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Playing politics with Medicaid would be catastrophic to state

Staff Report • Feb 25, 2013 at 8:53 AM

There’s an important decision on Medicaid looming in Nashville, one that will greatly impact both the physical health of poor Tennesseans and the fiscal health of state hospitals.

A key component of the Affordable Care Act allows the state 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 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.

There is, however, just one catch.

In handing down its historic decision last year legitimizing the Affordable Care Act, the U.S. Supreme Court decided states should have a right to refuse an expansion of their Medicaid programs.

This proviso concerns hospital officials in Tennessee. They worry the Republican-controlled state General Assembly might decide to take a pass on the additional Medicaid funds. Many GOP lawmakers have already said they do not want anything to do with what they call “Obamacare.”

As a result, they would be content to send billions of precious health care dollars to states (like California and New York) that have agreed to expand their Medicaid rolls.

Denny DeNarvaez, the president and CEO of the Wellmont Health System, told the Press last week failure to expand TennCare would be “devastating” to the state’s “most vulnerable” hospitals and uninsured patients.

While she understands the intense ideological objections many have for anything Obama, DeNarvaez doesn’t understand how a lawmaker could put such considerations ahead of the health and well-being of state residents.

“People need to put politics aside and do the right thing,” she said.

We agree with DeNarvaez when she notes Tennessee can ill afford to send $5.6 billion in health care dollars to other states that could be helping patients here.

We also agree with Dennis Vonderfecht, the president and CEO of Mountain States Health Alliance, who says refusing the additional Medicaid funds “will not make Obamacare go away.” It is, as he put it, “the law of the land” and will remain so for years to come.

Craig Becker, the president of the Tennessee Hospital Association, told us he believes state lawmakers should just stick to “the economics” of the issue and leave politics out of it. He’s right. The numbers do speak for themselves.

Becker’s group, which is leading lobbying efforts on the expansion, estimates failure to accept the funds will result in the loss of 90,000 health care and health-related jobs in Tennessee. (A study commissioned by the THA suggests 3,425 of those jobs will come from Washington County.)

Cutting these jobs would be the only choice for hospitals (particularly, the small rural hospitals that are now just barely getting by) if state lawmakers refuse the additional Medicaid funds.

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

That would be catastrophic. As Vonderfecht pointed out last week, health care is “a major economic driver of our region.”

Failure to expand the state’s Medicaid program would be an economic tsunami, destroying whatever progress this area has made to claw its way out of 2008 recession.

Gov. Bill Haslam is expected to make a decision in March on whether to expand the Medicaid program. We urge him to take this money and lead the effort to convince his Republican brethren in the legislature to back the expansion.

We remind the governor and members of the General Assembly that there is too much at stake to become entrenched in political theatrics that do nothing to better the health care of Tennesseans.

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