I decided I’d post this now, just in case it gets pulled like some other articles have been and the links go bad.
Posted: Mar 27, 2013 6:43 AM CDT- Updated: Mar 27, 2013 10:56 AM CDT
NASHVILLE, Tenn. (AP) – Tennessee Governor Bill Haslam announced Wednesday that he won’t pursue expanding the state’s Medicaid program to help cover the uninsured as part of the federal Affordable Care Act.
Haslam told a joint session of state lawmakers that he decided not to do that because he prefers a third option to use federal money to subsidize private insurance. The federal government hasn’t accepted that proposal.
“I cannot recommend to you that we move forward on this plan,” Haslam said in a 12-minute speech. “Our budget amendment will not include language to accept the federal funds.”
The announcement appeared to catch lawmakers by surprise, as there was only tepid applause by group dominated by usually vocal opponents of President Barack Obama and his signature health care law.
Expanding TennCare, the state’s Medicaid program, had been estimated to cover roughly 140,000 of Tennessee’s nearly 1 million uninsured residents and bring in $1.4 billion in federal money in the first year alone.
Haslam was among the last of the Republican governors to declare a decision on expansion. Both the health care program and President Barack Obama are widely unpopular in the highly Republican state.
Under an expansion of TennCare, the state’s Medicaid program, the federal government would pay the entire cost for the first three years and at least 90 percent thereafter.
Haslam said he had tried to get approval for a “Tennessee Plan,” in which the state would accept the federal money to subsidize private insurance.
“The plan would include co-pays for those that can afford to pay something, so the user has some skin in the game when it comes to health care incentives,” he said.
While Republican governors have been highly critical of the federal health care program, a number of them are re-evaluating their opposition to accepting federal dollars to expand health care coverage to the poor as they review the budget implications and face pressure from hospitals that treat the uninsured. Republicans also are proposing alternatives that would cover fewer people than Obama’s plan, guarantee less financial help or rely more on private insurers.
The hospital industry has called expansion crucial to boosting jobs in that sector, and has warned that declining the money could cause some rural hospitals to go out of business.
The prospects of getting the Republican supermajority to agree to an expansion of Obama’s signature law looked daunting.
“The politics of it are difficult,” Haslam told reporters earlier this week. “And we’ve recognized that from the very beginning.”
Haslam has said he pored over the deals struck by other Republican governors who have decided to pursue Medicaid expansion.
Committees in Florida’s Republican-led Legislature have rejected a Medicaid expansion for roughly 1 million of the state’s poorest residents, even though it is backed by GOP Gov. Rick Scott. Now a Republican state senator is pursuing an alternative that is much like what Haslam said he wanted — using federal funds to provide vouchers for low-income residents to buy private policies.
Republican Ohio Gov. John Kasich also has been in discussions with the Obama administration about providing subsidized insurance instead of full Medicaid coverage for more adults. Republican governors in Texas, Nebraska and Indiana want the federal government to award Medicaid money as block grants to states.
Haslam vowed not to be swayed by political considerations, though his previous decisions not to pursue either a state-run health insurance exchange or a joint one with the federal government hewed closely to the ideological preferences of Republicans in the Legislature.
“You’re elected to try to make the hard decisions on the big issues,” Haslam said earlier this week. “And there’s no question that health care is as big an issue facing Tennessee and the country as there is.”