslam said. “I think at this point in time, all we’re trying to do is to help (legislators) understand all the different ramifications of the decisions.”

A handful of southern states have already washed their hands of much of the Obamacare program, saying they’ll have nothing to do with assembling the exchanges and will refuse to expand their Medicaid rolls.

Top lawmakers have lately toned down their rhetoric of exercising state control in implementing Obamacare in favor of waiting out the general election to see if former Massachusetts Gov. Mitt Romney defeats President Obama and follows through on promises to repeal the health care law.

House Minority Leader Craig Fitzhugh said Haslam is meeting with top Democrats soon to review the state’s options. He said he already favors the idea of expanding TennCare and running the health care exchanges and called both options “foolhardy” to pass up.

State Seeking Input on Affordable Care Act Health Coverage Mandates

Press release from the Department of Commerce & Insurance; July 26, 2012:

NASHVILLE, TN – This is a reminder that Commerce and Insurance Commissioner Julie Mix McPeak will be conducting outreach meetings across the state to gather input about the health conditions that should be covered under essential health benefit categories.

These public meetings are geared toward gathering public opinion on the determination of an essential health benefits package for health insurance coverage under the federal Patient Protection and Affordable Care Act or PPACA. For more information, visit http://tn.gov/commerce/insurance/ehb/health_essentials.shtml.

The July 17 Nashville meeting yielded informative questions and comments from residents and advocates alike. Infertility, hearing aids, HIV/AIDS testing and counseling – these were but a few of the topics raised. A list to sign up as a speaker at the meetings is at http://tn.gov/commerce/insurance/ehb/ehb-hearings-signup.shtml. The remaining dates are:

  • July 31, 2012, 9 a.m. to 11 a.m. – Kingsport Renaissance Center, 1200 E. Center Street, Kingsport, TN 37660
  • July 31, 2012, 4 p.m. to 6 p.m. – UT-Knoxville Conference Center Building, 600 Henley Street, Knoxville, TN 37902
  • August 1, 2012, 10 a.m. to noon – Lee University Dixon Center, 1053 Church Street NE, Cleveland, TN 37311
  • August 3, 2012, 10 a.m. to noon – Hamilton Eye Institute, Freeman Auditorium, 930 Madison, 3rd Floor, Memphis, TN 38103
  • August 3, 2012, 2 p.m. to 4 p.m. – Jackson State Community College’s McWherter Center: Ayers Auditorium, 2046 North Parkway, Jackson, TN 38301

All interested parties are invited to indicate which of 10 potential benchmark plans designated by the U.S. Department of Health and Human Services should be selected by the state as a benchmark or reference plan. Interested parties may also indicate how any of the plans might be modified, either to ensure the benchmark covers each of the 10 PPACA-required benefit categories, or for other reasons.

After she considers the public input provided at the meetings and through written comments,

Commissioner McPeak will recommend an essential health benefits benchmark to Tennessee Governor Bill Haslam. Within 30 days of an approval by the Governor, the Insurance Commissioner will enact an administrative rule, based on his recommendation, that will designate the benchmark plan and the essential health benefit package to be included in individual and small-employer group health insurance plans offered on or after January 1, 2014.

At the meetings, following brief introductory comments reviewing the purpose of the hearing, interested parties will be invited to take up to five minutes to offer comments. Written comments and related materials may also be submitted by email both during the meeting and through August 10, 2012, at PubComm.HRF@tn.gov, or by mailing them to:

Chlora A. Lindley-Myers
Tenn. Dept. of Commerce and Insurance
500 James Robertson Parkway, 12th Floor
Nashville, TN 37243.

Public comments on Essential Health Benefits that are recorded at the meetings or are sent in to Commerce and Insurance may be viewed and/or left at http://tn.gov/commerce/insurance/ehb/ehb-public-comments-form.shtml. Posted on the Commerce and Insurance Essential Health Benefits page are documents related to the discussion of an essential health benefits package:

  1. Slides summarizing the determination of an essential health benefits package, including:
    • required coverage categories and allowed variations;
    • what the U.S. Secretary of Health and Human Services intends to propose as federal rules; and
    • related matters.
  2. Slides outlining the benefits covered by the nine Tennessee essential health benefit benchmark options.
  3. A bulletin by a U.S. Department of Health and Human Services agency on how it proposes to define essential health benefits.
  4. Frequently Asked Questions related to the bulletin.
  5. A related list produced by HHS identifying the three federal employee plans that may qualify as benchmark options and the three largest, small-employer group products from which a benchmark may be selected. The Tennessee Department of Commerce & Insurance is in the process of confirming the accuracy of the small employer product designations.

Haslam Among Republican Governors Who Believe Block Grants Would Improve Obamacare

Gov. Bill Haslam was mentioned prominently in a Forbes piece Thursday, after he and four other GOP governors said they would consider an expansion of Medicaid under the federal health care reform law if the money were awarded as a block grant.

“Obviously, as a Republican, I’m with those folks who say, if you can block grant us Medicaid, we’d look at it differently,” Haslam said, according to Politico. The governors were at a weekend meeting of the National Governors Association in Virginia.

The block grant idea is dear to the hearts of conservatives, who say the setup would free states from onerous federal restrictions and give states the power to keep expenses in check. Governing magazine explains the history and criticism that such a plan would reduce the number of people covered, especially in times of economic strain.

The governors have the option of saying no to a Medicaid expansion in their states without losing existing Medicaid funding, based on the U.S. Supreme Court ruling last month that upheld the Affordable Care Act.

This week the state held a meeting at Vanderbilt to seek input on what insurers should be required to cover in plans offered in the state, according to the Tennessean:

These rules will apply to individual policies and small-employer group plans, including those offered through the state insurance exchange after Jan. 1, 2014. The federal law, often referred to as Obamacare, directs that these plans have the same level of coverage as those typically offered by a large employer. But the law leaves it up to the states to set those benchmarks. …

States have 10 basic plans currently offered by large employer groups from which to choose a benchmark, but they can modify whichever reference plan they choose.

The meeting attracted people with health complaints from loss of hearing to infertility, wanting to make sure the state’s standards would require their ailment be covered, WPLN reported.

Another component of the health care law got a boost from a Tennessean Wednesday. Former Sen. Bill Frist urged states to set up their own health insurance exchanges. The exchanges will foster competition and are “the most innovative, market-driven, and ultimately constructive part of the law,” Frist wrote in a column for The Week.

Opponents of the law have urged the opposite. The Cato Institute calls them “the new government bureaucracies” for forcing people “to purchase Obamacare’s overpriced and overregulated health insurance.”

In May, the Kaiser Family Foundation expressed doubt that Tennessee would meet a deadline to submit a plan for its exchange this fall. The state has accepted more than $9 million in federal tax dollars for planning and establishment efforts.