Haslam to Announce Medicaid Expansion Decision Wednesday

By Erik Schelzig, Associated Press
NASHVILLE, Tenn. — Republican Gov. Bill Haslam will address a joint session of the Tennessee General Assembly on Wednesday about his decision on whether to expand Medicaid to cover more uninsured people under the federal health care overhaul, according to a person familiar with the plans.
Lawmakers plan to authorize the gathering during regular floor sessions Wednesday morning, the official told The Associated Press on the condition of anonymity because the joint assembly hadn’t yet been publicly announced.
The governor’s office did not immediately return messages seeking comment, though Haslam’s spokesman recommended reporters attend the House floor session at 9:30 a.m. CDT.
Haslam hasn’t indicated whether he’ll recommend expanding TennCare, the state’s Medicaid program, with the federal government paying the entire cost for the first three years and at least 90 percent thereafter.
“This is an incredibly complex issue,” Haslam told reporters earlier this week. “Every day I learn something new about the law, about its impact on Tennessee, about its impact on local governments, about its impact on businesses.”

The expansion is estimated to cover roughly 140,000 uninsured Tennesseans and bring in $1.4 billion in federal money in the first year. The hospital industry has called expansion crucial to boosting jobs in that sector, and has warned that declining the money could cause some rural hospitals to go out of business.
But the prospects of getting the Republican supermajority to agree to an expansion of President Barack Obama’s signature law could prove daunting.
“The politics of it are difficult,” Haslam said. “And we’ve recognized that from the very beginning.”
Haslam said his administration was working to the “last minute” to work through the various scenarios with federal government.
“Ultimately we have to be convinced it’s the right thing for Tennessee and we’re not taking on a lot of added burden that’s going to cost us down the road,” Haslam said.
A study commissioned by the AARP estimates that the state’s participation in Medicaid expansion would result in $9.4 billion in direct federal funding through 2019, while the state’s share would be about $315 million.
The report says that federal money would result in additional production of goods and services valued at $17.6 billion and wages, salaries and benefits worth $7.9 billion. The study calculates there would be a nearly $30 return for every state dollar spent on expanding Medicaid.
But skeptics have cited the state’s experience as a pioneer in expanding Medicaid to cover the uninsured back in the 1990s. Federal funding for that expansion was cut after the White House and governorship changed hands and ballooning expenses set off incendiary fights over taxes that reshaped the state’s political landscape.
Haslam’s predecessor, Democrat Phil Bredesen, in 2005 cut 170,000 adults from the TennCare rolls and reduce benefits to thousands more. It was an acknowledgment that the state had given up on expanding Medicaid and would revert toward the traditional approach of covering only poor women and children.
Haslam has said he has been pouring over the deals struck by other Republican governors who have decided to pursue Medicaid expansion, and said would want maximum flexibility for Tennessee under an expansion.
The governor vowed not to be swayed by political considerations, though his previous decisions not to pursue either a state-run health insurance exchange or a joint one with the federal government hewed closely to the ideological preferences of federal Republicans in the Legislature.
“You’re elected to try to make the hard decisions on the big issues,” Haslam said. “And there’s no question that health care is as big an issue facing Tennessee and the country as there is.”

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