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VOL. 39 | NO. 13 | Friday, March 27, 2015

Haslam undaunted by difficult prospects for Insure Tennessee

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NASHVILLE (AP) — Gov. Bill Haslam said Thursday that he is willing to risk a second defeat of his Insure Tennessee proposal to highlight the need for improving health standards in the state.

The Republican governor told reporters after a prayer breakfast at Lipscomb University that the more often lawmakers take up his plan, the more chances his administration has to quell concerns about the proposal to extend health coverage to 280,000 low-income Tennesseans by drawing down $2.8 billion in federal Medicaid funds.

"I don't think it's a bad thing at all for it to be discussed every chance that it gets to be discussed," Haslam said. "Obviously we're hoping it passes, but if it doesn't pass, there's still that much more airtime for the issue and for people to understand it."

Haslam's original proposal failed in a special legislative session last month, but has been revived by a Democratic lawmaker in the Senate. The resolution sponsored by freshman Sen. Jeff Yarbro of Nashville was approved by the Senate Health Committee on a 6-2 vote on Wednesday evening, but faces tough prospects at its next stop in the Senate Commerce Committee.

"It's going to be tough sledding," Senate Speaker Ron Ramsey, R-Blountville, said after the breakfast. "I'm not going to try to sway them one way or another. I just want everyone to vote their conscience."

The revived proposal incorporates three new elements to address concerns raised by lawmakers during the special session. They include adding a "lockout provision" for enrollees who repeatedly fail to pay premiums; assurances from Haslam not proceed if the U.S. Supreme Court rules against federal health insurance marketplaces; and requirements for the federal government to guarantee that Tennessee can drop the program if it ends up being more expensive than planned.

"This is a complex and difficult issue that a lot of people have a problem with," Haslam said. "I think we have answers to all those problems, whether it be: 'Will it really cost the state anything? No. Can we get out of it? Yes. Can this improve health outcomes? Yes.'"

The governor added that the renewed effort also removes concerns some lawmakers raised about running the proposal in a special session apart from the budget process. "Well now we have a chance of discussion during a regular session," Haslam said.

Hospitals have agreed to cover the $74 million state share to draw down the federal Medicaid money, but many Republicans are still wary of the political implications of supporting a key element of President Barack Obama's health care law.

Under a 2014 state law supporters dubbed the "Stop Obamacare Act," Haslam must seek legislative approval before striking an agreement with the federal government on Medicaid expansion. Tennessee lawmakers have been joined by counterparts in Wyoming and Utah in rejecting Republican governors' Medicaid expansion proposals this year.

Those outcomes stand in contrast to the experience of Indiana's Republican Gov. Mike Pence, who didn't need legislative approval for his Medicaid expansion deal with the federal government in January.

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