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‘Stop Obamacare Act’ Doesn’t Violate State Constitution: AG

Proponents of expanding Medicaid in Tennessee got another dose of bad news last week when the state’s ranking government lawyers doused the idea that an anti-Obamacare law passed in 2014 might be unconstitutional.

Introduced by Sen. Brian Kelsey of Germantown and Rep. Jeremy Durham of Franklin, the so-called “Stop Obamacare Act” won passage about a year and a half ago along GOP-dominated party lines, 64-23 in the House and 23-6 in the Senate.

It was designed by the Republican sponsors to put up roadblocks to Affordable Care Act implementation in the Volunteer State by mandating that lawmakers get the final up-or-down vote on any agreement a Tennessee governor makes with the federal government that expands Medicaid eligibility under President Obama’s signature health-care reform initiative.

The Stop Obamacare Act falls well within lawmakers’ constitutional authority and doesn’t violate the Tennessee Constitution’s “separation of powers” principles, according to an opinion co-authored by Attorney General Herb Slatery and Solicitor General Andrée Sophia Blumstein.

The Kelsey-Durham law “involves nothing more than an exercise of legislative authority by the General Assembly through constitutionally permissible means,” the attorney’s wrote in their opinion, published Sept. 14.

sos haslam yarbroSenate Democratic Caucus Chairman Jeff Yarbro of Nashville had requested the opinion. Yarbro, a freshman state legislator, also asked for basic clarification as to whether the governor in fact needs acquiescence from both chambers of the General Assembly to implement a Medicaid expansion agreement, as the Stop Obamacare Act purports to require.

While the governor is free to negotiate all he wants with the federal government, he must indeed win the Legislature’s stamp of approval to enact any agreement with Washington that expands the number of low-income Tennesseans eligible for taxpayer-financed health care, wrote Slatery and Blumstein.

“Because the General Assembly has authorized the executive branch to negotiate and cooperate with the federal government regarding expansion of the Medicaid program, the absence of a joint resolution passed pursuant to (state law) would not prohibit the governor from negotiating an agreement with the federal government to expand Medicaid,” the opinion stated. “Absence of authorization by the General Assembly in the form of a joint resolution would, however, prohibit the governor from making a final decision to bind the State of Tennessee to that agreement or to implement that agreement.”

Republican Gov. Bill Haslam presented a plan to the General Assembly back in January seeking to enlarge the state’s publicly funded medical-coverage eligibility pool by about 300,000 Tennesseans of modest means.

Haslam promoted his “Insure Tennessee” proposal as a more market-oriented approach to government-funded coverage than simply expanding traditional Medicaid.

Haslam secured the Obama administration’s blessing on the policy, but Insure Tennessee died in state legislative committees, both during a special session and then again after the issue was resurrected a couple months later.

Key Republicans in the General Assembly, like House Speaker Beth Harwell and Lt. Gov. Ron Ramsey, have said there’s little chance any kind of Medicaid expansion legislation will succeed until Obama is out of office.

Randy McNally, an Oak Ridge Republican who chairs the powerful Senate Finance, Ways and Means Committee, told TNReport recently he expects Insure Tennessee will remain an oft-discussed topic during the 2016 legislative session.

But the bulk of GOP lawmakers won’t give their endorsement to any plan that doesn’t involve the state assuming greatly more in the way of administrative control over the Medicaid program than under the current arrangement with the federal government, he predicted.

“It will come up, but I don’t foresee it passing,” McNally said in a Sept. 10 interview.

McNally said “something similar to a block grant” issued to Tennessee “on a permanent basis” that included a lot more flexibility to create and administer policy might win majority support in the General Assembly.

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Obamacare Inflating Health Coverage Costs, says TN Insurance Commissioner

The woman in charge of overseeing and regulating Tennessee’s insurance industry took umbrage at some of President Barack Obama’s remarks in Nashville recently.

The president was speaking at a Davidson County grade school where he delivered a glowing appraisal of his signature health care law Wednesday on the heels of the King v. Burwell decision in his administration’s favor last week. Obama encouraged the Tennessee public to keep a close eye on Insurance and Commerce Commissioner Julie Mix McPeak and her subordinates to make sure they dutifully impose health-coverage price controls on insurance companies operating in the state under the federal health insurance exchange.

“I think the key for Tennessee is just making sure that the insurance commissioner does their job in not just passively reviewing the rates, but really asking, ‘OK, what is it that you are looking for here? Why would you need very high premiums?’,” said the president. “And my expectation is that they’ll come in significantly lower than what’s being requested.”

President Obama instructed the audience to “stay on your insurance commissioner — pay attention to what they’re doing.”

In a statement issued Thursday, McPeak defended her office’s process for reviewing requests from companies to raise premiums on consumers in wake of passage of the Affordable Care Act.

A press release from McPeak’s office declared that “our seasoned team of insurance regulators are not passively reviewing insurance rates for the coming year as the President suggested.”

“The Commissioner and our team have always taken the job of protecting Tennessee consumers seriously and are unafraid to ask hard questions of the companies we regulate in order to better protect consumers,” the release stated.

All requests for premium hikes are analyzed “in accordance with statutes, regulations and accepted actuarial guidelines for completeness and actuarial justification,” the statement continued.

President Obama’s comments at the ACA promotional event came in response to a question from an audience member about managing the rising cost of premiums in Tennessee.

Obama offered that if state commissioners perform their due diligence when requiring companies to justify premium-increase requests, then oftentimes a company’s plea to raise rates on policyholders will be refused.

“Last year there were a number of states where the insurance companies came in requesting significant spikes in premiums,” said President Obama. “And there were a lot stories in the newspaper, just like there are this year, about (how) premiums are skyrocketing and this is going to be terrible and all that. When all the dust settled and the commissioners who were empowered to review these rates forced insurance companies to justify what they were seeking, what you discovered was, is that the rates actually didn’t go up as much as people thought.”

Just a week ago, on the eve of the Suprme Court’s  King v. Burwell decision, Commissioner McPeak testified before a subcommittee of the U.S. House Ways and Means Committee about upward pressures on monthly premiums.

“The ACA and its implementation by HHS has challenged state regulators and carriers by creating and continuing consistent uncertainty,” McPeak said in a prepared statement on June 24. “Uncertainty in the business of risk nearly always drives up costs and/or lessens competition. In the case of the ACA, I think it has done both.”

McPeak told members of Congress that insurance providers in Tennessee are requesting permission to inflate premiums in 2016 by anywhere from less than one percent to more than 36 percent. Her office has until August to make determinations as to what the state will allow.

“Tennessee had a competitive marketplace before the ACA and that marketplace remains competitive today,” McPeak told the subcommittee. “Market competition, in part, gave Tennessee some of the lowest priced (federally facilitated marketplace) products in the country.”

“Having a competitive market, however, does not isolate Tennesseans from seeing significant rate increases over the next few years,” she added.

McPeak, who Gov. Bill Haslam appointed to her current post in 2011, said insurance companies are having to pay out more in claims as more people access medical care. Blue Cross Blue Shield of Tennessee, the state’s largest insurance carrier on the federal exchange, claimed “a medical-loss ratio of well over 100 percent” in 2014, she said.

“To put that in perspective, for every $1 in premium received, the company paid out over $1 in claims, operating at a net loss – not including administrative costs of the company,” said McPeak.

“The ACA’s strict underwriting and business requirements have left carriers with few options to consider to maintain or reduce costs,” she said.

In summing up her remarks, McPeak said, “We continue to review policy forms and rates for next year but we anticipate that Tennessee consumers will see increased insurance costs in 2016.”

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Obama Addresses ACA Backers in Nashville

Fresh off winning a high-court declaration that his administration can expand the Affordable Care Act beyond the express wording of the law, President Obama stopped off in Nashville to tout the controversial initiative.

“There are a whole host of things that fall under the Affordable Care Act that are benefitting 100 million, 150 million people,” Obama told a crowd of supporters at Taylor Stratton Elementary School. “They just may not be aware of it.  But what it’s done is it’s made health care stronger, more secure, and more reliable in America.”

“The good news is that, contrary to some of the expectations, not only has the law worked better than we expected, not only are 16 million people now getting health insurance that didn’t have it before, not only do we now have the lowest uninsured rate since we started tracking people and how much health insurance they had, but it’s actually ended up costing less than people expected,” the president said.

“And health care costs have been held — the inflation on health care costs have actually proved to be the lowest — since the Affordable Care Act passed — in the last 50 years. So we’re actually seeing less health care inflation,” he added.

Topping the president’s agenda, in addition to talking up the 2010 health reform package, was to press for the state to expand government-financed health care coverage for lower income Tennesseans.

“I think because of politics, not all states have taken advantage of the options that are out there,” he said. “Our hope is that more of them do.”

The Volunteer State was one of 22 states that have refused to grow their Medicaid populations after a 2012 U.S. Supreme Court decision declared that the administration and the Democratically controlled Congress that passed Obamacare had unconstitutionally attempted to coerce states into increasing the number of people receiving taxpayer-funded coverage.

Twice in the last six months, Republicans in the Legislature have rebuffed attempts by Gov. Bill Haslam’s proposal to expand Medicaid, dubbed “Insure Tennessee,” which he claims “won’t cost the state a dime.”

GOP leaders like Lt. Gov. Ron Ramsey of Blountville and House Speaker Beth Harwell of Nashville have expressed an unwillingness to give Insure Tennessee further consideration until after the 2016 election, when they hope a Republican president is elected who will give the states greater latitude to run their own Medicaid programs.

Obama was asked about Insure Tennessee by several in the audience.

One of those was state Rep. Brenda Gilmore, a Nashville Democrat, who solicited advice from the president for how to encourage Gov. Haslam, who did not attend the event, “to stay on the journey and to continue to find solutions to present Insure Tennessee and to bring some of our colleagues over on the other side so that we can take the politics out of it and help them to understand how important this is to the quality of life for Tennesseans.”

The president noted that each state finds itself in a unique situation with respect to political dynamics, and suggested tactical plotting is best be left to homegrown “experts” like Democratic U.S. Rep. Jim Cooper of Nashville.

“But here’s the one thing I do know, is that elected officials respond to public opinion,” said Obama. He added, “If ordinary folks feel it’s important, then usually elected officials start responding.”

The president, who managed to speak for more than an hour without taking any critical questioning in a state where his popularity tends to be dismal, said “one of the challenges that we’ve had throughout this fight has been that there’s been a lot of misinformation out there.”

Obama also needled conservatives for, in his estimation, seemingly having reversed themselves into opposing ACA-style policies they once endorsed, like forcing people by law to purchase subsidized health coverage.

“People tend to forget that the Affordable Care Act model, with health care exchanges and buying on the — in the marketplace, and getting subsidies from the federal government — that was originally a model that was embraced by Republicans before I embraced it,” said Obama. “It’s the model that Mitt Romney signed into law in Massachusetts. It’s the model that conservative organizations like Heritage Foundation thought were a good idea.”

The president also defended the so-called “individual mandate,” saying that the ACA’s prohibition against insurance companies rejecting coverage applicants on the basis of their having preexisting medical conditions demands a corollary governmental decree that everyone purchase health insurance.

“If somebody tells you we’re going to prohibit insurance companies from barring you from getting health insurance if you’ve got a preexisting condition, which is popular, but we’re going to allow people not to get health insurance if they don’t feel like it, then the truth is that doesn’t work,” Obama said. “And the reason it doesn’t work is, if you think about it, if you knew that the insurance company couldn’t prevent you from getting health insurance once you were sick, you wouldn’t pay all those premiums until you got sick. And then you’d go to your health insurance company and say, there’s a law you got to sell me health insurance — and you’d save a whole lot of money, but, of course, the whole insurance system would collapse — it wouldn’t work.”

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Supreme Court Rules in Favor of IRS on Obamacare Exchange Subsidies

(Note: This post will be updated with reactions from Tennessee advocates, organizations and elected officials throughout the day)

The United States Supreme Court has ruled that the Obama administration’s interpretation and implementation of the Patient Protection and Affordable Care Act is close enough for government work.

Writing for the court’s 6-3 majority, Chief Justice John Roberts acknowledged that the plain wording of the ACA relating to whether or not participants in federal health insurance exchanges should receive subsidy tax credits “is properly viewed as ambiguous.”

But despite the ambiguity, the court concluded that the Internal Revenue Service validly interpreted the law when it deemed that all Americans are potentially eligible for the coverage subsidies, regardless of whether they are enrolled in state- or federally run exchanges.

An estimated 6.4 million Americans will hence get to keep their subsidies if they obtained government-approved medical insurance through

“In a democracy, the power to make the law rests with those chosen by the people. Our role is more confined — ‘to say what the law is’,” wrote Roberts, citing the seminal Marbury v. Madison case, an early 19th Century Supreme Court opinion that’s generally regarded as the cornerstone of judicial review. “That is easier in some cases than in others. But in every case we must respect the role of the Legislature, and take care not to undo what it has done. A fair reading of legislation demands a fair understanding of the legislative plan.”

Roberts concluded that the Democratically controlled Congress that passed the Affordable Care Act did so “to improve health insurance markets, not to destroy them.”

“If at all possible, we must interpret the Act in a way that is consistent with the former, and avoids the latter,” continued Roberts, who back in 2012 provided the swing vote in favor of upholding the constitutionality of the Affordable Care Act’s individual insurance mandate.

In the King v. Burwell opinion released Thursday, Roberts concluded that, taken in the context of the whole law, the disputed provision of the ACA that seems to grant subsidies only for participants of state-run exchanges can in fact “fairly be read consistent with what we see as Congress’s plan, and that is the reading we adopt.”

Critics of the Affordable Care Act, which became law in March of 2010, argued that the phrasing of the ACA clearly indicates health-insurance subsidies should be available only to participants of health insurance exchanges “established by the State” — and by extension, not the federal government’s exchanges.

During congressional debate over Obamacare, it was anticipated that most if not all states would create their own online exchanges for citizens to purchase subsidized insurance. In fact, though, only 13 states now run their own exchange “marketplace” websites for individual health insurance coverage.

Tennessee is among the 18 states that have left creation of an exchange entirely to the federal government. In total, 36 exchanges are administered in some capacity by the federal government under the Affordable Care Act.

In a derisively worded dissent joined by conservative justices Clarence Thomas and Samuel Alito, Antonin Scalia wrote that the court’s majority had essentially added words to the statute, and in so doing expanded the scope of the law beyond its established limits.

“The Court holds that when the Patient Protection and Affordable Care Act says ‘Exchange established by the State’ it means ‘Exchange established by the State or the Federal Government’,” declared Scalia. “That is of course quite absurd, and the Court’s 21 pages of explanation make it no less so.”

Later in his dissent, Scalia wrote:

“Words no longer have meaning if an Exchange that is not established by a State is ‘established by the State.’ It is hard to come up with a clearer way to limit tax credits to state Exchanges than to use the words ‘established by the State.’ And it is hard to come up with a reason to include the words ‘by the State’ other than the purpose of limiting credits to state Exchanges.”

In the majority’s opinion, Chief Justice Roberts wrote that “the meaning of the phrase ‘an Exchange established by the State under (the ACA)’ may seem plain” on its own. But such a reading is “untenable” when weighed against the entirety of the law.

“In this instance, the context and structure of the Act compel us to depart from what would otherwise be the most natural reading of the pertinent statutory phrase,” wrote Roberts.

Below are some reactions to the Supreme Court’s ruling from Tennessee politicians and organizations:

Press release from the Democratic Party of Tennessee:

Nashville, Tenn. (June 25, 2015) — Tennessee Democratic Party Chair Mary Mancini released the following statement after the Supreme Court’s ruling on King v.Burwell regarding the Affordable Care Act:

“We are relieved for the nearly 200,000 Tennesseans who will continue to have access to affordable health care. It’s clear that the Supreme Court justices did the right thing in looking at the intent of the law rather than siding with a twisted interpretation of individual phrases.

The Affordable Care Act has saved lives and will continue help build a healthier America. The TNDP will continue to work to ensure every Tennessean has access to affordable health care, especially those in the “insurance gap” left by the Republican failure to pass Insure TN. For Democrats, the fight for strong families and effective government is not over, even with this ruling.”

Press release from the Republican Party of Tennessee:

NASHVILLE, Tenn.–Tennessee Republican Party Chairman Ryan Haynes released the following statement regarding the Supreme Court’s decision in King v. Burwell:

“ObamaCare was created, passed, and implemented on a party-line basis. Democrats essentially shoved this down the throats of Americans and it is disheartening to see the Court develop another avenue to keep this hurtful law alive. Individuals and businesses are struggling under this law. Republicans are going to continue offering solutions to actually drive health care costs down and make quality health care accessible once again—which is the exact opposite of what Americans have gotten under this flawed law.”

Statement from U.S. Sen. Lamar Alexander, R-Tennessee:

WASHINGTON, D.C., June 25 – Senate health committee Chairman Lamar Alexander (R-Tenn.) today released the following statement on the Supreme Court’s decision in King v. Burwell:

“It’s unfortunate that the Supreme Court didn’t read the law the way that Congress wrote it. The 36 percent increase in some individual health care rates announced recently should remind Tennesseans that Obamacare was an historic mistake. It gave Americans higher health care costs while reducing our choices of health plans, doctors and hospitals. Republicans are ready to reduce the cost of health care so more people can afford it, put patients back in charge, and restore freedom and choice to the health care market.”

Statement from U.S. Sen Bob Corker, R-Tennessee:

WASHINGTON – U.S. Senator Bob Corker (R-Tenn.) released the following statement regarding the Supreme Court’s decision on King v. Burwell.

“Today’s ruling affirms that it is up to Congress to come together around a responsible solution that provides relief from the damaging effects of the president’s health care law, including policies to provide far greater choice in the marketplace so affordable plans that meet the actual needs of Tennesseans can openly and effectively compete for their business,” said Corker.

Corker voted against passage of the health care law and has voted for legislation to repeal it.

Statement from U.S. Rep. Phil Roe, R-Tennessee 1st District: 

WASHINGTON D.C. – Today, Rep. Phil Roe, M.D. (R-TN) released the following statement on the King v. Burwell Supreme Court ruling:

“The president’s health care bill is so deeply flawed it cannot be fixed, and today’s ruling does not change that fact. Folks around the country are still struggling because of ObamaCare, and I will continue the fight to bring certainty to the American health care system and to transition away from this monstrosity to a patient-centered, market-based health care system.”

Statement from U.S. Rep. John Duncan, R-Tennessee 2nd District:

“The President and his supporters assured us many times that Obamacare would save the average family $2,500 a year.  Instead, most people have seen their premiums and other health care costs go way up.  Unfortunately, this ruling leaves Obamacare in place and preserves the status quo of rising prices and a declining quality of medical care for everyone.  The only way to really bring costs down and make health care affordable for all is to go totally in the opposite direction away from government-run health care.”

Statement from U.S. Rep. Chuck Fleischmann, R-Tennessee 3rd District:

Fleischmann Agrees Supreme Court’s Ruling is Absurd

This morning, the Supreme Court released its ruling on King v. Burwell, upholding that subsidies are allowed in the federal marketplace despite language in Obamacare explicitly stating otherwise. After the decision, Rep. Fleischmann released the following statement.

“I agree with Justice Scalia that this decision is ‘quite absurd.’ While I am disappointed in the Supreme Court’s ruling, the decision today confirmed what we have said all along: Obamacare is a poorly written law that was not read by the Members of Congress who passed it. Although this is a setback, it is by no means the end of our fight. I will continue to work to repeal Obamacare and replace it with true free market healthcare reform that benefits hardworking families and businesses in East Tennessee.”

Press Release from U.S. Rep. Scott DesJarlais, R-Tennessee 4th District:

Congressman Scott DesJarlais, M.D. (TN-04) released the following statement in response to the Supreme Court of the United States’ decision in King v. Burwell upholding tax subsidies issued by federally run exchanges:

“I am terribly disappointed in the Supreme Court’s ruling. As I have said from the beginning, this issue goes well beyond the Affordable Care Act and to the very heart of our constitutional separation of powers. The Supreme Court has further expanded executive power to the point where the White House now believes it has the ability to unilaterally change laws – a power exclusively reserved for Congress. Though subsidies have been preserved for less than 5 percent of individuals, it does not change the fact that the vast majority of Tennesseans will continue to face unaffordable premiums and deductibles, which are set to increase by double-digits next year. That is why it is imperative we continue in our efforts to repeal this law and replace it with patient-centered solutions that meet the needs of Tennessee seniors, small business owners, and middle-class families.”

Statement from U.S. Rep. Jim Cooper, D-Tennessee 5th District:

Cooper Praises Supreme Court’s Health Care Ruling;
Says state must take next step and pass Insure Tennessee

WASHINGTON – U.S. Rep. Jim Cooper (TN-5) today praised the Supreme Court for preserving federal subsidies that help an estimated 6.4 million Americans – including nearly 200,000 Tennesseans – pay for health insurance.

Cooper celebrated the ruling’s implications not only for those with federal subsidies, but also the insurance market and the preservation of benefits in the Affordable Care Act. For instance, health care insurers can no longer deny people for pre-existing conditions, and young adults can stay on a parent’s insurance plan until they turn 26.

Cooper also noted that the ruling removes a stated obstacle for passing Insure Tennessee.

“Tennessee legislators said they were waiting for the ruling,” Cooper said. “We now have it. They should finish the job and provide protection for all Tennesseans by passing Insure Tennessee.”

On Monday, Cooper will join a coalition of state and community leaders for a press conference on what’s next after today’s positive ruling.

Statement from U.S. Rep Diane Black, R-Tennessee 6th District:

Washington, DC– Today Congressman Diane Black (R-TN-06), a nurse for more than 40 years and member of the Ways and Means Health Subcommittee, released the following statement on the Supreme Court’s decision in King vs. Burwell:

“Today’s irresponsible Supreme Court decision does not change the fact that Obamacare is a fundamentally broken law that has failed to deliver on its most basic promises,” said Congressman Diane Black. “I am deeply disappointed that the court shirked its duty as a coequal branch of government by not acting to hold this President accountable for following his own laws, but my resolve to erase Obamacare remains stronger than ever. After today, one thing is certain: if this disastrous law is to be stopped, it will require strong leadership from Congress. We as conservatives must redouble our efforts to repeal and replace Obamacare. That is what Americans voted for at the ballot box last November and that is what they expect from us today.”

Press Release from U.S. Rep Marsha Blackburn, R-Tennessee 7th District:

Congressman Marsha Blackburn (R-TN), who serves as Vice Chair of the Energy and Commerce Committee, issued the following statement expressing her disappointment with the Supreme Court’s decision in King v. Burwell.

“While today’s Supreme Court ruling in King v. Burwell is extremely disappointing, it does not change the fact that Obamacare is broken and was passed based on a series of deliberately misleading promises,” Blackburn said. “The president’s health care law has led to higher costs with even higher costs coming. The law has failed to provide affordable healthcare to Americans. It is nothing more than a broken promise – an insurance card but not actual health care. The law is fundamentally flawed, and the court’s decision does not change our resolve to repeal it and replace it with patient-centered solutions that will increase access to affordable healthcare for all Americans. Much like TennCare, Obamacare will have to be fixed by the next Administration.”

Press Release from U.S. Rep. Stephen Fincher, R-Tennessee 8th District:

WASHINGTON, D.C. – Today, Congressman Stephen Fincher (TN-08) released the following statement after the Supreme Court of the United States upheld the President’s healthcare law in the case of King v. Burwell:

“Today’s ruling does not change the fact that Obamacare is still harmful to many Americans,” said Congressman Fincher. “Millions have been faced with higher premiums, lost coverage, reduced paychecks, and many other damaging side effects. My Republican colleagues and I remain committed to repealing this unworkable law and giving the American people what they asked for all along – real solutions that increase people’s access to quality and affordable healthcare.”

King v. Burwell was a case brought before the Court by David King against Health and Human Services’ (HHS) Secretary,  Sylvia Mathews Burwell, over subsidies used to purchase health insurance on federally established exchanges. King argued that, as written, Obamacare only provides for tax subsidies to individuals if they purchase health insurance through an “Exchange established by the State.” The Court upheld Secretary Burwell’s argument, allowing citizens of states without a state based exchange to utilize federal subsidies to purchase health insurance.

Statement from U.S. Rep Steve Cohen, D-Tennessee 9th District:

WASHINGTON, DC] – Congressman Steve Cohen (TN-09) issued the following statement reacting to the Supreme Court’s King v. Burwell ruling that upheld the health insurance subsidies provided to millions of Americans through the Affordable Care Act:

“This ruling affirms that the subsidies provided by the Affordable Care Act to our citizens are legal,” said Congressman Cohen. “I am pleased the Supreme Court has reaffirmed the law which is working and making health coverage affordable for millions of Americans, including more than 230,000 Tennesseans who are receiving an average of $213 each month through the law. I hope that this ruling will help the nation to see that the Affordable Care Act is a federal law that is keeping Americans healthy and alive, and that it is here to stay. I also remain hopeful that the Tennessee General Assembly will finally act to expand Medicaid so that our citizens can access the same benefits of the law that residents of other states do.”

Reaction from Republican Tennessee Gov. Bill Haslam, reported by the Tennessee News Network:

“Number one, I’m surprised,I thought they would rule the other way.

“Number two, I’m disappointed in the sense that I really did think this would be an opportunity to fix some things in the law that were broken.

“Third, though, I am pleased for those folks who have insurance subsidies now and for the insurance companies that have a more predictable environment to operate in.

“So while philosophically I did not agree with the ruling, in terms of the smoothness of the market and people being able to obtain insurance in a predictable way, it’s good.”

Statement from Tennessee Lt. Gov. Ron Ramsey, R-Blountville:

The Supreme Court today provided mere short-term relief to a long-term problem. While the Supreme Court decision will not result in millions losing their health coverage immediately, it is clear to everyone that deep and fundamental flaws in the law remain. I look forward to 2016 and electing a president who can appropriately assess the damage and chart a course away from Obamacare.

Statement from Tennessee House Minority Leader Craig Fitzhugh, D-Ripley:

No more excuses on Insure Tennessee

Nashville, TN: House Democratic Leader Craig Fitzhugh released the following statement on the Supreme Court decision in King v. Burwell:

“Regardless of your feelings about the Affordable Care Act, one of the most conservative courts in the history of this country has ruled–again–that it is the law of the land. There are no more excuses for this legislature or its leadership to ignore the 300,000 working men and women waiting on health care. We have work to do. It is my hope that the Governor and our speakers will call legislators back to Nashville immediately to work on passing Insure Tennessee.”

Statement from Tennessee Senate Democratic Caucus Chairman Jeff Yarbro of Nashville:

Supreme Court decision means 155,000 Tennesseans can keep their insurance, and one less excuse not to pass Insure Tennessee

The United States Supreme Court rejected another challenge to the Affordable Care Act today. That’s great news for two reasons.

First, Tennesseans can continue to receive tax credits and cost assistance when they purchase health insurance on the federal exchange. More than 155,000 individuals and families use that help to pay for their coverage.

Second, now that it is clear that the Affordable Care Act will continue to be the law of the land, there is a much better chance of passing Insure Tennessee.

Opposition to Insure Tennessee has always been part of a national effort to overturn the ACA. In fact, the leaders of the opposition to Insure Tennessee signed onto a brief urging the Supreme Court to gut the law. Now that we know the law will survive, we can hopefully do what is right for Tennessee.

  • Will we continue to force over 250,000 to go without insurance?
  • Will we continue to reject the infusion of $1 billion into the Tennessee economy — without one additional penny of taxes on Tennesseans?
  • Will we continue to put Tennessee hospitals and the jobs of our health care workers in jeopardy?
  • Will we continue to force doctors and hospitals to provide uncompensated care to the uninsured and pass those costs along to everyone else who has insurance?

We all understand that there is opposition to the ACA. But today’s decision confirms that it will continue to be the law. And it’s increasingly unlikely that Congress will repeal it. Repeal in part or in full has been proposed and rejected more than 50 times.

Study after study demonstrates that states that have expanded Medicaid have seen significant budget savings, revenue gains, and made greater health coverage gains while saving money.

You can rest assured that some opponents will find a new excuse to oppose Insure Tennessee. It’s like a bad game of whack-a-mole. Some will say that now we should wait until a new President is inaugurated – 19 months from now. But serious people should recognize that continuing to oppose the expansion of health coverage in Tennessee at this point isn’t remotely what’s in the best interest of Tennessee.

No more excuses. Contact our legislators and let them know it’s time to get serious about Insure Tennessee.

Press Release from the Republican Caucus of the Tennessee House of Representatives:

Below are statements from House Republican leadership following today’s King V. Burwell decision by the United States Supreme Court:

“The Supreme Court’s decision is both surprising and disappointing. However, there will be no interruption for Tennesseans who have insurance through the federal exchange and no major disruption to the state’s insurance marketplace. The Supreme Court’s ruling shows the Affordable Care Act is a federal program, and this gives the U.S. Congress the opportunity to address the significant problems with the law. With Tennessee’s TennCare waiver up for renewal next year, I hope HHS will be in a different posture to consider additional flexibility for our state Medicaid program and will consider block grants.” — Speaker Beth Harwell (R–Nashville)

“Obviously, I am disappointed with today’s Supreme Court ruling. ObamaCare has been a failed law from the start, and it is unfortunate that it has survived another legal challenge. I am hopeful that our elected officials in Washington will take action to repeal this law and replace it with something that will be beneficial for all citizens.” — Majority Leader Gerald McCormick (R–Chattanooga)

“As the Speaker stated, this decision from the Supreme Court is both surprising and disappointing. Now, more than ever, it is time for us to stand firm and tell Congress that it needs to clean up its own mess. ObamaCare is Washington’s problem and it needs to be repealed by Washington. Here in Tennessee, we will continue our fight against federal government mandates in our personal lives as we look for additional ways to protect our state from this flawed law.” — Caucus Chairman Glen Casada (R–Thompson Station)

Tweets from Senate Minority Leader Lee Harris, D-Memphis:

“I’m glad the Supreme Court rendered a ruling that preserves health insurance subsidies that hundreds of thousands of Tennesseans rely on.”

“Now that the SCOTUS has ruled, there are few excuses for not bringing Insure Tennessee for a debate and vote on the floor.”

Tweet from State Sen. Brian Kelsey, R-Germantown:

“For the 2nd time, the Sup Ct has rewritten ACA to uphold it. It will take the new Congress & a new pres to repeal the flawed ObamaCare law.”

Statement from State Rep. Bryan Terry, R-Murfreesboro:

“The Supreme Court has saved Obamacare yet again. In this ruling, they have given the IRS the power to rewrite laws passed by Congress. Absolutely ridiculous, not to mention dangerous.”

Statement from State Rep. John Ray Clemmons, D-Nashville:

“The Supreme Court of the United States has ruled on King v. Burwell, and budget deficit arguments, as well as other reasons for opposition, have proven baseless.  No more excuses – we must act now on Insure Tennessee.  Further delay is harmful and inexcusable.  While the Governor and the majority in the state legislature sit on their hands quixotically awaiting political winds to change, hundreds of thousands of Tennesseans continue to needlessly suffer without access to affordable healthcare.  Thousands of Tennessee families sit around their dinner tables praying this week’s paycheck will not be their last.  Dozens of hospitals across the state remain in budgetary limbo doing whatever it takes to keep their doors open.
As elected officials, we have a duty to serve all the people of Tennessee.  Let us not forget that this is a duty each of us voluntarily placed upon our own shoulders.  The inexcusable failure to act immediately and effectively on this issue constitutes a breach of our public duty, and those responsible for this failure should be held accountable.”

Press Release from the Beacon Center of Tennessee:

Obamacare Subsidies Upheld by Supreme Court

Today, the Supreme Court determined that the IRS’s interpretation of the subsidy provision of the Affordable Care Act was lawful. Even though the plain wording of the Act provides that tax subsidies are available only for individuals who enroll “through an Exchange established by the State,” the IRS interpreted this provision to apply equally to states like Tennessee, where the federal government operates the exchange.

This decision underscores the need to continue working to make healthcare more affordable, effective, and protected from the arbitrary decisions of the IRS. It also means that thousands of small businesses and low-income Tennesseans who opt out of purchasing insurance will continue to be penalized by fines stemming from the individual and employer mandates—a scenario that could have been prevented if the Court had overturned the IRS rule.

Beacon CEO and attorney Justin Owen stated, “Despite the ruling today, we must find ways to make healthcare more accessible to all Tennesseans. Allowing the IRS to change the law to apply subsidies and penalties in states with no exchange means that the true cost of healthcare will continue to be disguised from consumers and shifted to someone else.”

Owen went on to note, “Obamacare has been proven to be unaffordable, unworkable, and unfair. We should not invite further consequences of this already failing law into our state by expanding Medicaid. Instead we should focus on real solutions that will help all Tennesseans obtain quality healthcare and the insurance plan they like. Examples include repealing the costly insurance mandate for all Americans, expanding charity care, embracing innovations such as telemedicine, and reforming the existing Medicaid program for those truly in need.”

 Press Release from the Tennessee Health Care Campaign:

Good Decision

Statement by Walter Davis, Executive Director of the Tennessee Health Care Campaign:

The Supreme Court was right to recognize that health reform provides tax credits for consumers in all states. Now it’s time for people on both sides of the aisle to accept that the law is working and take important steps to fully implement it.

Today is a good day for Tennesseans and all Americans. It is time for state and federal legislators to realize that the Patient Protection and Affordable Care Act (ACA) is the law of the land. More than that, it is a law that is working for the good of all Americans. Fewer uninsured. Calming of price increases. Preventive care available to millions reducing the costs and lessening the risk of serious diseases.

The Supreme Court was right to recognize that health reform provides tax credits for consumers in all states. Now it’s time for people on both sides of the aisle to accept that the law is working and take important steps to fully implement it.

The Court made the right decision on the law, which is good for millions of people, including the Tennesseans who have gained coverage through the Affordable Care Act’s federal health insurance marketplace.

The Supreme Court found what should have been obvious from the beginning… the intent of Congress was clear and the ACA is clear that subsidies are available in both federal and state exchanges.

Millions of people, including 220,000 in Tennessee, would have lost their subsidies and been at risk of losing their coverage, and insurance markets would have been destabilized had the Court invalidated the subsidies contrary to what Congress intended when it passed the Affordable Care Act.

Likewise, Congress should now reject harmful, drastic, structural changes to Medicaid, such as a block grant or “per capita cap” which would be strangling Medicaid access over time.

Now Tennessee policymakers should recognize health reform is working, abandon efforts to undermine it, and instead take advantage of the opportunities that health reform offers to improve lives. The first step should be to expand Medicaid – or accept Governor Haslam’s Insure Tennessee.

States that have expanded Medicaid have seen large gains in the number of adults with health insurance and they are saving money in family budgets. Hospitals in expansion states are treating fewer uninsured patients, and the amount of “uncompensated care” they are providing is declining steeply. Tennessee has already lost nearly One and a Half Billion Dollars since the beginning of the ACA.

Tennessee has failed to expand Medicaid and is falling further behind, leaving thousands of people unnecessarily uninsured and without access to affordable health coverage.
Nationally, 3.7 million people are uninsured and without access to affordable health coverage because of states’ failure to accept available federal funds for Medicaid coverage for their residents.

In short, the Supreme Court got it right. Now it is time for Tennessee’s legislators, starting with the Lt. Governor and Speaker of the House to accept the law of the land. Make sure people needing help get it. Don’t make life more difficult for people who need insurance and now have a path to affording it. Speaker Harwell and Lt. Gov. Ramsey, this time do the right thing.

Press Release from Grant Starrett, Republican Candidate for United States Congress, 4th District:

(MURFREESBORO, Tenn.) – Today, Grant Starrett released the following statement on the King v. Burwell Supreme Court decision:

“I am disgusted that the Supreme Court has continued its tortured analysis of the Frankenstein law known as ObamaCare. This goes to show the importance of vetting and getting the right judges, especially when Republicans appoint them. Unfortunately, Chief Justice Roberts, who pledged to merely be an umpire, has shown that his strike zone varies considerably based on the issue before the court. He himself concedes that the court rejects the “most natural reading” of ObamaCare in order to uphold a law that is unaffordable – both for the government supervising it, and the people regulated by it. This ruling also goes to show the importance of electing the right people to repeal ObamaCare entirely and reorient our healthcare system toward a free market alternative.

“We recently learned that under ObamaCare, individual plans in Tennessee could see drastic premium increases next year. Tennesseans need a free market alternative to this unaffordable law, and they need someone in Washington who will fight for that alternative.
“In short, we need people who will actually do what they say they’re going to do – on the bench, and in Congress.”

Press Release from the Tennessee Medical Association:

TMA Statement on King vs. Burwell

The Supreme Court’s ruling today provides much-needed clarity for healthcare providers and patients in Tennessee.

The uncertainty surrounding tax credits and federal and state health insurance exchanges jeopardized patient care and was a potential disruptor to our healthcare system, especially for the nearly 156,000 Tennesseans who currently use federal subsidies to purchase health insurance on the federal exchange.

We can now all move forward with a continued focus on increasing access, delivering quality care and improving patient health.

Statement from the Tennessee Hospital Association:

“The King v. Burwell case has been one closely watched by hospitals across the country, but especially here in Tennessee. As we continue to provide services to more than 400,000 uninsured Tennesseans, maintaining coverage for the roughly 156,000 people in our state who have insurance through the federal Exchange with subsidized premiums is increasingly important.

“With today’s ruling from the Supreme Court, the future of federal subsidies for this coverage is secured and thousands Tennesseans will rest easier knowing they can continue to afford their monthly premiums.

“Our state’s hospitals are committed to caring for all people in our state, regardless of coverage status. However, in an era of significant reimbursement cuts and financial challenges, widespread insurance coverage is a critical issue for hospitals. As a result, the Supreme Court’s ruling is especially good news for our industry.

“THA and its members are grateful for today’s decision and its implication for the future of insurance coverage in our state and across the nation.”

Press release from the Tennessee Chapter of Americans for Prosperity:

NASHVILLE, Tenn. — Americans for Prosperity Tennessee issued the following statement in response to today’s U.S. Supreme Court decision on the case King v. Burwell:

“We will not let politics be a distraction in the discussion on healthcare; our focus should be on people” said Andrew Ogles, state director of Americans for Prosperity Tennessee. “Today’s decision only adds to the anxiety of Tennesseans who have already been harmed by Obamacare’s burdensome mandates and out-of-control costs. Our efforts to encourage Congress to bring state-based and patient-focused reforms to healthcare will not stop.”

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Romney in Nashville: State-by-State Solutions Still Best for Health Reform

Mitt Romney told an audience of insurance industry executives gathered in Nashville this week that he still thinks states, not the federal government, should be leading in the realm of health reform.

The Affordable Care Act, signed into law five years ago, encourages just the opposite, said the two-time Republican presidential candidate.

The ACA thwarts states from doing what makes the most sense for their own vulnerable populations, said Romney, who delivered a Thursday afternoon address before a national trade association called America’s Health Insurance Plans at the Music City Center.

Washington has imposed a one-size-fits-all solution on the entire country, and the result will be ever-increasing insurance premiums and a predominant sense of dissatisfaction Americans have with their coverage, said Romney, who hit upon and has refined some of the same points he made on the matter in his failed attempt to oust President Obama in the 2012 election.

The former Massachusetts governor was asked at the AHIP conference to talk about how some of the components of Obamacare mirror the state health-coverage overhaul he signed into law nearly ten years ago — an issue that dogged him in his White House bid.

Romney said he’s in fact “proud of what we did” with “Romneycare,” as the Bay State’s system of insurance mandates and coverage subsidies came later to be known.

“By virtue of what we did, we helped save lives,” Romney said. He added later, “I’m glad we did what we did, but I wish people would have listened to me when I said it is right for Massachusetts, it is not something that should be adopted by the entire country.”

Romneycare was tailored for Massachusetts alone, he said.

“What we did is we expanded private insurance, not government insurance, but private insurance to the people in my state who were uninsured,” he said. “Now, we had some unusual circumstances in Massachusetts, and what we crafted was with those unusual circumstances in mind.”

One of those circumstances peculiar to Massachusetts was that pricey minimum-benefit medical coverage plans were already mandated by the state when the reform package was passed in 2006. “You really couldn’t buy a stripped-down, catastrophic-care plan. You had to buy a gold-plated plan. And so as a result, Massachusetts health insurance was the most expensive in the nation, and still is,” said Romney.

As governor, Romney said he in fact tried to do away with the health-plan mandates that he believed unnecessarily elevated the cost of insurance, but was rebuffed by the legislature.

Requiring that health insurance plans include coverages that consumers don’t necessarily want or need makes even less sense in states where such mandates didn’t exist prior to passage of Obamacare, said Romney. The result of making citizens “purchase plans that look like Massachusetts plans,” will be that “premiums go through the roof,” he said.

Romney’s prediction on the issue is shared by the organization he spoke to, which notes on its website that, “The Affordable Care Act (ACA) expands access to coverage to millions of Americans, a goal health plans have long supported, but major provisions will raise costs and disrupt coverage for individuals, families, employers, and Medicare and Medicaid beneficiaries.”

Romney said he still believes states need the flexibility to chart their own health-coverage courses. States that want to mandate a more comprehensive style of coverage should have the latitude to do so, and those that want to keep reform basic should be able to do that as well, he said.

“If people want to copy what we did in Massachusetts, fine. If Vermont wants to be a single-payer, let them try. If Texas wants to put in place a plan that has a health savings account-oriented plan or a catastrophic care plan instead, then let them try that,” Romney said. “If a state wants to use clinics as a away of providing care for low-income folks, let them try what they will.”

“Their objective will be to get everybody insured, cover prexisting conditions, but don’t put in place Massachusetts-style insurance requirements on the entire nation.”

“A lot of people lost their insurance that shouldn’t have — even though that was a promise not kept,” he said.

Also, higher premiums will result in a more aggressive push for a government-financed “public option,” Romney said. “I am concerned about them trying to move to a single-payer system — there are some who haven’t given up on that,” he said.

As for the government-run health programs already in existence prior to enactment of the Affordable Care Act, Romney said he’s frustrated by an apparent lack of commitment in Washington to modernize and restrain them so they don’t require ever deepening reservoirs of taxpayer resources to stay afloat.

“You might think in a circumstance like this that there would be great effort to try and reform those programs such that they don’t overwhelm the federal budget,” he said. “But of course there’s been no progress whatsoever on improving or reforming those programs to make them sustainable.”

Bill Clinton is scheduled to speak Friday to conclude AHIP’s three-day conference, although the former president’s address is closed to the press and public.

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Democrats Demand More ‘Insure TN’ Debate

Tennessee Democrats continue to prod Gov. Bill Haslam to convene another legislative special session so they can once again take a crack at passing the twice-defeated Medicaid expansion proposal known as “Insure Tennessee.”

State Democratic Party chairwoman Mary Mancini and House Minority Leader Craig Fitzhugh, as well as several other Democratic lawmakers, held a press conference Wednesday in which they derided the Republican supermajority for obstructing the Haslam administration’s Affordable Care Act-related initiative.

fitzhugh square picThey also assured reporters that, at least in the General Assebmly’s lower chamber, there are enough votes to pass it.

“In the last session, we had all 26 of our caucus members ready to vote for this,” said Fitzhugh. “That meant only 24 out of 73 (Republicans) would be needed to put this over the top in the House.”

Legislation needs 50 votes to pass the House. In the Senate, where Republicans outnumber Democrats 28-5, a bill must garner 17 votes to win approval. Several GOP senators are in fact on record in support of Insure Tennessee, but a number of key supermajority caucus leaders and committee chairs oppose it.

None of the Senate Democrats took part in the morning press conference at Legislative Plaza, although Memphis Rep. G.A. Hardaway said that wasn’t in any way a sign of lackluster support for the governor’s plan among their thin ranks, but rather “merely logistics.”

Mancini, who formerly headed the liberal activist group Tennessee Citizen Action and was a runner-up Davidson County state Senate primary candidate last August prior to taking the TNDP reins in January, cast Republicans as more focused on “their personal political future” than providing “access to affordable health care” to lower-income Tennesseans. Up to 300,000 or more people are predicted to become eligible for taxpayer-subsidized medical insurance and government-financed doctor visits, hospital stays and drug prescriptions under the Haslam plan.

“Democrats are concerned with the future of all Tennesseans, which is why we are the ones that worked with the governor to create Insure Tennessee, to give access to affordable health care to 280,000 hardworking Tennesseans,” said Mancini.

She condemned Tennessee GOP lawmakers for objecting to the state releasing information about their own taxpayer-subsidized health coverage.

Mancini also criticized state legislative opponents of Insure Tennessee for aligning themselves with Republican politicians at the federal level against President Barack Obama’s signature health reform initiative. The Patient Protection and Affordable Care Act, signed into law five years ago, passed without any support from Republicans in Washington, who were the minority party in both chambers of Congress at the time.mary mancini square pic

“Why are Republicans more concerned with what (U.S. House Speaker) John Boehner and (U.S. Senate Majority Leader) Mitch McConnell want? We know that they have been playing politics with this issue, with the issue of health care, for years,” said Mancini. “They have put everything in its path to stop it, and now the Tennessee Republicans are falling in lockstep with them.”

In the event that another special session is launched, Fitzhugh offered that Democrats are quite willing to educate skeptical House GOP legislators on the merits of the Republican governor’s Medicaid expansion plan.

“We as a caucus are trying to answer every question that our colleagues on the other side of the aisle put forth in their opposition to Insure Tennessee,” said Fitzhugh. “We believe we have answered those, and stand ready to answer them at a special session, or even before a special session.”

Even while, in the Democrats’ view, Insure Tennessee is “not the best program in the world,” Fitzhugh said, the proposal does enjoy “a hundred percent support from our caucus.”

“It’s not a political issue. It is a moral and a mathematical issue for Tennessee,” the Ripley lawmaker said. He suggested a prime time to convene a special session will be in wake of the United States Supreme Court’s opinion on taxpayer subsidization of Obamacare’s federally run health insurance exchanges, which is expected to come down next month.

Gov. Haslam has expressed disappointment that Insure Tennessee didn’t get more traction in the Legislature, where it failed on lopsided Senate committee votes in a February special session and then again during the regular session in March. The House never actually took a formal vote on the measure, even though it was sponsored during the special session by Majority Leader Gerald McCormick, R-Chattanooga.

Haslam told reporters earlier this month that he gets “a little frustrated” with Republican lawmakers who keep expressing anxiety over the potential costs of his handcrafted Medicaid expansion plan.

Insure Tennessee is designed to secure billions of dollars in Obamacare funding and leave responsibility for funding the state’s share of the program to Tennessee hospitals, which stand to directly benefit from the transfusion of federal cash. Gov. Haslam maintains it “won’t cost Tennessee a dime,” although a “fiscal note” was attached to the legislation.

But the governor’s also aware hostility to the Affordable Care Act is deeply held among GOP lawmakers, and not just in Tennessee.

“We knew from the very beginning that was going to be hard,” the governor told said during a May 15 press conference. “And if you look anywhere there is a Republican legislature around the country, it hadn’t passed. So it is not like we are in a unique situation in the state of Tennessee.”

“Obviously, we need to do something to help change the impression of the Legislature,” Haslam continued. “We’re going to continue to have those discussions and look to see are there things that we can do in the program, that Washington will let us do, that we can change.”

Haslam said he hopes legislators’ constituents will make it known they support Medicaid expansion, and in turn lawmakers will warm to it. That was a sentiment reiterated Wednesday by the ranking House Democrat, who also touted a recent poll from Vanderbilt suggesting Tennesseans by a 2-1 margin want expanded health care options for the poor. If members of the General Assembly who’ve opposed Haslam’s plan “start hearing from their constituents, I think that’s what will change their minds,” said Fitzhugh.

Lt. Gov. Ramsey, R-Blountville, who serves as speaker of the Tennessee Senate, has said he doesn’t anticipate the GOP-dominated Legislature approving any kind of Medicaid expansion until the country has a new president — whom he hopes is a Republican — and likely then only if the state is granted federal permission to overhaul TennCare top to bottom.

Haslam said that while he understands and appreciates Ramsey’s perspective, there’s really no guarantee that a future president, even a fellow Republican, will grant Tennessee any Medicaid reform deal more attractive than what the governor says he’s already negotiated with the Obama administration.

“The thing to think about there is, and Lt. Gov. Ramsey and I have had these conversations, is No. 1, we have a new president, it still depends on what happens in Congress if the law is going to get changed,” said Haslam. “We have had Republican presidents before who could have given us block grants and haven’t. So it is not like that is a brand new idea. We have tried that for years in the state of Tennessee.”

Republicans want a lump-sum chunk of federal no-strings-attached funding to underwrite TennCare, so the state can run the health-care-for-the-poor program as it sees fit.

The governor suggested such an overhaul would in fact likely approximate the Medicaid “waiver” his administration developed over the last two years to access Obamacare funding. It includes patient co-pays and coverage premiums and “market-based” incentives to encourage healthier lifestyles and shrewder use of the health system by those signed up for government-funded medical coverage.

“If we got a block grant, it would be really similar to Insure Tennessee — not exactly, we would do more, I want to be really clear, we would do more if we got a block grant,” said Haslam. “But if we got a block grant, it would look relatively similar to what we are talking about.”

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Haslam Signs New Abortion Regs

A pair of intensely debate abortion bills passed by the Tennessee General Assembly have been signed by Gov. Bill Haslam.

On Monday, Haslam inked a measure requiring women seeking abortions to wait 48 hours after having consulted a physician before undergoing the procedure. Senate Bill 1222 was sponsored by Rep. Timothy Hill and Sen. Mae Beavers, both Republicans. It passed mostly along party lines last month in the House 79-18, and on a straight party line vote in the Senate, 27-5.

On May 8, the governor signed House Bill 1368, which requires new state regulations for any facility in the state that performs more than 50 abortions a year. The measure was sponsored by Mt. Juliet Rep. Susan Lynn and Sen. Joey Hensley of Hohenwald, also both Republicans.

The governor hasn’t issued a formal statement on either bill. When asked for comment earlier this month, Haslam indicated he supports the state taking a more active role in regulating clinics.

“I think that what the Legislature felt like on those, in terms of having regulatory oversight there, that that’s a medical procedure that is being done that I think most Tennesseans would say that’s a good thing, to make certain that they are safe and clean,” Haslam said on May 4, prior to signing either bill.

Both HB1368 and SB1222 were passed by the Legislature in reaction to voters last November approving an amendment to the state’s constitution granting government express authority to regulate abortion. Haslam supported Amendment 1, which passed with 53 percent of voters in favor. Amendment 1 declared: “Nothing in this Constitution secures or protects a right to abortion or requires the funding of an abortion. The people retain the right through their elected state representatives and state senators to enact, amend, or repeal statutes regarding abortion, including, but not limited to, circumstances of pregnancy resulting from rape or incest or when necessary to save the life of the mother.”

A bill proposing to require pregnant women seeking abortions to view an ultrasound of the fetus beforehand was discussed in the General Assembly but withdrawn.

A poll released last week by Vanderbilt University showed 52 percent of respondents favor the ultrasound mandate. The poll also showed 60 percent of Tennesseans support the 48-hour waiting period requirement.

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‘Right to Try’ Becomes Law in TN

People diagnosed with terminal illnesses in Tennesseans will now have the right to access experimental medications that haven’t passed the federal Food and Drug Administration’s final approval processes.

Gov. Bill Haslam signed the “Phil Timp-Amanda Wilcox Right to Try Act” into law Friday.

The measure, sponsored by Rep. Jon Lundberg of Bristol and Sen. Joey Hensley of Hohenwald, both Republicans, unanimously passed both chambers of the General Assembly in April.

The legislation, House Bill 143, will grant Volunteer State doctors the ability to prescribe to terminally ill patients drugs that haven’t yet been fully vetted by the FDA, as long as they’ve passed phase 1 testing for safety.

The measure has been pushed nationally by the Goldwater Institute, and it received support in the Volunteer State from the Beacon Center and Tennessee’s chapter of Americans for Prosperity.

“By passing the Right to Try bill, Governor Haslam and the state legislature have given terminally ill patients a fighting chance,” said Lindsay Boyd, Beacon’s policy director, in a statement Friday.

However, while the measure has enjoyed wide support, some remain skeptical the law will be a panacea, and concerns have been raised about the law possibly raising false hopes among Tennessee’s terminally ill of a miracle cure being found.

Similar legislation has become law in 17 other states, and is awaiting the governor’s signature in Florida. And the legislation has been introduced in about 20 more states across the nation.

Alex Harris can be contacted at

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House Republicans Douse Last-Ditch Medical Pot Amendment

For the first time since Lamar Alexander was governor, a medical marijuana legalization measure appeared on the full floor of a Tennessee legislative chamber. But unlike three decades ago, when the General Assembly approved the use of government-grown cannabis with a doctor’s prescription, this year’s proposal was snuffed.

On Tuesday, Nashville Democrat Sherry Jones, a long-time advocate of easing pot prohibition, made a motion to amend a GOP-sponsored bill dealing with elder abuse to include language allowing physician-prescribed cannabis. The amendment sought to grant ailing Tennesseans the right to possess up to one ounce of marijuana and grow up to six plants at home. Sufferers of serious illnesses like cancer, glaucoma, multiple sclerosis, AIDS, ALS, Alzheimer’s and post-traumatic stress disorder were among those listed who would have qualified under the provision.

“I believe firmly that cannabis helps people, and it helps people that have debilitating pain and disease,” Jones said on the House floor. “I am asking those of you who believe in compassionate care for all people — and you have seen those people up here and you know who they are and you see how they are suffering — to help me pass something to help them. Let’s show a little compassion to some of these people who have been coming up here for years.”

The Republican supermajority however voted en masse to kill the medical marijuana amendment, 73-22. Three Democrats were listed as having not voted.

Criminal Justice Committee Chairman William Lamberth, R-Cottontown, spoke forcefully against the amendment. He said it hadn’t been vetted properly by the chamber’s committee system.

“In Washington, D.C., there are all kinds of different ideas that they toss onto a bill that have nothing to do with that bill — that’s not how we run this chamber,” Lamberth, a former prosecutor from Cottontown, said on the floor.

Lamberth said members of the Criminal Justice committee who voted to to set medical marijuana legalization aside for another year “did not take this issue lightly.” He asserted that Republican lawmakers are “very serious about continuing this discussion,” and suggested Rep. Jones wasn’t prepared to convincingly present her case when the bill came up in subcommittee.

“We want to hear from doctors, patients, individuals — none of which actually showed up in the criminal justice committee to testify for your bill,” said Lamberth.

Jones shot back that she didn’t feel compelled to invite a list of witnesses to the earlier proceedings because Republicans had already made it known to her “that the bill wasn’t going to pass out of that committee.” She denied she was “playing politics” with with the issue by attempting to tack it on to an unrelated bill so late in the session, noting that the elements of her amendment were the result of years of legislative talks.

The House Criminal Justice Subcommittee voted in late March to send Jones’ perennial medical marijuana legislation to summer study following a motion by Morristown Republican Tilman Goins, who voiced concern the group had lacked the time to properly vet and weigh the outcomes of moving forward with such a measure.

Jones alleged on the floor that Republicans had pushed her proposal to the side to make way for their own measure, which they subsequently also tabled for the year.

“I just thought that since the Republicans had said that they were going to pass their own, and then withdrew it, that we needed to try to do something for people,” Jones told TNReport later Tuesday.

Jones said she hopes the “70 percent of their constituents in favor” of allowing the medical use of marijuana will put pressure on their representatives to reconsider their positions.

“The right thing to do is pass that, and let them have those little plants,” Jones said.

Recent statewide polls by Vanderbilt University and Middle Tennessee State University have shown a sizeable majority of Tennesseans favor legalizing marijuana use for at least medical use. Additionally, 23 states, as well as D.C., have legalized the medical use of marijuana, and support for legalizing the plant polls 51 percent nationwide.

Jones also pointed out the measure had been introduced several times in the years prior, but had never come up on either chamber’s floor for a vote by the full body.

The Tennessee Medical Marijuana Act was first carried in 2005 by then-Sen. Steve Cohen of Memphis, as Senate Bill 1942.

But although the Legislature was Democrat-led at that point in time, the measure failed 3-3 in the Senate’s General Welfare committee.  Its House companion never received a hearing before being taken “off notice” April 19, 2005.

similar measure appeared in 2007, carried by Jones, but was deferred to summer study — a familiar resting place since.

But while it may seem like extremely long odds to get the General Assembly to even consider discussing changes to the state’s pot policies, medical marijuana was allowed in the Volunteer State once before.

In 1984, then-Gov. Lamar Alexander signed a law to include Tennessee in the federal medical marijuana state research programs. However, the program petered out later that decade, given the difficulty in receiving approval for federal marijuana.  And when AIDS patients began inundating the federal program with applications in the early 90s, it was scrapped altogether, and subsequently repealed in Tennessee in 1992.

Two medical marijuana measures — the one sponsored by Jones, and a more-restrictive proposal crafted and sponsored by Republicans — were already sent to summer study by their respective committees earlier this year, amid fears of increased drug abuse by Tennesseans, as well as of running afoul of federal supremacy.

But the tone of the federal debate could be changing as well.

A bill filed at the federal level with bipartisan support — co-sponsored by Republican presidential hopeful Rand Paul of Kentucky and Democrats Cory Booker of New Jersey and Kirsten Gillibrand of New York — would reclassify cannabis from Schedule I down to Schedule II, expand access to the plant for research, allow inter-state transport of some medicines derived from the plant and allow banks more freedom to work with the industry.

The U.S. House version is co-sponsored by Tennessee’s own 9th District Democratic Rep. Steve Cohen.

Additionally, the National Institute of Drug Abuse recently gave the green light to supply marijuana for a study approved by the federal government in 2014 to consider the effects of marijuana on veterans suffering from PTSD.

Alex Harris can be contacted at

Featured Health Care NewsTracker

New Abortion Regulations Sent to Governor

Both chambers of the Tennessee Legislature have approved a duo of bills aimed at reestablishing state government regulation of abortions.

One bill requires women to wait 48 hours before obtaining an abortion. The other, that abortion clinics be regulated by the state. Both passed Tuesday along mostly partisan lines in the Republican dominated lower chamber. Having already been approved in the Senate, the bills go now to Gov. Bill Haslam, who has indicated he’ll likely sign them.

Passage of the measures represents a milestone for anti-abortion activists, who last year successfully convinced a majority of the state’s voters to pass an amendment declaring that abortions are not protected under the Tennessee Constitution. That constitutional revision was presented to the voters in an effort to nullify a Tennessee Supreme Court decision in 2000 that struck down several state abortion laws on the books at the time, including certain restrictions on outpatient abortions and a mandatory waiting period.

Democrats argued strenuously against both the abortion bills on the House floor, alleging that they amount to transparent attempts to make obtaining abortions more difficult and expensive for women.

Republican Susan Lynn of Mt. Juliet, who sponsored the proposal that clinics be monitored by the state as surgery centers, rejected that charge. She said new regulations are necessary “to protect the health and safety of women.”

“We are placing the health of women and the welfare of women in jeopardy by not having licensure and inspections,” Lynn said. She added, “The Legislature, in its wisdom, long ago saw fit to have these facilities licensed and inspected (but) the courts did remove that on a legal technicality.”

House Democratic Caucus Chairman Mike Stewart of Nashville challenged Lynn to show examples in Tennessee “where someone was injured” at an abortion facility as a result of poor government oversight. When she did not, Stewart suggested the bill was motivated more by political than safety concerns.

Lynn responded that proponents of the bill want to impose the regulations in hopes of averting future misfortunes. “Do we need something terrible to happen to somebody? No, we don’t, we don’t,” she said. “We should just be wise and have clinics licensed and inspected, for the health and safety of women.”

The measure, HB1368, passed 79-17.

The bill to mandate a 48-hour waiting period after a woman first approaches a physician about obtaining an abortion was subject to about an hour of debate. Democrats derided the measure as an attack on women’s rights.

Rep. John Ray Clemmons of Nashville said the stipulation “will have the ultimate effect of creating a substantial obstacle in the path of a woman seeking to exercise her constitutional right to choice.”

Rep. Johnnie Turner of Memphis argued that it “works disproportionately against poor women who cannot afford to fly to another state to have an abortion.”

The Republican sponsor of the measure, Matthew Hill of Jonesborough, countered that the waiting period is necessary for women to weigh the potential risks and consequences of getting an abortion.

“We are not restricting access to abortion in the state of Tennessee,” said Hill. “What we are doing is making all the information and facts available to the ladies and to the girls in order to make a careful and fully informed decision.”

He said waiting periods exist already in states surrounding Tennessee. He said the United States Supreme Court has twice upheld so-called “informed consent.”

The bill passed 79-18.