The clock is ticking down on the next round of major health care changes.
But it’s still unclear whether 180,000 uninsured Tennesseans may be able to tap into new health insurance coverage through a TennCare expansion, and scant publicity has been given to the new online health insurance marketplaces available to state residents in October.
While Tennessee leaders have done much to criticize the law, they have had little to say about consumers’ preparedness — or lack thereof — for the changes set to take effect in just weeks.
Gov. Bill Haslam, announcing a new statewide health initiative in Chattanooga on Wednesday, did not once mention either the impact of the federal Affordable Care Act or one of the largest health care dilemmas facing the state: whether to expand TennCare under his proposed “Tennessee Plan.”
Afterward, Haslam said discussions are “ongoing” with the federal government about his proposal, which would put $1 billion a year in federal Medicaid money toward getting uninsured adults to buy private insurance on the federal health insurance exchanges. An “end of summer” deadline still is his goal, the Republican governor said.
“I hope to be in Washington sometime this month to hopefully push those discussions toward a little bit more clarity about the things we’d like to do and the things they’ll allow us to do,” Haslam said.
On Tuesday, Sen. Bob Corker, R-Tenn., told the Chattanooga Times Free Press that he foresaw the law damaging businesses and the economy. But he said that out of respect for state leaders, he was staying out of the debate on TennCare expansion other than vouching for Haslam’s plan to federal health officials.
He also had little comment about whether Tennessee’s online insurance marketplaces would be consumer-ready by October.
The Affordable Care Act requires every person to have health insurance or pay a fine. The online health insurance marketplaces are meant to be a one-stop shop for people to buy coverage for themselves and their families.
Because leaders in Tennessee, Georgia and Alabama all left it to the federal government to set up and run the exchanges, rather than doing it themselves, all three states received tens of millions of dollars less in funding for outreach and education about the exchanges. While states like Kentucky, Arkansas and California — all which chose to run their own marketplaces— have informational websites up and running, government resources about the Tennessee marketplace are scant and scattered.
Tennessee and Alabama are getting 73 cents per person to help residents understand the Affordable Care Act and decide if they want coverage through a health insurance exchange, according to The Associated Press. Georgia is receiving even less. Arkansas, by comparison, which is setting up its own exchange, is getting $8 per person of those federal tax dollars.
On Tuesday, Corker did acknowledge that states could view the marketplaces as “an economic development tool,” depending on how they participated.
“On the other hand,” he said, “I think they just had so little details as to how it was going to happen. I think that maybe what they’re thinking is … ‘Let’s see how this is all going to work and maybe the state takes it over.’ I think that’s an option that still exists.”
Haslam said he decided to hand the marketplace over to the federal government based on a desire for an easier transition.
“We felt like given the difficulties of all the data that had to interface between the federal system and our system, that it would be smoother if they ran it. This is a massive undertaking that’s happening. As we get under way, let’s let them run it at first, it’ll make for a smoother process than both of us in the middle of the kitchen.”
But it remains to be seen whether that transition will be smoother. Gordon Bonnyman, director of the Tennessee Justice Center, said complex logistical relationships between the state and the federal governments remain to be worked out.
“We’re really behind the eight ball compared to states that are doing the exchange themselves,” Bonnyman said. “Most of the people who would benefit from the marketplace, don’t know that they stand to benefit from it.”
About $240,000 in federal money has gone to Hamilton County and Erlanger Health System to start enrollment education programs for the county’s 50,000 uninsured residents. Insurance companies have launched informational ads and websites, and nonprofits and advocacy groups have been busy.
“The volunteer communities are doing everything they can. If the government is not going to do it, we’re going to step up and try to make it happen,” said Walter Davis, director of the Tennessee Healthcare Campaign, who said volunteers are sharing information across the state daily.
“Everywhere we go there’s a high degree of interest, they want to know how it affects them personally. I think as we get closer, we’ll see a spike of interest.”
Contact staff writer Kate Harrison at firstname.lastname@example.org or 423-757-6673.