published Thursday, February 7th, 2013

Senate GOP delays bill to ban Medicaid growth

NASHVILLE — Republican lawmakers are putting the brakes on a bill seeking to bar Tennessee from expanding Medicaid under the federal health care law.

Senate Speaker Ron Ramsey of Blountville announced the move at a legislative preview session Thursday hosted by The Associated Press and the Tennessee Press Association. He said he persuaded fellow Republican Sen. Brian Kelsey of Germantown to park his bill to block the expansion.

“It was on notice yesterday, and not on notice today, OK?” Ramsey said.

Ramsey remains skeptical about whether Tennessee should participate in growing the program known as TennCare in the state, but said he doesn’t want to preclude the governor from examining all angles before making a decision.

Haslam said he’s “seen some growing flexibility” in the U.S. Health and Human Resources Department about which services the state would have to cover among the expanded TennCare population. He also said he wants to check with other Republican governors who have recently decided to pursue an expansion in their states.

“We’re trying to go back to them and say specifically, what do you know now that you didn’t know before?” he said. “I don’t know if they’ve gotten any special deals yet. We’re trying to find that out.”

Expanding Medicaid eligibility to 138 percent of poverty could add an estimated 145,000 people to the TennCare rolls. The federal government would pay for all of the increased costs under the expansion for the first three years, and phase down its share to 90 percent after that — still well above the average 60 percent share it currently covers for Medicaid.

Kelsey, the chairman of the Senate Judiciary Committee, said in an earlier panel discussion that he doesn’t believe the federal government will keep its word on funding no less than 90 percent of the added costs.

“The 90 percent matching rate will likely be one of the first places the federal government looks to cut its spending,” he said.

Kelsey said if the federal government can’t meet its obligations, Tennessee could be forced to cut people from the TennCare rolls — just as it did in 2005 amid escalating TennCare costs.

“I don’t want to be put in a situation where I have to do it again, to be forced to take away health insurance from people that we have promised it to,” he said.

But Gordon Bonnyman, executive director of the Tennessee Justice Center, rejected arguments that it was better not to add people to the TennCare rolls than to have to drop them three years down the road.

Bonnyman presented a hypothetical situation of someone who has been diagnosed with cancer.

“Go to one of these people ... and say, ‘Here’s the deal: We know we can cover you for three years totally at federal expense, but we may have to cut you off at the end of that. Are you willing for us to put you through the trauma of cutting you off after three years?”’

“I think you can answer that question fairly clearly,” he said.

Tennessee Hospital Association President Craig Becker said his group supports an expansion because the added federal money would offset reductions in reimbursements.

Without Medicaid expansion, hospitals and the state’s health sector are projected to lose up to 90,000 jobs over the next decade, Becker said, with rural hospitals being particularly vulnerable.

But Kelsey was unimpressed by Becker’s comments.

“Look, my job is not to bail out the special-interest hospital lobby,” he said. “My job is to represent Tennessee taxpayers. I do not represent Tennessee hospitals.”

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