Sen. Brian Kelsey, an avowed opponent of Gov. Bill Haslam’s Medicaid expansion plan, is questioning its reliance on a voluntary hospital assessment that would fund the state’s future share, citing efforts two years ago by U.S. Sen. Bob Corker to eliminate the widespread practice, reports the Chattanooga TFP.
“I question whether the federal government is a reliable negotiator,” said Kelsey, who then cited Corker’s bill and noted it sought to “abolish the hospital tax to be relied on” in Haslam’s proposal.
Haslam is trying to win approval of what he calls his “market-driven” two-year pilot project in a Feb. 2 special session of the GOP-dominated General Assembly.
If approved, the pilot project would be entirely federally funded through 2016 under President Barack Obama’s Affordable Care Act.
After that the federal share would decrease over time. By 2020, the state would bear 10 percent of the costs. But Tennessee hospitals, desperate to see the coverage, have agreed to pay the state’s share through expansion of an existing assessment.
That’s allowed Haslam to argue that his plan — which includes vouchers for workers to join employers’ health plans and a re-tooled version of TennCare that introduces measures to control patients’ costs and providers’ charges — “won’t cost Tennessee taxpayers another dime.”
Asked about Kelsey’s assertions, Corker, a close ally of Haslam who has praised the governor’s plan, said in a statement that “while I am opposed to the policy that allows states to utilize provider taxes and have introduced legislation in the past to eliminate it as part of a broader fiscal reform package, I assume governors will continue to take advantage of federal laws as they exist today.”
As for whether the senator plans to reintroduce legislation eliminating provider fees or taxes at some point, Corker’s office later said the senator “has no current plans to introduce stand-alone legislation to eliminate the provider tax funding mechanism.”
In 2013, Corker introduced a bill called the Fiscal Sustainability Act of 2013. It was a comprehensive debt-reduction bill pushing changes not only in Medicaid but in other entitlement programs such as Medicare and Social Security. It called for eliminating all health-care provider taxes or fees in 2023.
The bill, co-sponsored by Sen. Lamar Alexander, R-Tenn., went nowhere in the Democratic-controlled U.S. Senate. Republicans now control the Senate as well as the U.S. House, but Democratic President Barack Obama remains in office for another two years and likely would not allow such a measure to become law.
But if a Republican wins the White House in 2016 and Republicans still control Congress, it could be another matter.
A spokesman for Alexander, also a Haslam ally who recently welcomed the governor’s plan, issued a statement that indicated more flexibility on the provider funding question.
“Congress should pass the Corker-Alexander plan, or one like it, to address out-of-control entitlement spending and fix the federal government’s $18 trillion debt,” spokesman Brian Reisinger said in an email. “Senator Alexander believes Gov. Haslam deserves credit for working to create a plan that Tennessee can afford, and that determining how hospitals contribute to that plan is a state decision.”
Note: See also the Commercial Appeal story along the same lines.