Legislation setting the stage for a state take over of Medicare and other health care programs from the federal government failed in a House committee Tuesday with four Republicans joining Democrats to vote against it.
The vote on the Health Care Compact Act (HB536) came out as a 9-9 tie in the House Insurance and Banking Committe, which means the bill was defeated under House rules. A similar measure failed on the House floor in the last hour of the 2012 legislative, getting 45 of the necessary 50 votes with several Republicans absent or abstaining.
Last year, no Republican voted against the bill. On Wednesday, however, House Finance Committee Chairman Charles Sargent, R-Franklin, led a round of critical questioning of the measure and its sponsor, Rep. Mark Pody, R-Lebanon.
“This scares me to death,” said Sargent at one point, contending the measure opens the door for Tennessee to lose funding from the federal government for TennCare and Cover Kids, a program providing health insurance for children in low-income families.
Both those programs are operated by the state with most the funding coming from the federal government, which also imposes many rules. The bill envisions the federal government turning over other programs as well – including Medicare but not including veterans health care – and nonetheless giving states federal funds along with all management responsibilities.
Sargent asked Pody what the federal matching rate for those two programs is currently and whether it would change. Pody did not know, but the bill makes no policy decisions and separate enabling legislation would be adopted in future years if Tennessee moves to a takeover.
Sargent said the state now gets $3 federal for each state dollar in Cover Kids, a rate more favorable than most states, and roughly a $2 for $1 match in TennCare.
“If it does nothing like you say, why are we putting something on the books?” said Sargent, saying the state could simply send a letter to federal officials or adopt a legislative resolution petitioning. “We’re going open-ended into something not knowing what we’re doing.”
Pody said passage of the bill would give the state “as many options as possible” for dealing with health care in the future. He repeatedly stressed that specifics would be left to further legislation and the state could withdraw from the compact later. Nine states have passed legislation to join a Health Care Compact.
— Note: This updates and replaces previous post.
Tennessee legislators this year are calling for a broad array of limitations on federal government authority within the state, a movement that the speakers of the House and Senate say reflects growing concern within the Republican supermajority.
“The number of bills (filed) indicates that this is a Legislature that firmly believes in states’ rights,” said House Speaker Beth Harwell. “The federal government is not running properly and state government is. … That is the driving force.”
But she and Senate Speaker Ron Ramsey, who ran for governor in 2010 under the theme “Give Washington the boot,” say they are still studying the pile of bills asserting states’ rights in one way or another and are not ready to declare support — or opposition — to specific proposals.
Ramsey said he has misgivings about some measures declaring that federal laws violating the Constitution are void in Tennessee. The threshold question, he said, is who decides what is unconstitutional.
“The last thing you want is some rogue sheriff out here deciding what’s unconstitutional,” he said.
Some proposals call for the Legislature to decide, notably including the Tennessee Balance of Powers Act (SB1158) proposed by Sen. Mae Beavers, R-Mount Juliet, and Rep. Judd Matheny, R-Tullahoma. It would create a joint House-Senate committee to review federal laws and executive orders and recommend to the full House and Senate those that exceed the federal government’s constitutional authority. If the full House and Senate agree, the bill declares that those laws will be null and void within the state.
Andrea Zelinski talks with Debra Maggart about the ramifications of the former House Republican Caucus chair’s defeat at the ballot box in the August GOP primary. Excerpts from a recommended read: “You could argue that I took a lot of bullets, in my position as caucus leader, for the caucus. And that was my job, and I did it,” said Maggart.
“No pun intended on bullets.”
…”All the lobbyists, all the special interest groups, have learned that if you just marshal enough and want to take one person out, you can,” she said.
“They’ve coined a new word called ‘Maggartized,’ ” she said. “If you don’t do what they want, they’re going to Maggartize you.”
That fear reveals something of a crack in the legislative Republicans’ armor as the party grapples with satisfying large swaths of business leaders and small business owners, the philosophical tea party groups disinterested in going along with the GOP’s political strategy — and everyone in between.
“I always said I just didn’t believe that people send us down here for any lobbying group, whether it’s for — I don’t know — any group, to use fear and intimidation to get their way. That goes against the very thing the Tea Party says all the time they’re against. It was just really a strange situation how all of that played out, that the gun lobby would turn on their friends. And they did,” she said.
To Maggart, the political realities of keeping happy an ever-widening Republican base apply not just to the guns-in-lots bill. The opportunities are great for other Republicans thinking long-term on the Hill to lose their seats when those in the far-right wing of their party pin members in uncomfortable positions.
Take former Metro Councilman and state Rep. Jim Gotto. He narrowly lost his bid for re-election to the state House last month to Democrat Councilman Darren Jernigan, a defeat Maggart contends could have been avoided had he not been pressured to vote for a tea party-driven health care compact bill.
The legislation as written, which Maggart said “didn’t do anything,” would ask the federal government to let Tennessee build its own health care program with other states, sending a message to the feds that the state was rejecting the Affordable Care Act. While demanded by tea party groups, the legislation gave fodder for urban Democrats to accuse Gotto of endangering the health benefits of seniors.
“We kept telling that group, the tea partiers, this is what’s going to happen with this bill,” said Maggart. “At the end of the day we had it on the House floor, and it died. I voted for it, but it died. It is one of the reasons why Jim Gotto lost. We lost a good House member because of different factions not listening.”
The risk of interest groups leveraging their power to bend lawmakers to their will has other ripple effects throughout the caucus. Take the $155,000 her campaign shelled out trying to keep her, an incumbent, in office.
“I hate it that we spent so much money on me,” she said, “when we could have spent it to protect Jim Gotto or to have helped a [Goodlettsville Republican] Charles Williamson get elected, or [Nashville Republican] Ben Claybaker.”
— UPDATE: Maggart continues her critique of the NRA in a video interview with the Huffington Post.
The state Democratic Party is criticizing Republican legislative candidates around the state for supporting a proposed Health Care Compact, which envisions a state takeover of all federal health care programs.
Brandon Puttbrese, communications director for the party, said similar news releases on the Republican-led effort in the Legislature are being sent to all districts where Republicans are running.
Here’s the start of the release targeting Rep. Steve Hall, R-Knoxville:
” Mitt Romney and Paul Ryan aren’t the only politicians with a plan to end Medicare as we know it. Earlier this year, Rep. Steve Hall co-sponsored a measure that would eliminate Medicare’s guaranteed benefit for 800,000 Tennessee seniors and force them into TennCare.”
The release then quotes Puttbrese as saying Hall “will try to distort his anti-senior record, but it’s time he explained why he would want to eliminate Medicare’s guaranteed benefit for Tennessee seniors and force them into TennCare… In times like these, extreme entitlement reforms that increase health costs and cut benefits for Tennessee seniors should be off the table.”
Several Republican state lawmakers plan to renew their push next year for a multistate “health care compact” that, if approved by Congress, could lead to Tennessee taking over most federal health programs, including Medicare, operating in the Volunteer State.
More from Action Andy Sher: Citing this week’s U.S. Supreme Court decision upholding the federal health care law, the lawmakers said the time is ripe for the bill, which failed on the last day of this year’s legislative session.
“I hope we can pass the Health Care Compact next year in Tennessee, and I look forward to working with Rep. [Linda] Elam, Rep. [Mark] Pody and other conservative lawmakers who hope to lower health care costs and raise quality in an efficient and constitutional manner,” Sen. Mae Beavers, R-Mount Juliet, said in a news release.
Republicans began pushing the bill in 2010 as a way to get out of President Barack Obama’s Affordable Care Act. It would require permission from Congress to do. Proponents said a state-based solution was preferable to a federal system that was already unwieldy.
The bill would authorize Tennessee to join a health care compact for states interested in crafting their own health care policies, which would supersede federal law.
Each state would receive a federal block grant covering programs such as Medicaid, the jointly funded state and federal health program for the poor. Tennessee’s Medicaid program is called TennCare.
…Senate Majority Leader Mark Norris, R-Collierville, raised the compact issue this week as he attacked the Supreme Court decision, which upheld an individual mandate requiring Americans to obtain private or employer-based insurance or, if eligible, a government-sponsored program.
“Perhaps next year our efforts to enact the Health Care Compact will finally succeed,” Norris said.
The court ruled as unconstitutional a provision requiring states to participate in a major expansion of Medicaid programs like TennCare. But it allowed the expansion to proceed, giving states the choice of whether to participate.
Republican Gov. Bill Haslam, who is still sorting through the implications of Thursday’s Supreme Court decision, wasn’t so sure creating the compact is the right idea. He has supported federal block grants for Medicaid.
“I don’t know that we have both the means or the ambition to take over all federal health care in the state,” Haslam said Friday. “I think there would be some cost concerns.”
Gordon Bonnyman with the Tennessee Justice Center, which advocates for the poor on health care among other issues, predicted the compact will never pass.
He said all it would take is one solid ad by Democrats, “saying, ‘Yo, Medicare beneficiaries, do you want to be enrolled in TennCare and have TennCare govern your health care?’ You can imagine the reaction. That’s what that compact would be.”
The legislative financial analysis of the bill was “very clear” that the measure would give Tennessee control over Medicare, Bonnyman said. Republicans should be wary about upsetting Medicare beneficiaries, who include the middle class and the wealthy, he said.
“It [bill] is the only thing that could restore a pulse to the Tennessee Democratic Party — and not only restore its pulse but get it up on its feet prancing around,” he quipped.
NASHVILLE, Tenn. (AP) — A proposal that would allow Tennessee to join an interstate compact challenging the federal health care law has failed in the House.
The chamber voted 45-26 along partisan lines to approve the bill sponsored by Republican Rep. Mark Pody of Lebanon. But that was five votes short of the majority needed to pass measures in the 99-member chamber.
The legislation would provide a waiver for each participating state to create its own health care system. Sponsors say the proposal is intended to give Tennesseans more choices concerning health care if the compact were approved by Congress.
The House had earlier approved a change to make Tennessee’s participation in the compact optional. That provision was taken out in the Senate.
Twenty-eight members were either absent or abstained on the vote.
— Note: All 34 Democrats either voted against the bill or did not vote. Three Republicans formally abstained, three more were officially excused and absent and 12 did not vote.
A comment from Sen. Mae Beavers, R-Mount Juliet, who sponsored the bill to passage in the Senate: “I’m disappointed that people played games down to the end.”
She said the games were played by Democrats with re-election campaigns in mind and “apparently it worked with some people.”
House Democrats today succeeded in attaching several amendments to a bill that lays the groundwork for Tennessee taking over federal health care programs, throwing a cloud over whether the proposal can win final approval in a frantic push to adjourn the 107th General Assembly.
The first successful Democrat-sponsored amendment declares that Tennessee will not participate in the Health Care Compact, “if participation includes expanding abortion rights, especially late term abortion.”
Republican Rep. Mark Pody of Lebanon tried to table, or kill, that proposal – as he had successfully done with earlier Democrat amendments. But only 35 representatives backed him, so the effort failed. The amendment was then adopted.
From there, Democrat-sponsored amendments were approved to declare veterans health care benefits could not be impacted by the Health Care Compact; that senior citizens and the disabled would be “held harmless” by any compact actions; and that nothing in the compact should be seen as supporting “any United Nations health plans.”
And, finally, House Democratic Caucus Chairman Mike Turner proposed that the line in the bill (SB326) declaring Tennessee “shall” become a member of the Health Care Compact be changed to “may” become a member. That, of course, would appear to negate the entire bill. But that amendment, too, was approved.
The measure now returns to the Senate for concurrence -or non-concurrence – on the amendments.
Legislators are again trying to wrap up the 107th General Assembly today.
Legislation that lays the groundwork for state government taking over the federal Medicare program in Tennessee was approved Wednesday in a House committee where it stalled last year.
Five Democrats on the House Health and Human Resources Committee voted against the Health Care Compact bill, HB369. All 11 Republicans voted for it.
Rep. Mark Pody, R-Lebanon, who took over sponsorship of the measure this year, began his presentation in support of the bill with a video tape, saying “I have somebody on screen who can help me” with passage of the bill. The video showed President Obama saying that he is “open to states coming up with their own ideas” for health care reforms.
Some of the buzz-word bills – “guns in cars,” school vouchers, “don’t say gay,” Health Care Compact – were more or less tossed overboard by the Republican majority last week to lighten the load in rush to end to this year’s legislative session.
The measures join other buzz word legislation – wine in grocery stores, birther bills, the nullification bill – in the trash bin of the 2010 session. There are suspicions that still more – “guns on campus,” for example – are soon to meet a similar fate. Of course, they can be recycled next year.
Meanwhile, most of the bills that are aboard the Republican railroad have either been already passed into law or are positioned for approval within the next week or two on party-line votes. Even with some time allotted for Democratic grumbling along the way.
The much-debated Health Care Compact bill, which envisions Tennessee state government taking over federal Medicare and Medicaid programs, was quietly shelved for the year today in a state House Committee.
“It’s just going to have to wait until next year,” said Rep. Glen Casada, R-College Grove. “Time has caught us.”
The lead House sponsor of HB369, Rep. Mark White, R-Memphis, was absent Wednesday after the death of his mother, Peggy Ruth White, 82. Casada said that White’s absence and the push to close down legislative committees combined to make shelving the controversial bill for the year prudent.
“It’s just a matter of unfortunate events,” he said.
Casada made the motion to put off further consideration of the measure in the House Health and Human Resources Committee, which adopted the motion on voice vote. The bill had already cleared committees in the Senate and awaited a House vote.
The bill proposes that Tennessee join other states in creating a Health Care Compact, which would take over all federal health care programs and the money to pay for them. It would require congressional approval.
Casada noted that the compact, as envisioned, would not take effect for at least two or three years, so delay on enactment of the bill until next year would not hurt the cause.
Some Republican leaders, including Lt. Gov. Ron Ramsey and House Majority Leader Gerald McCormick, said last week that the compact legislation was not a priority.
McCormick voiced doubt that it would ever become reality, though it was an important symbolic gesture to some lawmakers. The idea also had considerable support among Tennessee tea party members.
“I don’t think it’s a real issue. It’s not going to happen,” McCormick told reporters last week. “Congress is never going to go along with that.”