House Will Get First Crack at Haslam’s Medicaid Expansion Plan

It looks as if the Tennessee House of Representatives will take the lead on deliberations over Gov. Bill Haslam’s proposal to expand state Medicaid eligibility using federal Obamacare dollars.

The General Assembly is scheduled to go into an “extraordinary session” beginning Feb. 2 to approve or reject the Haslam administration’s “Insure Tennessee” plan, the centerpiece of which is a system of Affordable Care Act-financed vouchers for lower income residents to purchase private-sector health insurance.

The “vehicle” in the Legislature for discussing Insure Tennessee will likely be a “joint resolution” originating in the House that’ll be carried by the chamber’s GOP majority leader, Gerald McCormick of Chattanooga.

Before it gets to the full floor of the 99-member chamber, though, the joint resolution will have to win approval from several committees and subcommittees, among them the House Insurance and Banking Committee, the Health Committee, the Finance Committee and the Calendar and Rules Committee, a spokeswoman for Speaker Beth Harwell, R-Nashville, told TNReport.

McCormick indicated this week that the vote-count within the House GOP caucus appears very tight at present. There are 73 Republicans and 26 Democrats in the House. Fifty votes are required to pass a measure out of the chamber.

Although the Senate will likely hold hearings and discussions about Insure Tennessee while the resolution is working its way through the House, upper-chamber Republican leaders said Senate committee-votes won’t be taken until after — and only if — the resolution clears the House.

“If it fails in the first House sub(committee), we’re done,” Lt. Gov. Ron Ramsey, R-Blountville, who presides over the Senate, told majority-party lawmakers during a caucus meeting Thursday afternoon.

Both Ramsey and Senate Majority Leader Mark Norris estimate that as many as three-quarters of their caucus remains undecided on the Haslam plan. Among them are Jack Johnson of Franklin and Randy McNally of Oak Ridge, who chair powerful committees that will likely handle the resolution.

Republicans outnumber Democrats in the Senate by a tally of 28-5. It takes 17 votes to pass a measure in the Senate.

“We have members who are outspokenly opposed to the proposal,” Norris said at the Senate GOP caucus gathering. “There are other members here supportive of it. But most members are just in the middle with open minds.”

Norris, who has himself voiced reservations about Haslam’s plan, said he’s hopeful there’s a full and robust discussion about all facets of the proposal. He described Insure Tennessee as “very complicated” in the way it touches on numerous aspects of state and federal law, the Internal Revenue Code and previous developments in the history of TennCare, the state’s program for administering the federal Medicaid system.

“All those things interrelate,” said Norris, a lawyer from Collierville. “Regardless of which side of the issue you may find yourself on, all these issues could be very important, whether you are against it, whether you are for it or whether you are unsure which way to go.”

He added, “What we are trying to do is lay out a timely and orderly process to get everyone through it in the best way possible, so that you can truly say that you are representing your constituents.”

Norris said one of the goals is to avoid the accusation of passing legislation “and not knowing what is in it.”

“Nobody wants to be in that situation,” he said.

Insure Tennessee has been offered by the administration as a two-year pilot program, and it includes incentives for healthier lifestyles. It is designed to enable the state to draw down Medicaid expansion funding through the Patient Protection and Affordable Care Act to cover people making up to 138 percent of the poverty level — which could translate to more than 450,000 potentially eligible Tennesseans.