The following is the text of Gov. Bill Haslam's address to the state Legislature on his decision not to accept federal dollars for Medicaid expansion:
Earlier this year, I committed to providing some clarity around our Medicaid expansion decision prior to the end of March. And just a few minutes ago, I had the opportunity to address a joint session of the General Assembly to share where we are regarding this significant decision.
I think we all can agree that there is no more important or complex issue facing our country and our state than health care. Health care costs and the entitlement programs that cost our federal and state government so much money are on an unsustainable path. For example, regardless of whether we decide to cover any additional people through Obamacare, the Act will cost Tennesseans almost $2 billion over the next eight years. I shared with the General Assembly this morning that Tennessee will not expand TennCare rolls under the Affordable Care Act, but will instead work to leverage the available federal dollars to pursue real health care reform.
Tennessee has shown the nation how to produce true reform in education, based on students’ results and educational outcome. We’re beginning to do the same thing with reforming government service – again by measuring outcome and results rather than just years of service as a state employee. I believe Tennessee can also be a model for what true health care reform looks like, so we've been working toward a different plan: A Tennessee Plan for Health Reform.
The "Tennessee Plan" would take on the critical issue of aligning incentives among users, payers and providers of health care. Specifically, the plan would:
Leverage available federal dollars to purchase private health insurance for Tennesseans up to 138 percent of the federal poverty level who don’t have access to health insurance, which would translate to 175,000 more insured Tennesseans;
Allow co-pays for those who can afford to pay something;
Include a definitive circuit-breaker or sunset that could only be renewed with the General Assembly’s approval;
And reform the payment structure for providers so they are compensated for health outcomes, not just based on services performed.
To succeed, we need cooperation and assurances from the Department of Health and Human Services. At this point, we cannot get those assurances so I cannot recommend to the General Assembly that we move forward on this plan until we have more clarity and cooperation. Our upcoming budget amendment will not include language to accept these federal funds.
I’ll continue to pursue a vision for a healthier Tennessee with access to health care but at a lower cost for our state and our country. It is my hope that we can provide quality health care for more Tennesseans while transforming the relationship among health care users, providers and payers. If Tennessee can do that, we all win.
I appreciate your support and look forward to hearing your thoughts on this important issue.