Gov. Bill Haslam is expected to travel to Washington, D.C., today, where he will sit down with health officials to discuss a proposal that could have a major impact on low-income Tennesseans' access to health coverage, along with the ability of hospitals in rural areas of the state to remain open.
A decision based on the governor's discussions could also have an adverse effect on state budgets down the road.
Haslam will be in the nation's capital to discuss the prospect of expanding TennCare, the state's Medicaid program, under the Affordable Care Act. Tennessee is only one of a handful of states that have not officially accepted or rejected a federal offer to expand coverage for residents making up to 138 percent of poverty.
In March, the governor told members of the General Assembly he wanted to hold off on making a final decision on the federal offer to instead pursue a "third option." That proposal, called the Tennessee Plan, would involve the state's use of federal funds to purchase private insurance plans for low-income residents and ensure future state budgets not be hammered with expenses when portions of federal assistance were gradually rolled back over time.
Under an expansion of TennCare, the federal government would cover 100 percent of the costs for added beneficiaries for the first three years, with assistance dropping to 90 percent through 2020. For Tennessee, the offer amounts to an estimated $1.4 billion in aid and could be enough to keep some community and rural hospitals operating steadily, health experts in the state have said.
Speaking to reporters in Nashville, Haslam said he had a handful of items he expected to go over with officials.
"There are four or five things we'll be discussing in the morning," Haslam was quoted saying in a WKRN report.
According to a Nashville Post report, the governor said he wanted to ensure people buying insurance still had "skin in the game" under an expansion, that providers would still have incentives to control costs and identify what people would need in order to stay on traditional Medicaid rolls.
Haslam also said if the state were to expand its Medicaid program he wanted to be certain the state would not be forced to make cuts to TennCare rolls, like former Gov. Phil Bredesen was forced to do when 350,000 beneficiaries were slashed in order to accommodate rising costs in health care.
Tennessee currently has approximately 1.2 million residents who receive some form of TennCare coverage.
In his comments Thursday, Haslam also said he didn't expect to return from Washington Friday with a definitive answer of whether an expansion would occur.
"I don't think [the talks] will be definitive where I am going to come back tomorrow afternoon with a final answer, but we will be having conversations," he was quoted saying.
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