Sen. Green is not supporting Insure TN — or developing an alternative

The Clarksville Leaf Chronicle reported Saturday that state Sen. Mark Green was developing alternative legislation to Gov. Bill Haslam’s Insure Tennessee proposal, should it fail during a special legislative session starting next week. Today the newspaper reports Green has issued a news release declaring that’s inaccurate.

Sen. Mark Green has never expressed support for Insure Tennessee, the proposal to expand Medicaid that will be the subject of a special session of the General Assembly next week.

Green moved quickly Sunday to clarify his position in reaction to a report in The Leaf-Chronicle’s print and online editions which he said “conveyed an inaccurate message.”

The Leaf Chronicle’s online version of the story was headlined, “Sen. Green formulating option if Insure Tennessee fails.” The report inaccurately stated that Green, R-Clarksville, had a backup legislative proposal to expand Medicaid should the much-discussed plan of Gov. Bill Haslam fail to gain support in the General Assembly.

“Because we get so accustomed to a legislative proposal being rooted in a government solution, assumptions are made,” Green said in a press release Sunday. “The working poor who do not have access to health insurance is a problem, but the answer doesn’t always have to involve a program accepting federal funding.”

The Leaf-Chronicle report inaccurately combined aspects of two separate pieces of health care legislation Green is working on that are not directly tied to Insure Tennessee, Green said.

At a town hall meeting in Erin last week, Green referred to a legislative alternative that would assist in the creation of nonprofit organizations, such as Project Access, in Knoxville. The initiative is operated through Knox County’s Medical Society and employs the provider services of “Good Samaritan” health care providers in a clinical setting that serves the working poor. This service has been operational since 2006 serving more than 19,000 low-income patients with more than $150 million donated in health care services. Green’s plan would take the charitable care model statewide.

The other legislative proposal Green discussed would address a need to provide more incentives for saving by current TennCare enrollees.

Note: It appears the original post has been taken off the newspaper’s website. The first lines were included in the Haslam administration roundup of news stories on Sunday, thusly:

State Sen. Mark Green is working on a alternative in the event Gov. Bill Haslam’s Insure Tennessee proposal to expand Medicaid does not pass in the legislature. “I’m concerned there are some Republicans in the Legislature that will say no to Insure Tennessee,” Green said following a town hall meeting in Erin on Jan. 21. “If it doesn’t pass, this will be a contingency.” Last week, Haslam began a tour of the state to promote his proposal to extend health coverage to more than 200,000 low-income Tennesseans. Insure Tennessee has received a cool response in the Legislature because it draws on federal money available under President Barack Obama’s health care law. Haslam has stressed that the proposal differs from straight Medicaid expansion adopted in other states because it would require co-pays and offer vouchers to buy private insurance. The plan has been endorsed by hospitals that argue it would defray costs for treating uninsured patients. The program is to be financed entirely by Tennessee’s hospitals and is being touted to not create any new taxes or add any state cost to the state budget.

Huckabee campaigns — uh, make that promotes book — in TN with TN help

Former Arkansas Gov. Mike Huckabee is in Knoxville and Johnson City today on a tour to promote his most recent book (“God, Guns, Grits, and Gravy”) that coincidentally comes as he’s eyeing another run for the Republican presidential nomination in 2016. He ran in 2008, of course, and carried Tennessee in the primary.

In a report on the Knoxville visit, Georgiana Vines includes some comments from Tennesseans helping Huckabee in his endeavors:

Chip Saltsman of Nashville, who ran his previous campaign and then assisted U.S. Rep. Chuck Fleischmann of Ooltewah, Tenn., as a candidate and officeholder in 2009-12, is Huckabee’s senior adviser. Saltsman also was a political adviser to former Senate Majority Leader Bill Frist and former chairman of the Tennessee Republican Party.

“He is working through the process of deciding to run for president again. I am helping him in the process. I am biased, but that’s because I think he should,” Saltsman said Sunday from the bus bringing Huckabee to Knoxville.

Huckabee has drawn large crowds in Knoxville since the 2008 campaign when he came for other book signings and to speak.

Knoxvillian Bonnie Brezina, campaign manager for state Sen. Richard Briggs’ recent election, said she, too, is helping Huckabee.

Brezina said she’s helping with the Tennessee book tour and then will “hang out” in Texas when he’s there in February. She said she’s helping with getting legislators and donors to the book signings. She said Briggs and Rep. Eddie Smith, both Republicans, are expected to attend the book signing at noon today at Sam’s Club in West Knoxville.

Note: Huckabee has been no stranger to Tennessee before he launched the 43-stop book promotion tour this month. See, for example, previous posts on a trip to Nashville and another on a trip to Jackson back in September.

TN police, college officials holding two-day meeting on campus sexual assault

Police officers, counselors and educators from 76 public and private colleges across the state will descend on Tennessee State University in Nashville on Tuesday for a two-day summit on campus sexual assault, reports the News Sentinel.

Combining their efforts will allow the schools to learn from each other while also attracting national speakers and sharing the event’s roughly $40,000 costs, leaders from each of the state’s major higher education systems said last week.

“We believe students have every right to expect to be safe on our campus,” UT President Joe DiPietro said Thursday in a conference call with reporters. “We want to do everything we can to be there and support our students when they need us most.”

More than 400 higher-education staffers are expected to turn out for training on issues like defining consent, student disciplinary hearings, complying with changing federal laws and sexual assault prevention.

The event, officially titled the Tennessee Sexual Assault and Relationship Violence Summit, comes on the heels of revisions to federal standards and laws on how schools should respond to and report assaults.

At the same time, campuses around the country have come under fire for mishandling assault cases. The U.S. Department is currently investigating nearly 100 schools, including Yale, Princeton and the University of North Carolina, for violations of Title IX, the gender equality statute governing schools that receive federal funding.

The trial of two Vanderbilt University football players accused of raping an unconscious student in a dorm room continues this week in a courthouse three miles from the Tennessee State campus.

In Knoxville, the district attorney’s office is still considering whether to charge two former UT football players accused of raping a fellow student. This week’s event does not specifically include sessions on athletes and sexual assault, but that would not prevent participants from discussing the topic, DiPietro said.

Brooks in radio ad crossfire over Insure TN

A group supporting Gov. Bill Haslam in his efforts to win legislative approval of a modified Medicaid expansion plan is defending state Rep. Kevin Brooks in radio ads after the Bradley County Republican was attacked for supporting the proposal by a group opposing the governor’s efforts.

The radio ads both declare dislike of Obamacare, the increasingly popular name for the Affordable Care Act that generally has been unpopular in polling of Tennesseans.

The difference is that Americans for Prosperity, opposing Haslam’s “Insure Tennessee” proposal, says the governor’s program amounts to backing the Obamacare “disaster.” Coalition for a Healthy Tennessee, supporting the governor’s proposal, says that Haslam is “standing up against Obamacare.”

The Brooks-focused ads echo contentions in statewide radio and direct mail advertising by both groups and the general lobbying of Republican state legislators in advance of the special legislative session on whether to adopt Insure Tennessee. The session starts Feb. 2.

Brooks was the first legislator to be individually targeted for criticism by AFP. A spokeswoman for the group indicated that other Republican legislators supporting Haslam may soon get similar treatment.
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Blackburn re-brands TV networks

Tennessee Congressman Marsha Blackburn gets a mention in Politico columnist Roger Simon’s commentary on the Freedom Summit gathering in Iowa Saturday. The article starts by declaring that “the Republican Party’s clown car has become a clown van.”

The Marsha mention:

Rep. Marsha Blackburn decided to re-brand some major TV networks:

“ABC: All About Clinton network

“NBC: Nothing But Clinton

“CNN: Clinton News Network

“CBS – – just think about it!” Translation: Clinton b.s.

Kinda funny. But kinda third grade.

Lobbyist wining and dining report: Record $725K spent in 2014

Organizations that hire lobbyists at the state Legislature spent a record $725,000 on 96 “wining and dining” events for lawmakers during 2014 and have already sent out invitations to 24 gatherings for the 2015 session, according to reports filed with the Tennessee Ethics Commission.

The 2014 spending – precisely $724,982 – compares to $650,873 in spending a year earlier and $565,318 in 2012. (Note: The 2014 list is HERE.)

Under a law enacted in 2006 during a special legislative session on governmental ethics, lobbyists and their employers are generally prohibited from making gifts to legislators. But there are exceptions, including events to which all members of the Legislature are invited.

In those cases, the amount spent could not exceed $50 per person in 2006, though there is a cost-of-living adjustment for each legislative session. For the 109th General Assembly, which begins this year, the limit is $59 per person – up about $1 from the 108th General Assembly.

The law also requires lobbyist employers to notify the Ethics Commission of a planned event in advance and provide a copy of the invitation sent, then report afterwards the amount spent on the event.

In 2006, when the law took effect on July 1, only six events were reported to the commission and total spending listed on the commission website was just $5,774. Most events come while the legislators are in session, but a few are held later in the year.
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Sunday column: Balderdash and a texting lobbyist

Louie Lobbyist sent a text message the other day that read, “SB141 is repression of free speech!”

The reference was to Senate Bill 141, introduced recently by Sen. Reginald Tate, D-Memphis. It basically would prohibit lobbyists — or anyone acting on their behalf — from sending text messages or making phone calls to legislators while they’re in a committee meeting or in a floor session.

On a whim, I texted back: “Balderdash.” Louie is the only person I have ever heard use that word in an actual conversation. Suspected it would provoke him, and I was right. He called from his iPhone within a few minutes.

“You media morons are always harping on First Amendment stuff and now you’re saying a citizen cannot tell an elected representative how he feels about an issue! You’re a (expletive deleted) hypocrite. I don’t know what Sen. Tate was thinking here, but that’s gotta be unconstitutional.”

Well, I replied, actually it is something of a head-scratcher of a proposition and I haven’t talked to the senator. But I have watched while you were sitting there in a committee meeting jabbing at your iPhone while a couple or three legislators were looking and poking at their devices without paying much attention to the discussion.

And I sorta think other states have done things along the same lines — though by legislative rule rather than by statute, according to a lady at the National Conference of State Legislatures. One could maybe draw a legal distinction between an average citizen letting a legislator know his or her views and a hired-gun lobbyist coaching a legislator how to vote on an amendment while debate was underway — or maybe promising via text message that a campaign contribution is forthcoming with the proper vote.

“Well, it’s a slippery slope when you start restricting people from talking with elected representatives. That’s what this country was founded on. Legislators can’t represent the people without hearing from them. It’s traditional. It’s history. And on some of these complex issues, the legislators need our advice.”

Yes, but legislators already hear from you guys a lot more than from average folks. You meet with them in their offices, chat in the hallways, have your clients hold receptions, line up campaign contributions and so on. The proposition here is just to say that, while a debate is underway, you can’t text or phone instructions to a legislator on how to vote or what to say.

“The same sort of thing has always been done. It’s historic and traditional besides being constitutional.”

OK, I do remember the pre-cellphone days when a lobbyist used things like the old eyes and nose thing (touch his eye to signal a legislator to vote “aye” or touch his nose to recommend a “no” vote). I think you did that yourself, in fact. And, sure, you can always get the legislator to step out of the meeting room for a talk, then have him pass the word along to colleagues. Or send him a note through a sergeant-at-arms.

But those things are fairly conspicuous. Texting somehow seems more surreptitious and sneaky. If such things are going on, the texting should at least be public information. Maybe Sen. Tate’s bill could be amended to require that all text messages to legislators are an open record. You could just copy in all the messages to a public website where they’d be available for anyone to see. You could go along with that, right?

“(Expletive deleted) no! That’s ridiculous … an outright invasion of privacy … putting an unnecessary burden on honest lobbyists.”

Invasion of privacy? I’d say not when public business is involved. Burden? Oh, come on. How many people did you send that SB141 message? I suspect I got it just because I’m on a list — probably along with some legislators. So it wasn’t any burden to copy in another address.

“Actually, I think texting is proving to be burdensome. Guess I’ll delete media morons from my list. And I don’t think that bill is going to pass anyway.”

Probably not. Sen. Tate is a Democrat and that alone makes it tough in supermajority times for anything that doesn’t have pretty much unanimous support. This surely doesn’t.

“You can bet on that. Especially after our friends in the Legislature hear a little more talking and get a little more texting on this unconstitutional idea. Good bye and balderdash.”

Note: This is a column written for the News Sentinel (slightly revised) and is also available HERE.

Survey finds most TN NFIB members oppose Haslam’s Medicaid expansion plan

News release from National Federation of Independent Business-Tennessee
State members of the National Federation of Independent Business are wary of Gov. Bill Haslam’s Insure Tennessee proposal according to a statewide member survey, said Jim Brown, state director of NFIB/Tennessee, the state’s leading small business association.

Sixty-five percent oppose the current proposal, 22 percent favor and 13 percent are undecided.

“Many small business owners have reservations about the proposal, as currently structured,” Brown said. “They’re concerned with more federal borrowing, how the plan will operate, likely loopholes and a lack of benchmarks. Members appreciate core principles in the governor’s plan, but most aren’t convinced yet it would operate effectively enough and believe taxpayers would be pressured to foot any cost overruns.”

Specifically, members expressed the following concerns in the survey:

87 percent say not establishing measurable outcomes and tying them to any continuance of the plan is troublesome; members are suspicious of relying on continuance of federal and/or state funding.

80 percent believe the General Assembly should have more authority to terminate any unsound plan.

71 percent believe our existing Medicaid plan should be reformed before considering expansion.
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Two key differences between Insure TN and other Medicaid programs

According to a Tennessean report, there are two key ways Gov. Bill Haslam’s Insure Tennessee plan differs from traditional Medicaid programs throughout most of the rest of the country: People could be forced off public health insurance for late payments and employers could cut back how much they pay for employees’ insurance.

Insure Tennessee has two plans — the Volunteer Plan for those who have access to a plan through work and the Healthy Incentives Plan for those who do not. Insure Tennessee applies to those Tennesseans earning less than 138 percent of the federal poverty level.

… The Volunteer Plan requires employers to pay at least half of the cost of insurance for an eligible employee. However, it could lead to a new potential benefit for employers: They could choose to reduce their share of the insurance contribution down to that 50 percent and allow an Insure Tennessee voucher to make up the difference.

… Employers open themselves to discrimination claims if they reduce how much they contribute solely for those employees eligible for the Volunteer Plan, said Austin Madison, vice president of employee benefits for The Crichton Group, which helps companies weigh insurance options.

He said it’s hard to predict what the employers will do without more information from the state about the Volunteer Plan. Specifically, businesses want to know how much will be allocated to the vouchers, referred to in the plan as a “defined contribution.”

“I think that’s the million-dollar question. We don’t know what the contribution is going to be, we don’t know how sizable it’s going to be,” he said.

Haslam spokesman Dave Smith said an actuarial study to help the administration determine the amount of the contribution should be complete before the start of the special session on Feb. 2.

…(Under Healthy Incentives) People making between 100 percent and 138 percent of the federal poverty level will pay roughly $20 monthly in premiums. If they fail to pay premiums for 60 days or more, they can be removed from the plan — a feature that is not found in traditional Medicaid and TennCare. People making under 100 percent of the federal poverty line will not pay premiums.

Mary Bufwack, CEO of Neighborhood Health, a system of community clinics, said in an email that these differences are important to distinguish the program from other government plans and “not unworkable if premiums and copays are reasonable. Many will be able to meet them.”

On Kelsey, Corker, Alexander and the hospital fee that will pay for Haslam Medicaid expansion

Sen. Brian Kelsey, an avowed opponent of Gov. Bill Haslam’s Medicaid expansion plan, is questioning its reliance on a voluntary hospital assessment that would fund the state’s future share, citing efforts two years ago by U.S. Sen. Bob Corker to eliminate the widespread practice, reports the Chattanooga TFP.

“I question whether the federal government is a reliable negotiator,” said Kelsey, who then cited Corker’s bill and noted it sought to “abolish the hospital tax to be relied on” in Haslam’s proposal.

Haslam is trying to win approval of what he calls his “market-driven” two-year pilot project in a Feb. 2 special session of the GOP-dominated General Assembly.

If approved, the pilot project would be entirely federally funded through 2016 under President Barack Obama’s Affordable Care Act.

After that the federal share would decrease over time. By 2020, the state would bear 10 percent of the costs. But Tennessee hospitals, desperate to see the coverage, have agreed to pay the state’s share through expansion of an existing assessment.

That’s allowed Haslam to argue that his plan — which includes vouchers for workers to join employers’ health plans and a re-tooled version of TennCare that introduces measures to control patients’ costs and providers’ charges — “won’t cost Tennessee taxpayers another dime.”

Asked about Kelsey’s assertions, Corker, a close ally of Haslam who has praised the governor’s plan, said in a statement that “while I am opposed to the policy that allows states to utilize provider taxes and have introduced legislation in the past to eliminate it as part of a broader fiscal reform package, I assume governors will continue to take advantage of federal laws as they exist today.”

As for whether the senator plans to reintroduce legislation eliminating provider fees or taxes at some point, Corker’s office later said the senator “has no current plans to introduce stand-alone legislation to eliminate the provider tax funding mechanism.”

In 2013, Corker introduced a bill called the Fiscal Sustainability Act of 2013. It was a comprehensive debt-reduction bill pushing changes not only in Medicaid but in other entitlement programs such as Medicare and Social Security. It called for eliminating all health-care provider taxes or fees in 2023.

The bill, co-sponsored by Sen. Lamar Alexander, R-Tenn., went nowhere in the Democratic-controlled U.S. Senate. Republicans now control the Senate as well as the U.S. House, but Democratic President Barack Obama remains in office for another two years and likely would not allow such a measure to become law.

But if a Republican wins the White House in 2016 and Republicans still control Congress, it could be another matter.

A spokesman for Alexander, also a Haslam ally who recently welcomed the governor’s plan, issued a statement that indicated more flexibility on the provider funding question.

“Congress should pass the Corker-Alexander plan, or one like it, to address out-of-control entitlement spending and fix the federal government’s $18 trillion debt,” spokesman Brian Reisinger said in an email. “Senator Alexander believes Gov. Haslam deserves credit for working to create a plan that Tennessee can afford, and that determining how hospitals contribute to that plan is a state decision.”

Note: See also the Commercial Appeal story along the same lines.