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Haslam Looking to AR for TN Medicaid Expansion Ideas

Gov. Bill Haslam’s health policy specialists are probing into what Arkansas is doing with respect to increasing Medicaid coverage as part of federal Affordable Care Act reform initiatives.

During a press conference last week in Nashville, Tennessee’s Republican chief executive said his administration is “learning some things” from policies being pursued under Obamacare by Arkansas Gov. Mike Beebe, a Democrat.

Beebe appears to have secured approval from the Obama administration to funnel federal dollars earmarked for Medicaid expansions into private insurance for those eligible. According to the Washington Post’s “Wonkblog” today, other states considering such an approach are Florida, Ohio, Louisiana and Maine and perhaps even Texas:

We still don’t know the final details of the Arkansas agreement — or whether there is a final agreement. There are questions about whether this option will be more expensive than a traditional Medicaid expansion (the public program tends to cost a few thousand dollars less per enrollee).

What we do know, though, is that there are some very strong opponents of the Obamacare law — ones that have pledged never to expand Medicaid — who suddenly find this option palatable. It has the potential to grow the Medicaid expansion by millions of Americans, edging closer to the pre-Supreme Court version of the health-law’s coverage expansion.

One of the key differences between Arkansas and Tennessee is that The Natural State is partnering with the federal government on creating subsidized health-insurance exchanges. The Volunteer State is not.

Republicans in the Tennessee Legislature are divided between those who want to inoculate Tennessee against Obamacare to the greatest extent possible, and those who’re inclined to defer to Gov. Haslam to prescribe policy treatments that best suit the state’s unique conditions.

“Nobody likes the idea of just a sort of blanket Obamacare expansion, but that’s not what the governor is looking at,” said Mark Norris, the Tennessee Senate majority leader. “He’s real curious about what is happening in Arkansas, with their initiative to use Medicaid dollars for private insurance.”

Norris said he doesn’t anticipate Haslam making any decisions that could potentially put state government over a financial barrel. “He’s doing his due diligence. He’s doing what a good governor ought to do,” said the Republican from Collierville.

Norris added, “I have enough respect for the separation of powers and the three branches of government, and this particular governor, to wait and let him reach his own decision before we jump in and try to preempt something that he may never do anyway.”

However, this week a number of bills sponsored by lawmakers with no patience for the Patient Protection and Affordable Care Act are potentially coming for votes up in both House and Senate committees.

Senate Bill 666, sponsored by Dolores Gresham, R-Somerville, is scheduled for a hearing in the Commerce and Labor Committee Tuesday. The legislation, according to the official summary on the Legislature’s website, prohibits insurers doing business in Tennessee from participating in any health coverage exchange in the state operated under Obamacare. The bill’s companion measure, House Bill 476 by Republican Vance Dennis of Savannah, is slated for discussion in the lower chamber’s Banking and Insurance subcommittee on Wednesday.

Brian Kelsey, chairman of the Senate Judiciary Committee, told TNReport he favors the uncompromising approach taken recently by the Florida Legislature. Last week the GOP majority there put the brakes on Republican Gov. Rick Scott’s bid to expand his state’s Medicaid program.

“I think that was absolutely the right decision, and my hope is that all of us involved in the issue in Tennessee will also make the right decision to reject the Medicaid expansion,” said Kelsey, a Shelby County Republican. “I don’t think the votes are there to expand Medicaid in either the (Tennessee) Senate or the House, but time will tell.”

Kelsey’s Senate Bill 804 is up for a hearing Tuesday in the Commerce and Labor Committee. The House’s legislation that prohibits Medicaid expansion, HB937, could be discussed Wednesday by lawmakers on the insurance subcommittee.

House GOP Caucus Chairman Glen Casada anticipates Republican lawmakers flatly opposed to Medicaid expansion will start pressing their case in earnest on the Hill this week. In the House of Representatives “there are probably a lot of (Republican) members who are leaning ‘no,’ but they will give the due deference to Gov. Haslam to listen to what he has to say,” said the Franklin Republican.

Nevertheless, Casada said, “I think you will see the House and Senate acting quicker than what the governor is prepared to act.”