Medicaid Expansion: “Bait and Switch” or Good Deal for Tennessee

Rep. Jim Cooper tells Nashville lawyers that Medicaid expansion is a good deal for Tennessee, saying the state depends on Washington to pay its way.

Last month’s Supreme Court decision may have freed Tennessee from having to expand its Medicaid program. But Nashville’s Congressman says the state needs to think twice before opting out.

The federal government has no right to essentially force states to expand their Medicaid programs, set up decades ago. That was the high court’s opinion issued last month. At a panel discussion on the topic, Vanderbilt law professor James Blumstein says it was the right call.

“It’s bait and switch. The states got into Medicaid thinking it was poverty medicine…and it was being broadened to a whole area that no state could have anticipated reasonably when they opted in.”

The Affordable Care Act intended to use Medicaid to get health insurance for 17 million more Americans. While the federal government was picking up most of the tab, states – particularly those with Republican governors – have bristled.

At least five governors now say they will opt out, including Texas and Florida. But Nashville Congressman Jim Cooper says Tennessee is more reliant on Washington’s money. If the U.S. were the Eurozone, Cooper says Tennessee might like to think it’s the economic powerhouse of Germany, but it’s not.

“I don’t want to scare ya’ll, but we’re in a state that’s more like Greece. Tennessee does not balance its budget. It only does so after it gets 10 billion free dollars from the federal government.”

Tennessee Governor Bill Haslam has been in search of a middle road. At the National Governors Association meeting over the weekend, he was counted as one of several willing to expand Medicaid if the state could get more flexibility.