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TN Lawmakers Toe Party Lines on Haslam’s Medicaid Expansion Decision

Democrats and Republicans react

Reaction from state lawmakers was mixed and decidedly partisan Wednesday to Gov. Bill Haslam’s decision not to pursue a federally funded Medicaid expansion program for Tennessee this year.

Haslam made the much-anticipated announcement during a special joint session of the state General Assembly.

While it appeared relatively unlikely that the governor, a Republican and outspoken critic of the federal Patient Protection and Affordable Care Act, would embrace the federal program over staunch opposition from within his own party, Haslam nonetheless seemed to surprise the gathered lawmakers by shying away from an outright rejection. Instead, the governor said he is working on an as-yet unfinished “third option” that could entail asking the feds for special permission to “leverage the federal dollars available to our state” to purchase private coverage for residents.

Haslam called the current health care system in the state “broken” but told lawmakers he’s confident a solution could be reached if the Obama administration allows for more flexibility.

“In the past several years, Tennessee has shown the nation how to produce true reform in education, based on students’ results and educational outcome,” the governor said during his address. “We are beginning to do the same thing with reforming government service…I honestly feel that we have a once in a lifetime opportunity to do the same thing in health care …To have a health care system that is based on a healthier Tennessee, which I think we can all agree is essential for our future.”

Following the address, leading Republican lawmakers were quick to praise the governor’s choice.

Lt. Gov. Ron Ramsey echoed Haslam’s sentiments about the current state of health care, which he said was reason enough not to accept the Medicaid expansion money. “There is not a soul that won’t say just exactly what the governor laid out. It’s broken for the providers, it’s broken for the hospitals, it’s broken for the people receiving it,” the leader of the state Senate told reporters.

“I see it as pouring money into a broken system. If you just say yes with no strings attached, you’ll never have any leverage,” Ramsey added.

House Speaker Beth Harwell acknowledged the difficulty in passing up an estimated $1.4 billion that would go to insure low-income state residents, but placed much of the blame on the federal government”

“He really has spent hours and hours working with the federal government in order for them to allow him to truly reform healthcare…and to have the flexibility to have a cost-efficient program here in the state of Tennessee, and the federal government denied that,” said Harwell, the leading Republican in the state House. “And so because of that, we just feel like we don’t want to take money for a system that simply cannot be maintained.”

For their part, Democratic lawmakers had little time for the specifics of Haslam’s proposed “Tennessee Plan,” focusing instead on the fact that the expansion money would not be included in this year’s budget.

“The bottom line is we left a billion dollars on the table to insure upwards of 300,000 working Tennesseans,” House Democratic Leader Craig Fitzhugh told reporters.

House Democratic Caucus Chair Mike Turner was even more full-throated, charging that the governor’s decision “set Tennessee up to be the poorest state in the country.”

Lowe Finney, head of the Senate Democratic caucus, expressed frustration that the outcome wasn’t clear-cut.

“Today we had hoped that the governor would provide some clarity on this issue and really it’s just another layer of confusion,” Finney said. “We don’t really know what this plan is. We don’t know what it entails. Many people in his own caucus don’t understand it. We certainly don’t understand it…today we walk away simply more confused while more Tennesseans go without health care.”

It remains unclear if or when Gov. Haslam might reach a resolution with federal administrators or provide more answers for lawmakers.

One key GOP lawmaker in the Medicaid expansion debate, Sen. Brian Kelsey of Germantown, said that while he’s certainly pleased with Haslam’s decision to resist federal inducements this year, the governor in his speech before the General Assembly was “unclear as to whether he is going to reject Medicaid expansion in the future.”

Kelsey, a fervent Obamacare foe, is continuing to push a measure specifically requiring that the governor get legislative approval before agreeing with the federal government to any Medicaid expansion. Senate Bill 804 passed the chamber’s Commerce and Labor Committee on a party-line 7-2 vote Wednesday following Haslam’s announcement.

Initially, SB804 would’ve proscribed the governor from acting without an expressly authorizing resolution from the Legislature. However, an amendment proposed by Mark Green, R-Clarksville, allows the governor to slip a Medicaid expansion line item into a future budget without a separate approval vote by lawmakers.

A bill sponsored by Sen. Finney directing Haslam’s people to work with the Obama administration “in any reasonable manner as may be necessary to qualify for federal aid” to expand TennCare died Wednesday in the Labor Committee on a party-line vote.

Mark Engler contributed to this report.

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