House Speaker Beth Harwell is putting together a task force that will study ways to improve Medicaid in Tennessee, more than a year after lawmakers rejected Gov. Bill Haslam’s plan to expand the program.
Harwell announced the task force of four Republican lawmakers Tuesday. They’re to report back in June with some ideas to improve Medicaid, known in the state as TennCare.
The move comes as Harwell is being criticized for not forcing a floor vote on Insure Tennessee, which would have extended Medicaid coverage to about a quarter-million Tennesseans. Democrats called the task force an election year charade, designed to take pressure off the speaker for pushing ahead with Haslam’s plan.
Harwell and members of the task force say the team is an attempt to restart the conversation about Medicaid. It likely will not result in an endorsement of Insure Tennessee, but the task force’s recommendations could include pieces of Insure Tennessee, says state Rep. Cameron Sexton, R-Crossville.
“We’re taking some of what Insure Tennessee had in it, some good aspects that members have liked. But we’re also looking at other aspects — you know, health savings accounts and some other things — and not taking any option off the page,” he says.
Insure Tennessee was meant to close a loophole in the nation’s health insurance system created by the U.S. Supreme Court’s 2012 ruling on the Affordable Care Act. Although the court upheld the constitutionality of the law, it struck down a portion that required states to extend Medicaid coverage to people just above the poverty line.
Insure Tennessee would have provided that coverage, but it also included incentives for people to enroll in their employers’ health insurance plans and to take steps to improve their health, like visiting a doctor regularly. Tennessee hospitals also promised to foot the cost to the state of expansion — 90 percent or more of which would have been paid by the federal government in any event.
Haslam described the program as an innovative approach that would hold down the state’s costs and could become a model for other states to follow.
But the proposal died in committee last year. Activists have since been pushing Speaker Harwell to bring it directly to the House floor, a message driven home with a billboard campaign. Harwell says she can’t do so without buy-in from lawmakers.
In announcing the task force, which Harwell calls the “3 Star Healthy” project, the speaker said she never abandoned efforts to expand access to health care. She said she’d spoken to policy experts at Vanderbilt University’s School of Medicine, who’d told her it might be possible to win approval for smaller steps.
Harwell says she’s asked the task force to come up with pilot efforts that could be tested in portions of the state. If costs run over, these efforts could be abandoned. If they succeed, they can be copied across the state.
But Harwell and other members of the task force said they haven’t spoken to federal authorities about the feasibility of the effort. It’s also unclear whether the federal government’s offer to cover most of the cost of expansion would apply.
Haslam stood side by side with Harwell and task force members at the press conference. He praised the speaker for trying to move the debate over Medicaid expansion forward.
But the announcement did little to pacify critics. At the conclusion of the press conference, a supporter of Insure Tennessee loudly accused Harwell of using the uninsured as a political pawn. Shouting, he was removed by security.
Afterward, Democrats said naming a new task force after so much work went into Insure Tennessee demonstrates Harwell and Haslam are politically weak.
“They need more than a logo and a task force,” said state Rep. Bo Mitchell, D-Nashville. “They need a real plan. They thought they had one already.”
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