Lawmakers Give Insure Tennessee Cold Shoulder at First Hearing

Gov. Bill Haslam’s plan to expand Medicaid, known as Insure Tennessee, got a chilly reception during a crucial first hearing at the state legislature.

A Senate panel questioned Tuesday whether the state would be bound forever to the governor’s proposal to offer health coverage to 200,000 Tennesseans if it approves the plan at a special session next week.

Skeptics on the Senate Judiciary Committee
set aside an opinion released earlier in the day by Attorney General Herbert Slatery that sided with the Haslam administration that Tennessee can back out if costs go up or terms change.

The hearing was the latest demonstration of the uphill climb Haslam faces as he tries to sell skeptics within his own party on the plan. Lawmakers are likely to vote on Insure Tennessee at a special session next week.

Hospitals and the federal government have committed to foot the entire cost of Insure Tennessee. But lawmakers aren’t convinced the U.S. Department of Health and Human Services will hold to that agreement.

Senate Judiciary Committee Chairman Brian Kelsey, R-Germantown, opened the hearing with a music metaphor that summed up his reservations.

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

Robert Alt, a critic of Insure Tennessee invited to testify before the committee, echoed Kelsey’s analogy. He said the federal government might try to muscle the state into keeping Insure Tennessee by threatening to withdraw all funding for the state’s Medicaid program, known as TennCare.

Even as the hearing took place, a spokesman for Haslam circulated a letter to reporters in which HHS Secretary Sylvia Mathews Burwell says explicitly Tennessee would be free to leave.

Critics weren’t convinced. Several pointed back to a previous fight over Medicaid — Gov. Phil Bredesen’s 2005 effort to remove 170,000 Tennesseans from the program’s roles — as evidence of the kind of litigation that would ensure if Insure Tennessee were ever unwound.

Vanderbilt professor James Blumstein
, who advised Bredesen
 at that time, told lawmakers they should instead hold back support for now. He said Haslam’s hand would be strengthened by a hard line.

“It’s important for the governor to have a ‘bad boy’ to be able to say, ‘I’ve got to be able to convince my state legislature on this,'” he said. “And the deal that Tennessee gets will be a lot better if the state legislature doesn’t sign off at this point.”

That advice isn’t likely to sit well with Tennessee’s current governor.