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Haslam’s decision could really hurt Tennessee

Staff Report • Mar 28, 2013 at 8:24 AM

Disappointing. That’s the word many health care officials across Tennessee have used to describe Gov. Bill Haslam’s decision Wednesday to turn down federal money to expand Medicaid in Tennessee.

“To say that we are disappointed would be an understatement,” said Brad A. Palmertree of the Tennessee Health Care Campaign. “Governor Haslam had the opportunity to show real leadership for the people of Tennessee.

“We all know that those who need insurance the most are usually the ones who cannot afford it. Because of his decision, there will still be hundreds of thousands of uninsured Tennesseans.”

We would use another word to describe Haslam’s decision — shortsighted. A key component of the Affordable Care Act (or Obamacare, as the law’s critics have come to call it) allows Tennessee to add 180,000 state residents to the Medicaid program (which is administered under TennCare).

These new enrollees would be mostly the working poor — Tennesseans who have no health insurance with their employer, who can’t afford to be in the state’s new health exchange and who make up to 138 percent of the poverty level.

The federal government would cover the total cost of this coverage for the first three years and 90 percent thereafter. These funds are intended to soften the blow for as much as $7.8 billion in Medicare cuts to Tennessee hospitals.

Haslam’s decision to reject these funds means billions of precious health care dollars will now go to states (like California and New York) that have agreed to expand their Medicaid rolls.

At the same time, Tennessee’s failure to accept the funds will result in the loss of 90,000 health care and health-related jobs. Specifically, a study commissioned by the Tennessee Hospital Association says 3,425 of these jobs will be lost right here in Washington County.

Cutting jobs and reducing services will be the only choice for hospitals, particularly the small rural hospitals that are now just barely getting by. 

Failure to expand the Medicaid program will also result in higher health care costs for all Tennesseans and harm efforts to recruit businesses and industries to our community.

Haslam said his decision wasn’t based on the politics of his party. We would like to believe that, but his Republican colleagues in the GOP-controlled state General Assembly have made it abundantly clear they are opposed to all things Obama.

Even with Haslam’s endorsement of the measure, passage of a new state budget that included Medicaid expansion was going to be a struggle at best. Interestingly enough, though, the governor’s flat refusal of the Affordable Health Care Act funds does not mean the issue is entirely dead on Capitol Hill.

Haslam told a joint assembly of the House and Senate on Wednesday he is pursuing a “third” option on the Medicaid expansion issue by requesting permission from the U.S. Department of Health and Human Services to “leverage” federal dollars meant to purchase private health insurance for uninsured Tennesseans.

This third option appears to be little more than a crafty attempt at repackaging the Medicaid expansion provision of the Affordable Care Act.

Federal officials appear unwilling to entertain such a waiver, particularly in light of the fact that other states have accepted Medicaid expansion funds without making such demands.

Haslam said Wednesday that Washington has refused to give him the green light for the plan.

Meanwhile, local hospital officials say they are keeping their fingers crossed.

If the Feds don’t go for Haslam’s rebranding of Medicaid expansion, then the governor’s decision to turn down the Affordable Health Care Act dollars will result in major cutbacks for hospitals in the state.

As we said earlier, these cutbacks could prove to be very painful to small hospitals in rural areas.

Haslam’s decision could also result in more Tennesseans lining up at emergency rooms to seek charity care, thus placing additional financial strain on the already overburdened health system.

And to think all of this could be avoided if the governor and leaders of the General Assembly were able to put aside politics long enough to weigh the real consequences of their actions.

Now that’s really disappointing.

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