Health Care NewsTracker

Hopes, Suspicions Swirl in Legislature Over Haslam’s TennCare Plans

Many in supermajority GOP adamant where the governor seems ambivalent

During his state-of-the-state address Jan. 28, Gov. Bill Haslam dropped some tantalizing hints to supporters of Obamacare that he’s leaving the door open on the possibility of Tennessee at some point agreeing to a Medicaid expansion as proposed under the controversial federal health care law.

Many legislative Republicans, however — including the GOP supermajority caucus chairmen of both the House and Senate — remain adamant that nothing of the sort happen. They’ve signed onto bills introduced to prevent the Haslam administration from yielding to the allure of the federal government’s Medicaid-expansion enticement.

The Patient Protection and Affordable Care Act contains an offer to extend government-financed insurance to 30 million or more lower-income Americans. It includes the promise that the feds will pick up the expansion tab for the first three years, with contributions from Washington, D.C. gradually tapering to 90 percent after that.

During his speech, the governor said he’s “hesitant to commit additional dollars to Medicaid when it’s already eating up so much of our budget, and we have to remember what the state went through seven years ago when it made the difficult decision — many of you had to be a part of that — to cut a lot of people from the TennCare rolls.”

At the same time, though, the decision whether or not to broaden the scope of taxpayer-supported health insurance for Tennesseans of limited means “isn’t just as easy as standing here today and saying, ‘We’re not going to expand Medicaid’,” Haslam told the joint session of the Legislature.

“There are hospitals across this state, many of them in rural communities, that are going to struggle if not close under the health care law without expansion, and that’s not something to take lightly,” the governor continued. “Most of us, not all of us, but most of us in this room don’t like the Affordable Care Act. But the decision to expand Medicaid isn’t as basic as saying, ‘No ObamaCare, No expansion’.”

Haslam isn’t alone among Republican governors thinking long, hard and aloud about the seeming benefits of more “free” federal money. Other heads of U.S. states otherwise hostile to the Affordable Care Act who’re going along or contemplating going along with Medicaid expansion are Arizona Gov. Jan Brewer, Nevada’s Brian Sandoval, Jack Dalrymple of North Dakota, New Mexico Gov. Susana Martinez and Ohio Gov. John Kasich.

Key Republicans in the Tennessee Legislature, however, still aren’t buying it.

“In 1981 Congress reduced its Medicaid funding match to help cut the federal budget deficit, and with over $16 trillion of debt, I suspect they’ll do it again,” said Brian Kelsey of Germantown, who is sponsoring Senate Bill 804, the “TennCare Fiscal Responsibility Act.”

Speaking Feb. 1 on WKRN’s “This Week with Bob Mueller,” Sen. Jack Johnson, R-Franklin, pointedly spelled out the GOP’s anti-Washington antipathy percolating in the Tennessee Legislature.

Johnson blasted Congress and the president for their chronic failure to come to terms on a budget. He also suggested that to blindly assume the federal government can be trusted to honor its fiscal assurances in any long-term capacity would be irresponsible. “The first three years are paid for — supposedly,” said Johnson. “But let me tell you what the groundwork is, or the lay of the land is at the Tennessee General Assembly. We have no faith in this federal government, we have no faith in this president or the United State Congress and their inability to get anything done.”

“They are going to promise us billions of dollars and then leave us on the hook in future years for the rest of the tab. It has been done time and time again,” Johnson continued. “The federal government proposes some grand, glorious program, ‘Oh, we’ll pay for it — and then later on, we’ll pay for some of it.’ And the next thing you know we are on the hook for it.”

Nashville Metro Councilman Jerry Maynard, who was Johnson’s Democratic Party debate adversary on “This Week,” pointed out that Tennessee tends to sponge up more federal funding than its taxpayers collectively volunteer. He said GOP misgivings about Washington’s political dysfunction are overblown. ”We know the federal government works just fine — just look at all the money we bring back to the state of Tennessee,” said Maynard.

Democrats in the Legislature have argued that signing on to the the federal government’s three-year Medicaid expansion giveaway, followed by the ensuing 90 percent pick-up, is “not a bad deal at all.”

Even though in wake of the Gov. Haslam’s decision not to establish a state-run health insurance exchange they’d concluded that TennCare expansion “doesn’t stand a chance,” after his state-of-the-state speech Democrats are holding out new hope. House Minority Leader Craig Fitzhugh and Senate Democratic Caucus Chairman Lowe Finney are co-sponsoring a bill directing the state of Tennessee to “cooperate with the appropriate federal department in any reasonable manner as may be necessary to qualify for federal aid.”

Memphis Democratic Rep. Karen Camper said following the governor’s speech it appears to her that Haslam is still “open to the possibility.”

“I think he was kind of trying to get our minds open to think about it — I’m talking about both sides of the aisle,” said Camper. “He didn’t put it to rest — he didn’t really say ‘I’m not going to do it.’ I think he left the door open.”

For now, Lt. Gov. Ron Ramsey said his preference is to do nothing — even though he’s been pressured by members of his caucus to add his name as a co-sponsor to the Senate’s anti-expansion bill.

Ramsey said he has resisted in part because he’s comfortable with the Haslam administration’s assurances that it won’t try to make a decision unilaterally. “I think we will hold up till we actually get the proper data,” Ramsey said last week. “This is one that takes a lot of analyzing.”

Ramsey, R-Blountville, also noted that cutting back the TennCare rolls, should that become necessary down the road, “is easier said than done.” He added there’s “no timeline whatsoever,” “no deadline at all” that’s pressuring the state into a timely decision one way or another.

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