‘Insure Tennessee’ Special Session Starts Tonight

Today’s the day Bill Haslam passes the point of no return into his most difficult political engagement since becoming Tennessee’s governor four years ago.

Just how big is this moment?

For some long-time political watchers, like conservative activist and commentator Steve Gill, the fight ahead could prove reminiscent of Tennessee’s income-tax wars of the later 1990s early 2000s.

Back then, a popular Republican governor, Don Sundquist, kicked off his second term by proposing a plan that galvanized an opposition movement among members of his own party — and ultimately proved at least partly responsible over time for realigning the state’s legislative balance of power.

“I think you have conservatives around the state who are scratching their heads right now who remember Ron Ramsey running around the state saying ‘It matters who leads.’ Republicans have been saying for years that they need to be in charge because it matters who leads,” said Gill.

“So we elected Republicans and now they are pushing Obamacare, Common Core and raising taxes,” said Gill, referring on the latter point to suggestions by Haslam and Lt. Gov. Ramsey that the time might be right to bump up the state’s fuel tax.

“The reason there are only 26 Democrats in the House of Representatives is because they were doing stuff like this and that resulted in the voters saying, ‘No,'” said Gill, who has been narrating Americans For Prosperity radio ads attacking the Haslam plan and encouraging citizens to pressure lawmakers to vote against it.

Haslam is scheduled to address a joint special session of the Tennessee General Assembly at around 6 p.m. this evening.

It’ll likely be his last direct sales pitch to state lawmakers to buy into a plan he’s developed to use federal funding to finance health coverage for a projected 300,000 low- or no-income Tennesseans who aren’t already covered either by Obamacare or TennCare, the state’s Medicaid program.

Haslam’s plan, called “Insure Tennessee,” envisions using government money to fund coverage for uninsured Tennesseans through a mix of vouchers, co-pays and incentives that the governor’s policy advisers claim will encourage the aid recipients to make better choices with respect to their own health and the medical services they utilize.

Haslam has said that he’s structured “Insure Tennessee” so that the state’s hospitals — not the state government — will cover any costs associated with the plan beyond those picked up by federal taxpayers. The governor’s been quick to note that Tennesseans are already paying taxes for Obamacare, and that it’s only fair to bring some of that money back home for spending here.

However, in order to push the plan through the Legislature, Gov. Haslam will have to convince a majority of the General Assembly of two things that many members of the supermajority Republican caucuses in both chambers are going to have a hard time believing. One is that the federal government can be trusted to fund it in the amounts promised. The other is that Gov. Haslam’s “Insure Tennessee” isn’t just a repackaging of President Obama’s Affordable Care Act.

The resolution that the governor will formally present to the Legislature attempts to address both those concerns.

For starters, it declares that the Affordable Care Act “is the wrong approach to responding to the challenges of our healthcare system.”

It goes on to declare: “Insure Tennessee goes further than just providing coverage to low income Tennesseans by also preparing these citizens for a transition to private market coverage by promoting participant engagement and personal responsibility and by incentivizing appropriate use of the healthcare system, which distinguishes Insure Tennessee from Medicaid expansion.”

The resolution is sponsored in the House by Majority Leader Gerald McCormick, R-Chattanooga, and in the Senate by Doug Overbey, a Republican from Maryville.

“Insure Tennessee is also different from Medicaid expansion because it creates financial incentives for providers to furnish high quality care in an efficient and appropriate manner so as to reduce costs and improve health outcomes,” the resolution continues. “Insure Tennessee will not create any new taxes for Tennesseans or add any state cost to the budget, which is essential to the General Assembly’s authorization of Insure Tennessee.”

The resolution also states that Haslam’s plan “brings Tennessee taxpayer dollars back to this state to benefit Tennessee citizens.”

On all those points the Haslam administration is looking at a tough sell in both Republican-run houses of the Legislature. The reason the General Assembly is even meeting to discuss “Insure Tennessee” is because last year the General Assembly passed a resolution called the “Stop Obamacare Act” –supported by all Republicans in both legislative chambers — prohibiting the governor from obligating Tennessee “in any way with regard to the expansion of optional enrollment in the medical assistance program also known as the Medicaid program, pursuant to the Patient Protection and Affordable Care Act.”

The political waters don’t get any dicier — either for Haslam or state lawmakers who’ve spent the last several years swearing enmity to all things Obamacare.

House Republican Caucus Leader Glen Casada, who has said he opposes the governor’s plan, has indicated that enough lawmakers are still on the fence that it’s going to be tough to count votes until the votes are officially counted.

“The members are by-and-large still undecided,” said Casada on Thursday.