Haslam unveils health care reform plan, says ‘no’ to Medicaid expansion

Tennessee Gov. Bill Haslam on Wednesday said he will not expand TennCare rolls under the Affordable Care Act.

Instead, the governor said, he wants to use federal dollars as part of a plan to purchase private health insurance for Tennesseans who would not otherwise have access to coverage.

In a Wednesday press release, Haslam called his plan “real health care reform.”

The governor said he will not ask the General Assembly for approval to accept Medicaid expansion federal funds as he “continues to work for the flexibility needed to implement his plan.”

Haslam told the General Assembly in Nashville that the federal government has not agreed to some aspects of his “Tennessee plan,” the Knoxville News Sentinel reported. Legislation that would block any Medicaid expansion in Tennessee had been scheduled for hearings Wednesday.

“Tennessee has shown the nation how to produce true reform in education, based on students’ results and educational outcome,” Haslam said in the press release. “We’re beginning to do the same thing with reforming government service—again by measuring outcome and results rather than just years of service as a state employee. I believe Tennessee can also be a model for what true health care reform looks like; reform that will take significant steps to save the state and the nation from the unsustainable path we are on now.”

The governor said his plan would:

• Use available federal dollars to purchase private health insurance for Tennesseans up to 138 percent of the federal poverty level who don’t have access to health insurance, which would translate to 175,000 more insured Tennesseans;
• Allow co-pays for those who can afford to pay something;
• Include a definitive “circuit-breaker” or “sunset” of the plan that could only be renewed with the General Assembly’s approval; and
• Reform the payment structure for providers so they are compensated for health outcomes, not just based on services performed.

“Hospitals and medical providers have put a lot of sincere effort into working with us toward payment reform,” Haslam said. “I cannot emphasize enough how much I’ve been impressed with our hospitals’ willingness to work with us. To succeed, we also need cooperation from the Department of Health and Human Service, and we can’t get the same assurances from them at this point. Until we get those assurances, I cannot recommend that we move forward on this plan.”

The governor had earlier rejected setting up a state-based health care exchange and participating with the federal government in establishing an insurance exchange. Exchanges are online markets required under the Patient Protection and Affordable Care Act of 2010, which is often referred to as Obamacare by critics.

The exchanges will give consumers a place to buy individual private policies and apply for government subsidies to help pay their premiums, the Associated Press reported last month. Haslam’s decisions on the exchanges means Tennesseans will participate in an exchange completely run by the federal government, the AP said.