Medicaid Expansion to be Blocked by Doing Nothing?

Sixteen Republican state senators declared their support last week for legislation to prohibit expansion of Medicaid in Tennessee, but Senate Speaker Ron Ramsey says it’s likely there will be no action on the controversial subject in the 2013 session.
Sen. Brian Kelsey’s bill, refiled in the Senate in an updated version that matches the House bill (HB82), has 15 co-sponsors. Ramsey is not among them, though he is outspoken in declaring opposition to Medicaid expansion, which is permitted but not required under a U.S. Supreme Court decision on the federal Affordable Care Act, better known as “Obamacare.” The House bill by Rep. Jeremy Durham had 21 co-sponsors.
Gov. Bill Haslam has asked legislators to wait until he has studied the matter and Ramsey said that’s fine with him, though it’s almost certain the governor will study the matter until past adjournment of the 2013 legislative session — April 19, if legislative leaders meet their goal. The bill would pre-empt Haslam’s decision, effectively deciding “no” without him involved.
But inaction means no expansion, Ramsey explained to reporters, because legislative approval is needed to expand the rolls of Medicaid, which operates as TennCare in Tennessee.
“There’s no time line whatsoever,” Ramsey said. “We could hold off a year and see how other states do, how it’s working out.” Tennessee could wait until 2015, he suggested, as a “hypothetical.”
In his “State of the State” speech last week, Haslam said that he is “hesitant” to go along with expansion of a program “already eating up so much of our budget.”
“But I also understand that the decision isn’t just as easy as standing here today and saying, ‘We’re not going to expand Medicaid,’ ” the governor said. “There are hospitals across this state, many of them in rural communities, that are going to struggle if not close under the health care law without expansion and that’s not something to take lightly.”
Ramsey said he is skeptical of hospital claims, though acknowledging some hospitals will be “left in a lurch” and “that’s what makes this decision tough.”
“Hospitals are notorious for inflating numbers over what the truth is,” the lieutenant governor said, adding “hospital math has always puzzled me” because some facilities “lose money for five years in a row and are still in business.”
House Minority Leader Craig Fitzhugh and Senate Democratic Caucus Chairman Lowe Finney, meanwhile, have filed a bill (HB290) that would grant the governor authority to expand Medicaid. The measure has no co-sponsors so far, according to the Legislature’s website.

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