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Haslam makes final push for Medicaid expansion, Republicans quell proposal again

Zach Vance • Apr 14, 2018 at 12:52 AM

It could have been a legacy-defining moment for Tennessee’s 49th governor, but the state legislature’s Republican supermajority wasn’t having it in 2015.

They’re still not having it in 2018.

News broke Friday, as reported by the Tennessean, that Gov. Bill Haslam assembled House and Senate leaders behind closed doors for what seemed to be another nonchalant weekly meeting, only this time, Haslam — with just eight months left on his term — had an audacious, yet familiar request:

Will Republican leadership support one last push to extend federally funded health care coverage to the thousands of low-income Tennesseans who make too much to qualify for Medicaid, but do not generate enough income to qualify for subsidies through the Affordable Care Act marketplace?

Not a single Northeast Tennessee lawmaker was in attendance at the meeting; not Senate Health and Welfare Committee Chairman Rusty Crowe, nor Republican Assistant Leader David Hawk, who often works close to the Haslam administration.

Lt. Gov. Randy McNally and House Speaker Beth Harwell, who is vying to become Haslam’s replacement, did attend the gathering, and both were reportedly open to renewing discussion about Medicaid expansion.

However, House Majority Leader Glen Casada and others were reportedly “reticent” and stymied any talk about Medicaid expansion from leaving the conference room, the Tennessean reported, citing interviews with seven people familiar with the meeting.

“At this particular meeting, a number of issues surrounding Medicaid were discussed and Dr. Wendy Long, director of TennCare, was there as a resource to address questions. However, no specific proposal was discussed and there is no current plan to call a special session to consider Medicaid expansion,” Haslam spokeswoman Jennifer Donnals wrote in a statement to the Johnson City Press.

Reached by phone on Friday, Crowe said he was unaware of the meeting, since he apparently wasn’t invited, but he did say he was open to Haslam’s proposal.

“Now that all the Obama stuff has died down, if (Haslam) tried his Insure Tennessee again, it might pass because it’s a market-based plan. It’s a personal responsibility plan. You have to do something to get something,” said Crowe, who helped pass the proposal out of his committee in 2015.

Unveiled just before the 2015 session, Haslam’s initial plan would use federal funding to provide insurance to Tennesseans that fall between the income gap, although the participants would have to meet various personal responsibility requirements.

Based on the initial proposal, federal dollars would have paid for Insure Tennessee’s first 1.5 years, but those payments would decline each year until reaching 90 percent of the cost, at which point Tennessee would begin paying the balance.

Crowe said much of the Republican opposition against Insure Tennessee was based wholly upon the perception that the Affordable Care Act was unstable and the federal government might struggle sustaining its payments for the program.

“But the atmosphere is different now and I do think it’s good. This governor is leaving, but it would be a good time to bring it back up so the next governor will know it’s something that’s being talked about,” Crowe said.

Johnson City’s Republican senator isn’t the only Medicaid expansion advocate, as Ballad Health Executive Chairman Alan Levine openly supported Insure Tennessee in a February 2015 column published in the Knoxville News Sentinel.

“Ballad Health supports Medicaid expansion because it would benefit the most vulnerable population we serve. Access to coverage would foster economic development for all of our region, helping individuals get back to work and raising the quality of life for residents,” according to a Ballad Health statement.

“Those who have access to healthcare coverage are more likely to seek preventive care, which in turn improves quality of life and lowers healthcare costs for everyone.”

While his efforts to pass Medicaid expansion haven’t gone unnoticed, Haslam will surely linger on this unfulfilled goal for years to come once after leaving the governor’s, even going so far as calling its failure his “biggest disappointment.” 

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