A plan to expand healthcare coverage in Tennessee failed Wednesday in the state Senate.
State Sen. Janice Bowling was a member of the Senate Health Committee that voted 7-4 to defeat Gov. Bill Haslam’s plan called Insure Tennessee. Bowling was one of the seven senators who voted against it.
“There was a lot of rhetoric surrounding this plan, but the rhetoric did not match up to reality,” said Bowling, who represents Warren County as part of her seven-county district. “This was something I studied and studied. The more I looked at it, the more I realized it wasn’t going to solve the problems it set out to solve.”
The plan was touted as a way to extend the state’s Medicaid coverage to 280,000 low-income Tennesseans. These were described as the working poor – people who are working 40 hours a week, but stuck in low-wage jobs that make health insurance unaffordable.
In expanding coverage to these residents, it was stressed they would have a co-pay for every medical visit and the state could opt out of the plan if it became too expensive. These are items Bowling says the governor’s plan couldn’t guarantee.
“By federal code, you can’t suddenly kick them off once they are in the program," said Bowling. "We couldn’t just opt out. We would have to serve them and that was one of the more compelling arguments for not accepting the plan. We also couldn't require them to have a co-pay, which was a major part of it too.”
State Rep. Kevin Dunlap said he was disappointed the healthcare proposal couldn’t make it out of committee and be debated on the full House and Senate floors.
“We have a lot of people who are working for $8 an hour who really could have been helped with healthcare,” said Dunlap, who serves Warren County as part of his three-county district. “When you’re only making $16,000 a year, you can’t afford healthcare that might cost $700 or $800 a month. I think the governor put together a pretty savvy deal. It might have been a model for the nation.”
Dunlap said the plan would have used no Tennessee tax dollars, while state residents would have received the benefit of over $1 billion in healthcare coverage. He says that money will now be going elsewhere.
“We’re not getting that money back for Tennesseans and that’s $1 billion with a ‘B,’” said Dunlap. “Now it’s going to Kentucky, California, New York and other places to pay for the working poor in those states to have healthcare.”
Bowling said the program would have led to out-of-control spending. She said it was initially presented as a way to cover an additional 200,000 residents, but that number quickly jumped to 280,000. She said 400,000 could be a more realistic estimate, which would have created problems similar to 10 years ago when former Gov. Phil Bredesen had to remove thousands from the TennCare rolls.
“It’s not like there’s $1 billion in a box up in Washington with Tennessee’s name on it,” said Bowling. “This was deficit spending.”
Dunlap said Insure Tennessee would have benefitted an estimated 30,000 veterans of the Iraq and Afghanistan wars who are living in Tennessee without healthcare. It would have also been a boost to hospitals like River Park, which are providing uncompensated care. Dunlap said River Park delivered $9 million in uncompensated care last year.
However, Bowling said the money would not have trickled down to many of the state’s rural hospitals. She said 85 percent of it was earmarked for the state’s four teaching hospitals, which are all in urban areas.
State Rep. Judd Matheny, who represents Warren and Coffee counties, said the governor's plan didn't meet its claims when put to the test.
"It was an ill-conceived plan that was poorly presented," said Matheny. "There was a lot of propaganda and a lot of inaccuracies. I think the breaking point came when the state's fiscal office came out and said this would require an extra $100 million in state spending the first two years. The governor had said again and again there would be not state tax dollars in this. When the governor is not accurate with his facts and figures, that killed it."
Matheny said he is still very interested in crafting a healthcare plan that will help both Tennesseans and healthcare providers. He said he realizes rural hospitals are struggling with the burden of uncompensated care and would like to resolve that issue.
Gov. Haslam spent nearly two years talking with federal officials in crafting his plan. The measure was defeated in a special session of the General Assembly and could still be brought up during the regular session, which begins Monday. Haslam says he is unsure what his next step will be.
Indiana last month became the 28th state to expand Medicaid under President Barack Obama's health care law, and the 10th initiated by a Republican governor.
Politicians react to healthcare bill failing
NASHVILLE (AP) — Reactions to the defeat of Republican Gov. Bill Haslam’s Insure Tennessee to extend health coverage to 280,000 low-income residents:
“We still have health care cost issues that haven’t gone away, so I don’t know what the next step looks like. But I think people elected us to answer problems and to come here to make a difference. And we’ve got to figure out a way to do that.”
— Gov. Bill Haslam
“Ultimately, the absence of a clear, written agreement between the federal government and the state of Tennessee made passage impossible. ... We could not in good conscience put our stamp of approval on a mere verbal agreement with the Obama administration.”
— Lt. Gov. RonRamsey, R-Blountville
“When 280,000 Tennesseans are just hours away from getting insurance, Republicans get cold feet and walk away. This is an insult to Gov. Haslam, a betrayal of our constituents and proves Republicans are totally incapable of governing.”
— House Minority Leader Craig Fitzhugh, D-Ripley
“Tennesseans will die and hospitals will close as a result of our cruel state legislature. Rarely in state history have we seen such a devastating lack of leadership.”
— U.S. Rep. Jim Cooper, D-Tenn
“Ultimately, seven legislators made a decision that prevented the full General Assembly from having the opportunity to debate this extremely important issue. We are hopeful that members of the General Assembly will continue to consider ways for Tennessee to provide coverage to the hundreds of thousands of uninsured in our state.”
— Craig Becker, president and CEO of the Tennessee Hospital Association
“Foolish, foolish, foolish. Sad, sad, sad. Sick, sick, sick.”
— U.S. Rep. Steve Cohen, D-Tenn