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Health Care NewsTracker

Haslam Rejects Federal Dollars This Year, Offers ‘Third Option’ on Medicaid

Gov. Bill Haslam announced the state will not expand TennCare this year as called for by the federal health care law. The governor instead outlined what he called “a third option” for helping Tennesseans get coverage.

Haslam said neither a flat-out refusal to enlarge TennCare based on problems with the law nor an open-armed embrace – “expanding a broken system” – was the right path for Tennessee.

Under Haslam’s proposal, which he says the federal government will not agree to, payments to health care providers would be based on quality of care rather than just volume of services provided, and patients would have co-pays “so the user has some skin in the game when it comes to health care incentives.”

The state could also backtrack if the expansion of TennCare, the state’s version of Medicaid, wasn’t working.

“Our plan would have a definitive circuit-breaker or sunset that could only be renewed with the General Assembly’s approval based on when the amount of the federal funding decreases,” Haslam said Wednesday, speaking before the General Assembly.

Haslam also offered a critique of the law (Patient Protection and Affordable Care Act of 2010).

“To me, the scandal of the Affordable Care Act is that it doesn’t significantly address cost or alignment reform,” Haslam said. “And that’s what Washington does – it looks at a complex problem, realizes that some people aren’t going to like the changes, and as a solution, decides to spend more money.”

Read the full speech here.

 

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Tea Party Marshaling Anti-Obamacare Muster

Members of the Nashville Tea Party are planning a rally outside the state Capitol at noon Wednesday. Their hope is to put GOP lawmakers and Gov. Bill Haslam on clear notice that grassroots conservatives want Tennessee to disavow state-level cooperation and support for the federal health insurance exchanges outlined in President Obama’s healthcare overhaul.

“We’re calling it the ‘Just Say No’ rally, and we’re trying to send a message to the governor,” said Ben Cunningham, leader of the Nashville Tea Party. “We’re encouraging him to just say no to a state-run exchange and let the federal government own this disaster.”

Cunningham said he expects people from all three of Tennessee’s Grand Divisions to attend.

The Patient Protection and Affordable Care Act mandates that states choose between creating a state-run exchange where individuals may purchase health insurance eligible for federal subsidies or allowing the government to create a federally run insurance exchange.

Either way, those exchanges are supposed to be up and running by Jan. 1, 2014.

Haslam continues to say he has not made a decision on what course his administration will formally set — even after the federal government extended the deadline to make a decision to Dec. 14. Haslam and other state officials have complained that the federal government has failed to answer key questions as to how state-run exchanges would work.

Many governors, such as Rick Perry in Texas and Jan Brewer in Arizona, have said they will not set up a state-run exchange.

Tennessee tea partiers “would like Gov. Haslam to join with those governors and say, ‘No, we’re not going to be a branch office of the federal government,’” said Cunningham. He said a petition to that effect is circulating and “is getting a very good response.”

“If they (the federal government) want to implement this program, have at it, but our experience in the past with Medicaid, with education funding, is always a bait-and-switch situation where they fund much of the expenditures on the front end, and then the states are left with huge expenses on the back end,” Cunningham said. “There is some indication now that the phone calls and the emails that the governor is getting are overwhelmingly against a state exchange.”

The governor has indicated that while he opposes Obamacare in general, and he thinks the health exchanges are a bad idea overall, he’d prefer it if the state run them rather than the feds. However, high-ranking Republicans in both houses of the state’s General Assembly have indicated that support is lacking among the majority party for the state taking on that responsibility.

Trent Seibert can be reached at trent@tnreport.com, on Twitter at@trentseibert or at 615-669-9501.

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Haslam Among Republican Governors Who Believe Block Grants Would Improve Obamacare

Gov. Bill Haslam was mentioned prominently in a Forbes piece Thursday, after he and four other GOP governors said they would consider an expansion of Medicaid under the federal health care reform law if the money were awarded as a block grant.

“Obviously, as a Republican, I’m with those folks who say, if you can block grant us Medicaid, we’d look at it differently,” Haslam said, according to Politico. The governors were at a weekend meeting of the National Governors Association in Virginia.

The block grant idea is dear to the hearts of conservatives, who say the setup would free states from onerous federal restrictions and give states the power to keep expenses in check. Governing magazine explains the history and criticism that such a plan would reduce the number of people covered, especially in times of economic strain.

The governors have the option of saying no to a Medicaid expansion in their states without losing existing Medicaid funding, based on the U.S. Supreme Court ruling last month that upheld the Affordable Care Act.

This week the state held a meeting at Vanderbilt to seek input on what insurers should be required to cover in plans offered in the state, according to the Tennessean:

These rules will apply to individual policies and small-employer group plans, including those offered through the state insurance exchange after Jan. 1, 2014. The federal law, often referred to as Obamacare, directs that these plans have the same level of coverage as those typically offered by a large employer. But the law leaves it up to the states to set those benchmarks. …

States have 10 basic plans currently offered by large employer groups from which to choose a benchmark, but they can modify whichever reference plan they choose.

The meeting attracted people with health complaints from loss of hearing to infertility, wanting to make sure the state’s standards would require their ailment be covered, WPLN reported.

Another component of the health care law got a boost from a Tennessean Wednesday. Former Sen. Bill Frist urged states to set up their own health insurance exchanges. The exchanges will foster competition and are “the most innovative, market-driven, and ultimately constructive part of the law,” Frist wrote in a column for The Week.

Opponents of the law have urged the opposite. The Cato Institute calls them “the new government bureaucracies” for forcing people “to purchase Obamacare’s overpriced and overregulated health insurance.”

In May, the Kaiser Family Foundation expressed doubt that Tennessee would meet a deadline to submit a plan for its exchange this fall. The state has accepted more than $9 million in federal tax dollars for planning and establishment efforts.