Will Gov. Bill Haslam follow the lead of his counterpart in Florida and support an expansion of the Medicaid program in Tennessee?
Itís not going to be an easy decision for Haslam. On one side is the prospect of Tennessee losing billions of federal health care dollars to other states. On the other side, however, is the political reality that Haslam will infuriate many fellow Republicans if he embraces this key portion of Obamacare.
He need look no farther than Florida to see what could happen here. Ultra-conservatives in the Sunshine State have voiced their disgust with Gov. Rick Scottís decision to accept the additional federal dollars under the Affordable Care Act. Tea partiers, who backed the Republican for governor, say they feel betrayed. They donít understand how Scott ó a former hospital executive ó could do such an about-face on Obamacare.
Itís simple: Scott added up the numbers. His state simply canít afford to pass up the dollars. Doing so would mean major cutbacks for hospitals while uninsured Floridians continue to line up in emergency rooms seeking charity care. It would be a perfect storm of bad outcomes.
Hospital executives in Tennessee are hopeful Haslam and the Republican-controlled state General Assembly will crunch the numbers and come to the same conclusion. Craig Becker, president of the Tennessee Hospital Association, said doing the math shouldnít be that much of a head-scratcher for GOP lawmakers.
But it will. For more than four years now, the central strategy of the Republican Party (in statehouses and in Congress) has been to oppose all things Obama. If President Obama was to push legislation to give every terminally ill orphan in this nation free ice cream on his birthday, you can guarantee the GOP would oppose it.
Some Republican lawmakers believe accepting Medicaid dollars from Obamacare would be endorsing socialized medicine. Others say it, but they donít truly believe it. They say it out of fear that a well-financed tea partier will challenge them in the next GOP primary.
Becker told me last week that with Haslamís help, the Medicaid expansion has a good shot of passing the General Assembly. Without his endorsement, it will be nearly impossible.
Denny DeNarvaez, the president and CEO of Wellmont Health System, said not expanding Medicaid (which is administered in this state by TennCare) will have a devastating effect on the entire health system in Tennessee. Coupled with other federal mandates and possible cuts from the sequester, DeNarvaez believes hospitals in this state could be faced with a real ďparade of horriblesĒ in the coming months.
Her counterpart at Mountain States Health Alliance, Dennis Vonderfecht, says he has met ďface to faceĒ with legislators from the area to educate them on the importance of the additional Medicaid dollars. Most lawmakers, however, are not going to commit on the issue until the governor takes a position.
Becker said Haslam is expected to make an announcement in March. So we wait.
Robert Houk is Opinion page editor for the Johnson City Press. He can be reached at firstname.lastname@example.org.