While joining other Republicans in attacking “Obamacare,” the Commercial Appeal notes that Tennessee’s GOP leadership trinity — Gov. Bill Haslam, Lt. Gov. Ron Ramsey and House Speaker Beth Harwell — maintains silence on whether the state should a key provision by expanding Medicaid eligibility.
Although Tennessee’s governor has said he opposed the Affordable Care Act and took heat for using the term “Obamacare,” the politically charged nickname for the law on his official taxpayer-funded website, he hasn’t signaled whether he would block an expansion of TennCare, the state’s Medicaid program.
Immediately after the Supreme Court ruling, Haslam issued a statement calling the court’s language on Medicaid “unanticipated” and “significant,” but he said “it would be premature to know the exact ramifications” on the state. As of Friday, the governor’s office had nothing to add on the issue, according to a spokesman.
Lt. Gov. Ron Ramsey, an outspoken East Tennessee conservative, has called the Affordable Care Act “insidious” and has vowed, like many Republicans, to help Mitt Romney get elected president in November so he can repeal the law. Ramsey, however, has not publicly opposed the expansion of TennCare.
Tennessee House Speaker Beth Harwell’s latest public statement on the Affordable Care Act last week indicated she, too, would need time to study the impacts of the court’s decision on Medicaid expansion.
“Over the coming months we will carefully study how this law impacts our state and what needs to be done,” Harwell said in a statement.
Under the Affordable Care Act, the federal government agrees to pick up the entire tab from 2014 to 2016 for expanding TennCare. It’s an offer that could be worth $11 billion from the federal government and could cover some 200,000 now-uninsured Tennesseans. But to get the money, the state would have to spend an estimated $716 million to $1.5 billion over five years, based on Congressional Budget Office projections.
All of these figures can change depending on who wins the White House in November. They can also change if political or economic winds shift in the future and the Affordable Care Act is changed, which could leave states with expanded Medicaid rolls but without the promised federal funds to cover them.
But if the Affordable Care Act is implemented as-is, it could bring 3,480 jobs, with $160.8 million in new wages and a total of $451.3 million of new money to Shelby County in 2014, according to a 2011 study by researchers from the University of Memphis. The newly insured would generate 145,194 more medical visits here in 2014 bringing more work to hospitals, doctors’ offices and health care providers, the study said.
Gordon Bonnyman, executive director of the Tennessee Justice Center, said the state doesn’t really have any choice but to expand TennCare. Should the state fail to expand the program, Tennesseans will, in effect, see their federal taxes used to subsidize expanded Medicaid programs in other states, he said.
Because the federal government matches state spending on Medicaid programs, expanding TennCare is a way to get more federal money. That’s why, for example, the state’s hospitals voluntarily agreed to pay an “enhanced coverage fee” to the state in the last few years to help draw those funds.
“Without the Medicaid expansion, hospitals will have neither the financial ability, nor the political will, to continue paying the assessment,” Bonnyman said. “Without the hospital assessment, the resulting loss of federal funds would have a devastating impact across state government and local governments.”