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 have 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.”