Archive for the month “January, 2015”

‘We haven’t had that spirit here since 19(65)’

People had varying opinions going into the Senate Judiciary Committee on Tuesday. Some predicted it would be an informative discourse on Insure Tennessee.

But far more people did not think that.

Okay, here’s the rationale behind that camp. Members convened for the purpose of discussing the legal issues surrounding the governor’s health expansion plan. But, at that point, the resolution had not been introduced, and at this point, it’s still unclear whether this committee would even see this measure.

On top of that, Sen. Randy McNally (R-Oak Ridge) had posed several questions to Attorney General Herbert Slatery earlier this month. That list of questions was the only item on the agenda.

Then, one day before the meeting, Slatery issued the opinion on his website. He told me this was an intentional move by his office.

“We felt like it would be a benefit to the members,” Slatery said. “We think the way [the governor’s office] proposed [Insure Tennessee], there’s no legal obstacles to it.”

But the meeting moved forward.

Sen. Brian Kelsey (R-Germantown), the chairman of the committee, said several things in his opening remarks.

-Kelsey asked his fellow members to discuss legal issues – policies could be debated another time, he said.

-Kelsey voiced his concern that Tennessee taxpayers would be left paying for the plan if the federal government changes the rules involving Insure TN. The feds will fund the pilot program for the first two years, then hospitals have pledged to pick up the tab. Some Republicans have argued it just can’t be that simple.

-Then, Kelsey turned to classic rock.

“I’m concerned that this will be like the Eagles’ ‘Hotel California’, where you can check in, but you can never check out,” Kelsey said.

That’s when the sparks started flying – well, as much as sparks can fly in a committee meeting, at least.

Apparently, Sen. Doug Overbey (R-Maryville) thought they were all just prisoners there, but not of their own device.

“Ever since you called me a couple Sunday nights ago and mentioned this meeting, I have been wondering what the purpose of it is,” Overbey said. “And so far, it seems the purpose of it is to advance your opposition to Insure Tennessee.”

Overbey continued:

“Why are we reviewing a member’s request to the Attorney General for an opinion?…We now have it, we have that opinion, which to me, underscores as to why we are having this hearing.”

It should be noted now that Gov. Haslam announced yesterday Overbey will carry the legislation in the Senate.

Kelsey maintained he had legitimate questions about the legal issues. So he called on two experts to testify before members.

The first, Robert Alt, heads the Buckeye Institute, a public policy nonprofit. He previously worked at the Heritage Foundation, a conservative think tank.

Alt called the plan a “bad gamble for Tennessee,” claiming it’s foreseeable the feds would change the matching rates, leaving a tax burden on citizens.

This info seems contrary to what Gov. Haslam’s office is telling us. The state could drop the coverage expansion without hurting existing Medicaid dollars or financial penalty, according to a letter from Sylvia Burwell, the secretary of the Health and Human Services released Tuesday.

The second speaker, Vanderbilt professor James Blumstein, conveyed a milder reservation. He said the choice of discontinuing the program down the road, would be a “painful” decision. The ordeal would involve backing out of an expansion that deals with people’s lives, people’s health insurance. His bottom line to the committee? Wait. Talk to the feds. Learn more about this agreement.

One might argue that the AG opinion answered many of the questions that prompted the meeting in the first place. In general, I genuinely hope people glean something anytime they must sit through a three-hour meeting.

But on Tuesday, even if onlookers didn’t learn anything new after reading the opinion – at least one thing became a bit more clear: the true leanings of their lawmakers when it comes to Insure TN.

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The calm before the storm

We’re less than a week away from special session, and a lull has befallen the Capitol. Sure, a meeting has popped up every now and then, and more than a hundred bills have been filed. But this might be considered the calm before the storm – one which might unceremoniously end today.
Today the Senate Judiciary Committee will discuss the legal issues surrounding Insure Tennessee, Governor Bill Haslam’s health care proposal — his nessun dorma, if you will.
(You can read the agenda here.)
A slew of questions will be discussed. Most will involve whether the feds can legally change the funding structure of the program.
Gov. Haslam claims the feds will pay for the program 100% during the first two years. Eventually, the match drops to 90%, and hospitals have pledged to pick up the tab after that.
If either of those provisions change, the program apparently self-destructs and Tennessee can break its agreement. Lawmakers want to make sure that’s right, too. Gov. Haslam said “there’s a guarantee we can get out” as per the agreement with Health and Human Services.
It should be noted that Sen. Brian Kelsey (R-Germantown) heads this committee. He’s been one of the most ardent opponents of Medicaid expansion, someone who’s been openly dubious of Insure Tennessee.
Many a lawmaker have sparred over whether Insure Tennessee is true ‘Medicaid expansion’. The plan uses federal funds made available under the Affordable Care Act, otherwise known as “Obamacare.”
Gov. Haslam will spend the better part of this week urging people this is not Obamacare – at least that was his message last Wednesday at Jackson Madison County General Hospital.
Even he understands the task at hand.
“It will not be easy, I’ll be really honest,” Gov. Haslam told us. “Our task is to explain why this is the right thing and why it’s the right thing both financially and philosophically for the state.”
Obviously, some don’t buy it. As Justin Owen of conservative think tank the Beacon Center of Tennessee told me: “If it walks like a duck, and quacks like a duck, it is a duck.”
If it passes the legislature, Insure Tennessee would operate as a two-year pilot program.
Dueling reports/studies have emerged that either applaud Insure’s potential benefits or lambast its shortcomings. That slash indicates some people refuse to call either item scientific or legitimate.
A report conducted by Dr. William Fox of UT (and commissioned by a Medicaid expansion advocacy group) said the plan would reinvigorate hospitals burdened by uncompensated costs; pump millions of dollars into the state in the form of new income; and provide more than $1 billion in revenues.
A report released by the Beacon Center suggests Insure would ensure declining incomes for families and a shrinking of the private sector.
We all know that even if Insure TN does hurdle the legislature – and if it survives its trial run – some will still question whether the program is successful. So how will supporters measure that success?
1) Has the population become healthier because they’ve had a chance to be exposed to health care?
2) Has been there any financial impact for the state?
3) Has Tennessee moved forward on the reform efforts promised by the administration (i.e. provider reform taking costs out of system, user incentives, etc.)
But let’s not get ahead of ourselves.
As for today’s committee meeting, the governor basically says “bring it.”
“We obviously have full confidence in legal issues in this or we wouldn’t gov haslamhave done it,” he said Wednesday. “…If you have a committee, you can call a hearing. We’ll show up and give you the very best answers we have.”

Hello!

Thanks for reading my blog! My name is Alanna Autler, and I’ll be covering the statehouse beat this legislative session. We’ve aired several stories since we heard the gavel drop a little more than a week ago, but I plan to write about “extra material” here in this blog. Here’s the sad part about TV: we usually need to tell a story in less than two minutes. This space will be used to explore some of the interesting topics and tidbits we overhear at the State Capitol and beyond.

Some of the big issues that will dominate the conversation include abortion, education, and health care. Gov. Bill Haslam has called a special session for February 2 to discuss Insure Tennessee, which is his version of Medicaid expansion. This week he kicked off a statewide speaking tour to tout the program. Selling the idea to lawmakers will probably be one of the toughest challenges of his career – and even he admits garnering support will be difficult.

I always welcome your feedback. Feel free to comment here or shoot me a message at alanna.autler@wsmv.com.

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