Haslam, TennCare Chief Unhappy With Latest Fed Medicaid Rules

Gov. Bill Haslam and his TennCare chief aren’t happy with the final federal rules on Medicaid expansion, saying they don’t provide the flexibility the governor wants on cost-sharing for enrollees, according to Andy Sher.
The “early read” on the 606-page set of rules, released July 5 by the federal Centers for Medicare and Medicaid Services, are “not encouraging,” but Tennessee is “still having discussions,” Haslam told reporters this week.
Haslam, a Republican, doesn’t want to expand the state’s version of TennCare, as envisioned in President Barack Obama’s Affordable Care Act, to additional low-income residents.
But instead of flatly refusing to participate, he wants to use the additional federal money intended for the Medicaid expansion to buy these adults’ way onto the federal health care exchanges where the uninsured can purchase private insurance.
The governor said he still holds out hope that federal officials will accept his “Tennessee Plan” that includes higher cost-sharing for people under 100 percent of the federal poverty level than the new rules allow.
“It’s awfully early to get down,” he said.
TennCare Director Darin Gordon said the state still is sorting through the rules. But he noted “some of the early takeaways” are the added flexibility on cost-sharing Tennessee is seeking isn’t there.
The Haslam administration was looking for more flexibility in “nominal” charges on care that officials hope to use to shape enrollees’ use of services and lifestyle choices.
“What they did was basically finalize what they put out in January,” Gordon said. “If you’re trying to read between the lines, it doesn’t seem to indicate they are interested in being flexible beyond what they set out in the Jan. 22 rule. This is a final rule.”
Still, Gordon said Tennessee and several other states interested in the same approach “will have some discussions” with federal officials
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