On hospitals providing funding for Haslam’s version of Medicaid expansion

The deal Gov. Bill Haslam struck with the Tennessee Hospital Association as part of his push to expand Medicaid in Tennessee is being closely followed by state leaders and hospital executives in other states that have rejected expansion, according to WPLN.

The deal was proposed to Haslam more than a year ago, according to Craig Becker, who heads the THA. Since Haslam’s unveiling, several of Becker’s counterparts in other Southern states have called him to explore whether it’s a model that can be replicated. The fact that Haslam now heads the Republican Governors’ Association shouldn’t hurt in terms of rallying support among other state leaders.

Months leading up to the announcement, Hospital lobbyists were imploring the governor to act behind closed doors, but because of all the program’s moving parts, including the Affordable Care Act waiver, receiving approval from federal officials took time.

During that time, however, uninsured patient bills were mounting, some hospitals in rural Tennessee were closing and the whole industry was feeling squeezed.

“We basically left over $800 million on the table in federal dollars. Which is a lot of money that could’ve done a lot of different things,” Becker said, referring to the year in which Haslam was deliberating about whether to accept federal Medicaid money tied to the Affordable Care Act.

“We’ve all been telling him, look, we’re stressed. Each individual hospital has come to him and said, look we’re gonna have to lay people off. We’ve seen layoffs. We’ve seen hospitals close. We’re not just crying wolf here,” Becker said.

… For years, hospitals have helped out the state’s TennCare program in the face of falling revenue by effectively taxing themselves in order to draw down federal matching money.

Instead of having to write-off the entire cost of care for an uninsured patient, the federal government would pick up 90 percent of the tab for the newly eligible, once the ACA is fully implemented. At first, the feds cover 100 percent.

Becker said uncompensated care was one of the major drags on rural hospitals and it’s what sent as many as 20 hospitals statewide on the financial brink — some counties even instituting a wheel tax in order to keep local hospitals afloat.

To the association, putting in the state’s portion was a no-brainer in terms of dropping the number of uninsured and letting the federal government pick up nearly all of the expense.