The second time was not a charm for Gov. Bill Haslam’s plan to provide coverage to low-income residents in the state.
The proposed Insure Tennessee again failed in committee last week, and local lawmakers said health care reform in the state could remain in limbo.
The legislation, Senate Joint Resolution 93, proposes to expand eligibility requirements for Medicaid, known as TennCare in Tennessee, and allow the state to use federal money to assist employees in purchasing company health insurance policies.
The bill died in a special legislative session called by Haslam in February and was reintroduced last month in the Health and Welfare Committee, passing by a 6-2 vote. The bill later failed by the same count in the Senate Commerce and Labor Committee.
State Sen. Randy McNally, R-Oak Ridge, who sits on the state health panel, was one of the two dissenting voices in the earlier vote and raised numerous concerns about the proposal, noting that TennCare has cost the state an average of $187 million in the last four years.
“It takes up the lion share of new revenue each year, and this is without expansion,” McNally said, noting that Tennessee has had a challenge in keeping down health care costs with the current system.
Proponents of the bill, including Haslam, have contended the plan will extend coverage to about 280,000 low-income residents, and hospitals across the state will contribute $74 million of Tennessee’s share as part of an increased assessment to assist in drawing down $2.8 billion in federal funding.
McNally disagreed with the latter part of the plan, noting that more than 65 state hospitals don’t pay an assessment.
The Insure Tennessee program, which would operate as a two-year pilot, would have been offered to employees who make below 138 percent of the federal poverty level, which amounts to about 2,555 people in Loudon County, 2,680 in Roane County and 3,282 in Monroe County, according to data collected by the Chattanooga Times Free Press.
After the second failed vote, the governor’s office expressed regret that the plan was not approved by the state commerce committee. If approved, it would have gone before the state’s finance committee and then to the full body, McNally said.
“The governor is disappointed in the vote but glad Insure Tennessee had a chance to be heard in two different Senate committees during regular session,” David Smith, a spokesman with Haslam’s office, said in a statement. “... He will continue to work to find a way to cover more Tennesseeans and address growing health care costs in the state.”
State Rep. Jimmy Matlock, R-Lenoir City, said he thought Insure Tennessee failed to get enough support in Nashville because of unanswered questions, “which left legislators really distrusting the federal government.”
Opponents have also been reluctant to support the plan because of its association with the Affordable Care Act.
“I think everybody universally wants to find a fix, there’s no question there’s got to be a way we can make this health care issue work for everybody,” Matlock said. “The challenge is government’s role was way overblown from the get-go.
“What troubled most folks that I heard from, the vast majority of people that contacted us said we don’t want anymore government intervention,” Matlock said. “We’re already way beyond deeply in debt, and we’ve got to somehow say, ‘No more debt’, and this put a lot of pressure on the fiscal side of things. ... Is it fair to the generation coming forward that we forever keep passing debt on to them?”
Matlock said some possible solutions to addressing health care in Tennessee included making people more responsible for their lifestyle choices like overeating, drinking and tobacco use, increasing insurance options and opening up the possibility for residents to purchase health insurance across state lines.
“With more choice ... the marketplace pushes down price,” he said, noting that health savings accounts also made a lot of sense.
“It’s probably not fair that we don’t have some form or way to say to people, ‘You’ve got to start living better’,” Matlock said.
McNally said although the Senate version of the bill is effectively dead, state lawmakers could take up a vote on a House version of the bill. McNally and opponents of Insure Tennessee have suggested a plan to provide health care funding through a federal block grant, and he said a grant proposal may be the only way health care reform in the state could pass muster.
“We’re having difficulty controlling costs in the current Medicaid program,” McNally said. “Once you’re in a hole, the first thing you want to do is stop digging.”
