Governor’s plan provides health care coverage to more Tennesseans at no cost to the state
NASHVILLE – Tennessee Gov. Bill Haslam this evening addressed a joint convention of the 109th General Assembly as legislators began an extraordinary legislative session to consider his Insure Tennessee plan.
The proposal, a two-year pilot program to provide market-based health care coverage to more than 250,000 Tennesseans who currently don’t have access to health insurance or have limited options, does not create any new taxes for Tennesseans and will not add any state cost to the budget.
“Two years ago, the General Assembly made two requests of us,” Haslam said. “First, to bring a unique and specific plan to Tennessee that met the needs of our citizens and was financially responsible for our state and the country, and secondly, to bring that plan back to the General Assembly for a vote.
“I have done both of those things. This plan is overwhelmingly supported by Republicans and Democrats in our state. Tonight, I am asking for your vote to help Insure Tennessee.”
After the U.S. Supreme Court ruled in 2012 that the federal government could not force states to expand their Medicaid programs, the governor went before the legislature the next spring to announce that Tennessee would not expand its Medicaid program. He also said at the time that he didn’t think it made sense for Tennessee to reject federal dollars that Tennesseans are paying for, that are going to other states and that could cover more Tennesseans who need insurance, so he started to work on a third way – a “Tennessee plan.”
“After nearly two years of hard work, we have a Tennessee-specific plan that addresses health outcomes and cost,” Haslam said. “This is not Obamacare. If it was, it wouldn’t have taken this long to negotiate. We have done what you asked us to do and what we said we would do. We found a unique, Tennessee solution,” Haslam said.
Citing his own opposition to the Affordable Care Act, especially for its failure to address health care costs, Haslam continued, “As a Republican elected leader, I feel like we owe the country answers as to what we would do about health care. For too long, we’ve said what we don’t like – mainly Obamacare. This is a chance to show what we would do.”
The plan would provide coverage to more than 250,000 uninsured Tennesseans earning less than 138 percent of the federal poverty level, valued at slightly over $16,000 a year for an individual and $27,000 for a family of three.
Five key areas of the governor’s plan include: a fiscally sound and sustainable program; providing two new private market choices for Tennesseans; shifting the delivery model and payment of health care in Tennessee from fee-for-service to outcomes based; incentivizing Tennesseans to be more engaged and to take more personal responsibility in their health; and preparing participants for eventual transition to commercial health coverage.
The governor announced his Insure Tennessee proposal in December and issued a proclamation last month to convene the “extraordinary session” of the 109th General Assembly to consider a joint resolution. The special session, the first of the Haslam administration, began today at 4 p.m. CST.
Press release from Tennessee Sen. Brian Kelsey, R-Germantown; February, 2, 2015:
NASHVILLE, Tenn. – Sen. Brian Kelsey (R-Germantown) and Rep. Jeremy Durham (R-Franklin) today will accept a letter from a statewide coalition of conservative leaders and activists who oppose Medicaid expansion. Sen. Brian Kelsey stated, “Republican opposition to Obamacare Medicaid expansion is gaining momentum. These county party chairmen reflect the grassroots Republican opposition that is taking hold in the legislature.” Kelsey and Durham will discuss the open letter on behalf of the legislature at a press conference today at 10:30 am, scheduled for Hearing Room LP30.
Signatories to the letter include current chairs and party members from counties served by rural hospitals, such as West Tennessee Healthcare in Weakley County. Signatories also include persons recently included on a list of circulated by supporters of Medicaid expansion who did not intend to support the governor’s proposal. Party chairs signing the letter:
- Rachel Welch–Chairman, Putnam County Republican Party
- Gayle Jones–Chairman, Giles County Republican Party
- Barry Hutcherson–Chairman, Chester County Republican Party
- Chris Thompson–Chairman, Pickett County Republican Party
- Dolores DiGeatano, MD–Chairman, Fayette County Republican Party
- David Baldovin–Chairman, Moore county Republican Party
- Sue Jackson–Chairman, Obion County Republican Party
- Daniel Williams–Chairman, Carroll County Republican Party
- Ben Nixon–Chairman, Warren County Republican Party
- Harold Kemp–Chairman, Macon County Republican Party
- Constance Hightower–Chairman, Hamblen County Republican Party
- Debbie Baldwin–Chairman, Benton County Republican Party
- Judi Swilling–Chairman, Claiborne County Republican Party
- Jimmy Knight–Chairman, Union County Republican Party
- Fred Ellis–Chairman, Lincoln County Republican Party
- Ken Coppinger–Chairman, Rhea County Republican Party
- Richard Swink–Chairman, Robertson County Republican Party
- Ronald Wayne King–Chairman, Scott County Republican Party
- Robert Dunham–Chairman, White County Republican Party
An excerpt from the letter reads, “As conservatives in our communities, we have worked hard to elect leaders we trust will uphold our values of shrinking government, imposing less taxes and costs on businesses and individuals, and embracing a free market.
“We reject ObamaCare’s Medicaid expansion. And we need you to stand strong on these principles in the coming special session.” A copy of the letter is attached.
As conservatives in our communities, we have worked hard to elect leaders we trust will uphold our values of shrinking government, imposing less taxes and costs on businesses and individuals, and embracing a free market.
We reject ObamaCare’s Medicaid expansion. And we need you to stand strong on these principles in the coming special session.
Although Governor Haslam originally opposed Obamacare, it appears he has chosen to abandon those principles now that he is safely in his second term. His proposal for Insure Tennessee is no more than expansion of Obamacare by another name.
Nearly 9 in 10 Tennesseans eligible for Medicaid expansion are working-age adults without dependent children to support, according to the Urban Institute. Instead of adding a whole new generation onto welfare programs like Medicaid, we need to get working-age adults working again. Our state deserves a clear path to jobs and prosperity―not an ObamaCare Medicaid expansion like Insure Tennessee.
We are also concerned about how this ObamaCare Medicaid expansion is funded. In particular, $716 billion will be cut from Medicare in order to pay for the Medicaid expansion and other parts of the law, according to The Heritage Foundation. Medicaid expansion breaks the Medicare promise we made 50 years ago. And if other state Medicaid expansions are any indication, Medicaid costs will skyrocket―putting Tennessee seniors at further risk.
We are all aware of the mess that TennCare created and the difficulty our state had when we had to end the program and kick 350,000 Tennesseans off the Medicaid rolls.
Governor Haslam’s “two year pilot program” reeks of the same issues that we had less than a decade ago. Tennessee should not make the same mistake again.
We reject the ObamaCare Medicaid expansion known as Insure Tennessee. On behalf of many local Republicans oppose this expansion, we urge you to do what’s right for Tennessee and stand strong against this proposal.
Tennessee Republican Party Chairs
The Beacon Center of Tennessee today launched a radio ad ahead of the legislative debate over a Medicaid expansion. Amid massive spending by expansion proponents—led by the hospitals that will benefit from the expansion—state lawmakers will convene next Monday to vote on Gov. Haslam’s proposed expansion of Medicaid to more than 200,000 able-bodied adults.
The 60-second ad, titled “That’s Just Not Fair,” features a discussion between a senior citizen and her daughter about the proposed Medicaid expansion. It is running on radio stations in the Knoxville media market. You can listen to the full ad here.
“As lawmakers consider expanding Medicaid in our state under Obamacare, it’s important to realize how we got here, and what the consequences of that decision will be,” said Beacon CEO Justin Owen. “Ultimately, Congress made cuts to Medicare to fund other parts of Obamacare, including the expansion of Medicaid in the states. As the ad notes, that’s just not fair to our seniors.”
Here is the full text of the one-minute radio spot, “That’s Just Not Fair”:
Mom: Hey Amy, I heard state lawmakers will be voting to expand Medicaid here soon. What’s that all about?
Amy: It would mean giving government health insurance to more than 200,000 able-bodied Tennesseans under Obamacare.
Mom: Well, even if they’re able-bodied, it’s free federal money so what’s the big deal?
Amy: There’s no such thing as a free lunch, mom. In fact, the Medicaid expansion will be paid in part by $716 billion in cuts to seniors’ Medicare benefits.
Mom: To give health insurance to able-bodied adults?
Amy: You got it.
Mom: If they’re able-bodied, they can get a job…I can’t. And they want me to pay for them? That’s just not fair.
Amy: Well, that’s why it’s important for our state lawmakers to say no to Obama’s Medicaid expansion.
Mom: I agree. Don’t make seniors pay for more Obamacare in Tennessee. That’s just not fair.
To learn more about how a Medicaid expansion will impact your family, visit www.BeaconTN.org. That’s BeaconTN.org.
PAID FOR BY THE BEACON CENTER OF TENNESSEE
Nearly 80% of Volunteer State Voters Upset by $716 B in Cuts to Services for Seniors and the Needy to Pay for Insure Tennessee
A majority of Tennessee voters stand against ObamaCare’s Medicaid Expansion once they learn the true impacts the program will have on the state, with almost 60 percent of them opposed, says a Foundation for Government Accountability poll released today.
The poll was conducted after Gov. Bill Haslam reversed his opposition to ObamaCare to support Washington’s goal of expanding the welfare state in Tennessee, in spite of the lessons learned by the state’s failed TennCare program. Not too long ago, the TennCare Medicaid expansion nearly bankrupted the budget and forced lawmakers to kick hundreds of thousands of people off of the program to keep the state afloat. When reminded of the TennCare Medicaid expansion disaster, 62 percent of Tennessee voters said they were less likely to support the ObamaCare expansion Gov. Haslam’s wants today.
With ObamaCare still toxic, and the nightmares of the TennCare expansion debacle still fresh in peoples’ minds, Gov. Haslam is seeking to rebrand his ObamaCare Medicaid expansion plan, calling it “Insure Tennessee,” to dupe voters and legislators into thinking his welfare state expansion is both Tennessee-centric and market-based.
“There is nothing Tennessee-centric about caving to the dictates of Washington’s health care takeover through ObamaCare. Call it what you want, but the federal strings will be the same, the budget crunches will be the same, and the risks to patients and taxpayers will be the same. Insure Tennessee is ObamaCare expansion in disguise,” said FGA CEO Tarren Bragdon.
“Tennessee was able to climb out of the hole it dug itself after the TennCare expansion, but that may not be the case this time around. After the ObamaCare Medicaid expansion raises premiums, after the feds renege on their promises, after truly needy patients are pushed to the back of the line, the state may have no legal way to back out.”
While the U.S. Supreme Court ruled that ObamaCare’s Medicaid expansion was optional—doing so would turn these new expansion enrollees into a so-called mandatory population—the court did not clarify whether a state can back out of an ObamaCare expansion after passing it without losing their federal funding for all Medicaid enrollees. Upon learning that the state may not be able to reverse its decision after it expands Medicaid, two-thirds of Tennessee voters said they were less supportive. 73% of voters said they were less likely to support Haslam’s ObamaCare expansion plan knowing it could rob funding for critical priorities including education, safety and roads.
“Tennesseans don’t want Gov. Haslam’s ObamaCare Medicaid expansion. It’s time for the legislature to stand up for their citizens and protect them from a massive expansion of ObamaCare,” said Bragdon. “Gov. Haslam may be captivated by the allure of allegedly free money from Washington, but leaders in the Legislature need to keep a clear head and fight for what’s right for the people of Tennessee.”
When Haslam starts talking with legislators about Insure Tennessee, someone should remind him that the people of Tennessee don’t want to see the care of their parents, their health care system, their taxes, and their state jeopardized just so he can win points with the President. That’s no way for a conservative leader to lead, and that’s why 57 percent of Tennesseans and 78 percent of Republicans say they are less likely to reelect a candidate if they support ObamaCare’s Medicaid expansion, Insure Tennessee.
The FGA poll can be viewed here.
Radio, direct mail launch on 1/20/15 fuels statewide grassroots efforts
NASHVILLE – The Coalition for a Healthy Tennessee this week began radio ads and direct mail across the state to support passage of Insure Tennessee, the conservative, market‐based health care reform plan proposed by Governor Bill Haslam.
The media launch is an addition to the vibrant statewide grassroots campaign underway that involves thousands of business, health care and civic organizations across Tennessee who are making contact with legislators. The Coalition’s media presence includes www.insuretennesseenow.com, @InsureTNNow and facebook.com/insuretennesseenow.
“It is vital for people to know that what Governor Haslam is proposing is conservative, free‐market health care reform and not more of the same Medicaid from Washington, D.C. Insure Tennessee is distinctly not traditional Medicaid expansion,” said coalition spokesman Charlie Howorth, executive director of the Tennessee Business
Roundtable. “By departing from the Washington model, Governor Haslam has found a way to provide coverage for working Tennesseans caught in the coverage gap and to stabilize rural hospitals that are currently at risk of closure. We can achieve this with no new taxes and no cost impact to the state.”
The Coalition’s radio spots began airing today in markets across Tennessee. The entire radio script reads as follows:
“Time and time again, Tennesseans have rejected the Obama agenda and his Obamacare plan that moves health care decisions out of our state and into the hands of DC bureaucrats.
“That ‘s why Governor Haslam has introduced the Insure Tennessee Plan to cover hundreds of thousands of hard‐working Tennesseans. It’s a conservative, market‐based approach that will result in no new taxes, no new state government spending, and stability for our state’s rural hospitals.
“No new taxes and no new state government spending to make sure more of our fellow hard‐working Tennesseans have health care… That’s the conservative way, that’s the Tennessee way.
“Call 1‐800‐449‐8366 to tell your legislator to stand with Governor Haslam and Insure Tennessee Now or go to Insure Tennessee Now Dot Com for more information on Insure Tennessee. Paid for by The Coalition for a Healthy Tennessee.”
The Coalition’s first direct mail piece, attached here, emphasizes that Insure Tennessee is “a Common Sense, Conservative Solution for True Health Care Reform in Tennessee.”
The Coalition has more than 100 members, including many large member organizations, including chambers of commerce and other health care, business and civic organizations committed to gaining approval of Insure Tennessee. The group last month launched a website – www.InsureTennesseeNow.com – and is conducting grassroots advocacy in all 95 counties. The group is led by the Tennessee Business Roundtable.
Public health care forums featuring Insure Tennessee will held in Chattanooga, Jan. 22; Jackson, Jan. 30; and Tri‐Cities, Feb. 6. Forums have been conducted in Nashville, Memphis and Knoxville.
The campaign, including paid media, is entirely funded by private supporters of Insure Tennessee through the Coalition for a Healthy Tennessee.
Disagreement appears to have developed between the Republican-dominated chambers of the General Assembly over how to handle Gov. Bill Haslam’s “Insure Tennessee” proposal scheduled for discussion in a special session beginning Feb. 2.
On Thursday, leaders of the Tennessee Senate’s GOP supermajority indicated the upper chamber will be holding off on committee votes on the issue until the House approves a resolution authorizing Tennessee to sign up for the Affordable Care Act’s Medicaid expansion funding.
But that doesn’t seem to sit well with some Republicans in the House.
“Apparently, there was a Senate Republican Caucus meeting yesterday where it was fantasized to the effect that we would go through this process on Insure Tennessee through several committees before they even considered it in the Senate, and I would like to dispel that silly notion that they had in that Senate Republican Caucus meeting,” Majority Leader Gerald McCormick said Friday morning on the House floor.
“That will not happen,” said the Republican from Chattanooga, who is expected to attempt to guide the governor’s Insure Tennessee plan to approval in the House.
Haslam’s Medicaid expansion plan — the centerpiece of which is a system of Affordable Care Act-financed vouchers to allow the purchase of private-sector health insurance by lower income Tennesseans — has been met with skepticism by many members of the Republican Legislature, even as GOP leaders have pledged to keep an open mind about the expansion.
According to an emailed statement Friday from the office of Speaker of the House Beth Harwell, the lower-chamber leadership was under the impression “that the House and Senate would each run the resolutions concurrently. “
It looks as if the Tennessee House of Representatives will take the lead on deliberations over Gov. Bill Haslam’s proposal to expand state Medicaid eligibility using federal Obamacare dollars.
The General Assembly is scheduled to go into an “extraordinary session” beginning Feb. 2 to approve or reject the Haslam administration’s “Insure Tennessee” plan, the centerpiece of which is a system of Affordable Care Act-financed vouchers for lower income residents to purchase private-sector health insurance.
The “vehicle” in the Legislature for discussing Insure Tennessee will likely be a “joint resolution” originating in the House that’ll be carried by the chamber’s GOP majority leader, Gerald McCormick of Chattanooga.
Before it gets to the full floor of the 99-member chamber, though, the joint resolution will have to win approval from several committees and subcommittees, among them the House Insurance and Banking Committee, the Health Committee, the Finance Committee and the Calendar and Rules Committee, a spokeswoman for Speaker Beth Harwell, R-Nashville, told TNReport.
McCormick indicated this week that the vote-count within the House GOP caucus appears very tight at present. There are 73 Republicans and 26 Democrats in the House. Fifty votes are required to pass a measure out of the chamber.
Although the Senate will likely hold hearings and discussions about Insure Tennessee while the resolution is working its way through the House, upper-chamber Republican leaders said Senate committee-votes won’t be taken until after — and only if — the resolution clears the House.
“If it fails in the first House sub(committee), we’re done,” Lt. Gov. Ron Ramsey, R-Blountville, who presides over the Senate, told majority-party lawmakers during a caucus meeting Thursday afternoon.
Both Ramsey and Senate Majority Leader Mark Norris estimate that as many as three-quarters of their caucus remains undecided on the Haslam plan. Among them are Jack Johnson of Franklin and Randy McNally of Oak Ridge, who chair powerful committees that will likely handle the resolution.
Republicans outnumber Democrats in the Senate by a tally of 28-5. It takes 17 votes to pass a measure in the Senate.
“We have members who are outspokenly opposed to the proposal,” Norris said at the Senate GOP caucus gathering. “There are other members here supportive of it. But most members are just in the middle with open minds.”
Norris, who has himself voiced reservations about Haslam’s plan, said he’s hopeful there’s a full and robust discussion about all facets of the proposal. He described Insure Tennessee as “very complicated” in the way it touches on numerous aspects of state and federal law, the Internal Revenue Code and previous developments in the history of TennCare, the state’s program for administering the federal Medicaid system.
“All those things interrelate,” said Norris, a lawyer from Collierville. “Regardless of which side of the issue you may find yourself on, all these issues could be very important, whether you are against it, whether you are for it or whether you are unsure which way to go.”
He added, “What we are trying to do is lay out a timely and orderly process to get everyone through it in the best way possible, so that you can truly say that you are representing your constituents.”
Norris said one of the goals is to avoid the accusation of passing legislation “and not knowing what is in it.”
“Nobody wants to be in that situation,” he said.
Insure Tennessee has been offered by the administration as a two-year pilot program, and it includes incentives for healthier lifestyles. It is designed to enable the state to draw down Medicaid expansion funding through the Patient Protection and Affordable Care Act to cover people making up to 138 percent of the poverty level — which could translate to more than 450,000 potentially eligible Tennesseans.
Press release from the Tennessee House Democratic Caucus; September 23, 2014:
NASHVILLE, Tenn. (September 23, 2014) – House Democratic Leader Craig Fitzhugh is celebrating the beginning of fall as a countdown to the release of Governor Haslam’s long-awaited “Tennessee Plan” to expand Medicaid.
To mark the start of the season, Leader Fitzhugh has released a video asking Governor Haslam to make good on his pledge. Transcript to follow:
“Hi, I’m House Democratic Leader Craig Fitzhugh.
“Today marks the beginning of fall. This is the time of year that I look forward to cooler weather, changing leaves and UT Football.
“This year, I’m also looking forward to Governor Haslam’s “Tennessee Plan” for expanding Medicaid. A few weeks back, the Governor promised to submit a plan this fall.
“Well, Governor, fall starts today and the countdown for Medicaid expansion begins anew. I hope the Governor makes good on his promise. Meanwhile, we’ll be back throughout the coming weeks with updates about how the Governor’s dithering affects you, the tax payer.
“Again, I’m House Democratic Leader Craig Fitzhugh. Fall is here and—I truly hope—we can soon say the same thing about the Governor’s Tennessee Plan. Thanks.”
In August, Governor Haslam told reporters that he would probably go to the Department of Health and Human Services with a plan this fall that “makes sense for Tennessee.” Over the past year, House Democrats have implored Governor Haslam to follow the lead of Republican Governors like John Kasich of Ohio and Jan Brewer of Arizona who have put the residents of their state first by accepting federal funds to expand Medicaid.
It has been 545 days since Governor Haslam announced to a joint convention of legislators that he would seek a “Tennessee Plan” to expand Medicaid, and 266 since Tennessee began losing $2.5 million a day in federal funds, costing taxpayers $665,000,000 in lost revenue.
A federal judge has ordered state TennCare managers to hold hearings for Tennesseans who, because of application processing delays, have spent months waiting to find out if they qualify for taxpayer-finance health coverage.
U.S. District Court Judge Todd Campbell issued a preliminary injunction Tuesday — effective immediately — in a lawsuit against Tennessee’s Medicaid services agency that required the department to halt its refusal to provide hearings about delays in eligibility determinations within a certain number of days after one is requested. Those making the request have to prove that they have not learned the outcome of their application within 45 days if eligibility is based on income, while those seeking eligibility for a disability have to wait 90 days.
The lawsuit was also upgraded to class-action status.
“TennCare is committed to operationalizing the Judge’s Orders at this time,” TennCare spokesman John Goetz told TNReport Wednesday in an email.
The lawsuit was brought in July by the Southern Poverty Law Center, the National Health Law Program and the Tennessee Justice Center on behalf of several Tennesseans who felt their applications for assistance were not being heard in a timely enough manner, and that the state was not providing proper in-person assistance for applicants, instead sending them to the federal exchange.
The suit was filed shortly after the federal Centers for Medicare and Medicaid Services sent a letter to the state alleging it had failed to meet several of the requirements of the Affordable Care Act.
In his order, Campbell wrote that injuries suffered by the would-be TennCare enrollees “cannot be made whole by a retroactive award of money after the litigation process is complete.”
“The plaintiff class members are economically impoverished and, without TennCare benefits, have forgone or are forgoing vital medical treatments, services and prescriptions,” the judge added.
Tennessee Gov. Bill Haslam recently brushed off criticism that the state’s been dragging its feet signing up qualified applicants. Enrollment in 2014 is on record pace for the 20-year-old program’s history, the governor indicated.
One of TennCare’s attorneys argued that because of the issues the state has been having with getting its new eligibility system online, they had been given permission to send Medicaid applicants to the federal exchanges, and federal officials had failed to send necessary information to them about the plaintiffs that would help them process the applications faster.
Darin Gordon, the head of the agency, appeared before the General Assembly’s joint Fiscal Review Committee last week, and explained that Northrop Grumman — the company who won the bid to produce the system — was very much behind deadline, and the state had contracted with a third-party auditor to determine how much longer it would take for them to produce the necessary system.
However, Campbell wrote in his order that he was not persuaded that “the State can delegate its responsibilities under the Medicaid program to some other entity – whether that entity is a private party or the Federal Government.”
If a state decides to participate in Medicaid, “it is required to ensure that applications are adjudicated reasonably promptly and that hearings on delayed adjudications are held reasonably promptly,” Campbell continued in the injunction.
Additionally, according to the order, the federal government filed a “Statement of Interest” in the case, which said that TennCare “at all times retains the ultimate responsibility to ensure that a reasonably prompt decision is made on applications, including ones that have been submitted in the first instance to the federally facilitated Exchange in the State.”
Michele Johnson, executive director of the Tennessee Justice Center, said in a press release that her organization is “jubilant” that “vulnerable Tennesseans will now get the care upon which their lives and futures depend.”