Health Care Compact Emerges From House Committee

Legislation that lays the groundwork for state government taking over the federal Medicare program in Tennessee was approved Wednesday in a House committee where it stalled last year.
Five Democrats on the House Health and Human Resources Committee voted against the Health Care Compact bill, HB369. All 11 Republicans voted for it.
Rep. Mark Pody, R-Lebanon, who took over sponsorship of the measure this year, began his presentation in support of the bill with a video tape, saying “I have somebody on screen who can help me” with passage of the bill. The video showed President Obama saying that he is “open to states coming up with their own ideas” for health care reforms.


The bill, passed by the Senate last year, authorizes Tennessee to join a “health care compact” of states. Each would then take over administration of federal health care programs, including Medicare, along with about $11 billion in federal funds involved for coverage of Tennesseans on the program – subject to approval of the U.S. Congress.
Pody repeatedly declared the move as “just giving us another option” to federal control of health care, should Congress agree. He said congressional approval is doubtful.
Democrats criticized the idea at length.
“This is dangerous legislation,” said Rep. Gary Odom, D-Nashville. “If I was on Medicare right now, I’d be scared to death.”
Odom said that Congress, especially if controlled by Republicans, might well decide, “if those folks in Tennessee think they can manage Medicare better, let’s cut them a check.”
That, he said, would leave Tennessee with a mammoth administrative and financial undertaking without expertise or experience.
House Democratic Caucus Chairman Mike Turner of Nashville said Tennessee, in handling the TennCare program, had gone through a period of “almost bankrupting the state” and periods of cutting back by cutting people off from benefits. That experience bodes poorly for the state’s ability to take over Medicare, he sadi.
Turner asked Pody whether a state takeover could lead to state decisions to “cut people off of Medicare” and whether he would personally favor cutting Medicare.
“That has nothing to do with this bill. I have no idea,” replied Pody.
Rep. Joe Armstrong, D-Knoxville, also said the state should focus on fixing TennCare, where it shares funding and administrative responsibility with the federal government, rather than embarking on a takeover of the Medicare system. He said costs could run higher than proponents of a takeover expect.
The bill envisions federal funding coming to the state to cover all the costs. Legislative staff estimates it would cost about $52,000 in state fund to go through the paperwork of joining a compact.
Odom said that a national lobbying effort on behalf of health care compact legislation had some initial success in states like Texas but has since been rejected by legislatures in other states where considered.
Pody said that, if the bill passes, the state will still have to decide whether to actually follow through by joining a compact of states. But Democrats said the language of the bill requires that Tennessee join a compact if the bill passes.
“The only thing this is going to do is ask Congress if we can do this,” said Pody. “If they say yes, then we move ahead. If they deny, it’s not going to cost us one penny.”

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