Haslam Rejects Medicaid Expansion

By Bill Dries

Tennessee will not accept an expansion of Medicaid funding under the Affordable Care Act, Gov. Bill Haslam announced Wednesday, March 27, to a joint session of the state’s General Assembly.

But Haslam also told legislators he is pursuing a “third option” between acceptance and rejection of the funding that would use the federal funding to allow uninsured Tennesseans eligible for TennCare, the state’s version of Medicaid, to buy private health insurance.

Haslam said he had talked over the third option with hospital executives across the state who have expressed concern about turning down the 100 percent federal funding of the Medicaid expansion for the first three years.

“I cannot emphasize enough how much I’ve been impressed with our hospitals’ willingness to work with us,” Haslam said, adding that the plan needed the approval of the U.S. Department of Health and Human Services.

“And we can’t get the same assurances from them at this point,” he added. “Until we get those assurances, I cannot recommend that we move forward on this plan.”

Haslam’s proposed use of the federal funding would have been for Tennesseans up to 138 percent of the federal poverty level, which he estimated would mean coverage for 175,000 more Tennesseans now without such insurance.

The payments would also be based on “health outcomes” and not solely on services performed.

“All we’re asking from Washington is to allow us to use the federal funds to provide coverage on the health care exchange in the same way many other Tennesseans will access coverage regardless of whether or not we expand,” Haslam said. “It’s a reasonable ask.”

The third option also would have allowed co-pays for those judged able to afford a co-pay and had a sunset provision requiring approval from the legislature for the program to be renewed after a certain length of time.

Shelby County Mayor Mark Luttrell was among those who urged Haslam to approve the state’s participation in the Medicaid expansion. Luttrell cited what he said would be a “damaging … if not devastating” impact on the Regional Medical Center at Memphis.

Here is a sampling of some of the reaction Wednesday, March 27, to Haslam’s decision not to expand Medicaid in Tennessee.

Lt. Gov. and State Senate speaker Ron Ramsey:

“Without bold reform of the Medicaid program tailored to Tennessee's unique situation, there can be no compromise on this issue. Four out of every 10 dollars the federal government spends comes out of the back pockets of future generations. Tennessee must receive assurances that have not been forthcoming. Gov. Haslam has laid out a plan for what true health care reform looks like. I commend him for his continued thoughtful and measured approach to this complex issue."

Tennessee Democratic Party Chairman Roy Herron:

"Deuteronomy 30 urges us to 'choose life,' but self-proclaimed 'pro-life' Republicans applauded the governor denying health insurance to 300,000 Tennesseans in working families, even though that means each week another parent, another child, another loved one – or two – will die. Reactionary and radical Republicans should never again call themselves 'pro-life,' not while condemning working Tennesseans without health insurance to die. Tennessee should choose science instead of selfishness, people instead of politics, life instead of death.”

Tennessee Republican Party Chairman Chris Devaney:

“Once again, Gov. Haslam has proven he is a man of principle. He took his time to thoroughly research this issue and gather all the facts. Instead of merely providing an answer that was politically motivated, he dutifully went about the business of being a true leader. In the era of instant gratification, that is a lost art. I’m proud Gov. Haslam has stood strong for the best interests of Tennesseans.” 

U.S. Sen. Lamar Alexander:

"I trust Gov. Haslam to do what is in the best interest of Tennesseans. I will do all I can to help the state get the flexibility he has asked for."