Haslam’s Customized Medicaid-Expansion Plan Getting First Committee Look Next Week

The Legislature’s not scheduled to take up Gov. Bill Haslam’s voucher-driven plan to widen the scope of government-financed heath-insurance coverage until Feb. 2. But the Senate Judiciary Committee has scheduled a meeting next week to give the governor’s proposal a preliminary probe.

A press release issued by the upper-chamber GOP majority caucus Wednesday indicated the Judiciary Committee plans to meet on Tuesday afternoon “to study the legal issues raised by the governor’s proposed Obamacare Medicaid expansion plan.”

The committee is chaired by Sen. Brian Kelsey, a Germantown Republican who last year sponsored the “Stop Obamacare Act.” That legislation requires the governor to win the General Assembly’s approval for any deals he negotiates with the federal government to sign Tennessee up for Medicaid expansion under the Patient Protection and Affordable Care Act.

Kelsey is among the General Assembly’s most outspoken opponents of Obamacare. He’s declared his intention to try to kill the governor’s “Insure Tennessee” initiative “as soon as possible.”

Haslam’s Insure Tennessee plan would establish a two-year federally funded pilot program in which taxpayers would subsidize private health-insurance coverage for hundreds of thousands of Tennesseans making 138 percent of the designated poverty level, which for individuals is $16,100.

In the formal TennCare “Waiver Amendment Request” submitted earlier this month asking the Obama administration’s permission to embark upon the plan, the Haslam administration claimed, “Insure Tennessee will not only provide coverage for low-income Tennesseans, but it will prepare these members for a transition to private market coverage by promoting participant engagement and personal responsibility and by incentivizing appropriate use of the health care system.”

“Insure Tennessee is distinct from the regular Medicaid program in several important ways,” the Haslam administration claims. “It will leverage opportunities in the private market, such as Employer-Sponsored Insurance that is already available to certain applicants, and it will seek to reward behaviors that lead to better health, increased personal responsibility, and reduced health care costs.

However, powerful Senate Republicans in addition to Kelsey are skeptical of anything that binds the state to future financial commitments from the federal government — and in particular, anything related to the Obama administration’s signature health care reform law.

Finance, Ways and Means Chairman Randy McNally, R-Oak Ridge, said he’s on the fence with respect to the Haslam’s plan. However, McNally’s assessment of Obamacare isn’t ambiguous. The Affordable Care Act “was probably the worst piece of legislation I have ever seen passed by the federal government,” he told TNReport last week.

Earlier this month McNally submitted a letter to the state attorney general — former Haslam administration chief lawyer Herb Slatery — asking a series of questions about issues surrounding implementation of Insure Tennessee, and its potential legal ramifications on TennCare and other aspects of the state’s health care system.

Among the key points of McNally’s inquiry is whether the state can indeed opt out of the ACA-funded Medicaid expansion arrangement if the promised federal money tapers off from previously agreed-upon levels.

The attorney general’s office had yet to post a response to the Finance Committee chairman’s request as of Wednesday. McNally said last week he anticipates Slatery and his staff will provide answers to the legal questions he outlined in the letter in time for the special sessions that starts in less than two weeks.

On Wednesday, Gov. Haslam was campaigning for his Medicaid expansion plan in West Tennessee — and trying to make the case that Insure Tennessee isn’t really Obamacare. According to the Chattanooga Times Free Press, the governor told a group of lawmakers in Jackson that he, too, wants assurances from the Obama administration that Tennessee won’t be “making an irrevocable decision” in the event that the state approves Insure Tennessee and the federal government alters the terms of the funding formula.

Kelsey, who attended the governor’s presentation in Madison County, said in an emailed statement that while he appreciates the effort Haslam looks to be making to build support for the plan, “there are still many legal questions to be answered.”

“I look forward to diving into the legalities in detail next week,” wrote Kelsey. He added, “Regardless of what you call it, the governor is requesting an expansion of Medicaid for able-bodied adults under Section 1396a of Obamacare.”