Posts

VIDEO: BLOCK GRANTS VS. MEDICAID EXPANSION (Floor Debate Highlights)

Tennessee has lost $3.1 Million every single day since refusing to expand medicaid under the Affordable Care Act, which amounts to over $7 Billion and counting. 300,000 Tennesseans remain without coverage as a result, including 25,000 veterans.

The state leads the country in rural hospital closures, which even some Republicans say would be helped by expanding Medicaid.

Governor Haslam wanted to expand Medicaid. 37 other states have expanded Medicaid, including in “Red” states like Louisiana, to very positive results.

Instead, Tennessee’s Republicans are trying to have the Federal Government send the funding to the state in the form of a block grant, despite the warnings of many experts, who point out that block grants would cover fewer people, not more, and would do nothing to address the health care inequities in our state or to help with rural hospital closures.

Watch the FLOOR DEBATE HIGHLIGHTS:

The refrain from Republicans like Rep. Andy Holt is that we shouldn’t get “tangled up” with the federal government – which seems to ignore the fact that Tennessee is already tangled up with it plenty – between, the TVA, the V.A., Fort Campbell, Medicare, Social Security, SNAP, Oak Ridge National Lab, K-12 Federal funding, the Great Smoky Mountains National Park, the list goes on.

In fact, for every $1 Tennessee sends to the Federal Government it receives $1.46 in Federal spending.

This isn’t fiscal responsibility, it’s putting politics ahead of people.

TN Republicans Reject Protections for Pre-Existing Conditions, Rural Hospitals, Seniors in Nursing Homes

House Republicans have rejected four measures that would increase health care security for families enrolled in the state Medicaid program known as TennCare.

The measures, introduced by Democratic members of the House Insurance Committee, would have amended HB1280, a bill that directs the governor to apply for a Medicaid block grant from the federal government.

It would be the first such waiver of its kind in U.S. history. (Click here to learn how a Medicaid block grant could cost Tennessee $1 billion in federal funding by 2027.)

GOP Defeats Four Amendments

Protect coverage for pre-existing conditions: House Amendment 5080, presented by Rep. Darren Jernigan, D-Old Hickory, District 60, would ensure that Tennesseans with pre-existing conditions would still receive coverage if the block grant was approved.

Republicans voted it down.

Protect rural hospitals: House Amendment 5004a, presented by Rep. Dwayne Thompson, D-Cordova, District 96, would have ensured rural hospitals received due consideration in negotiations with federal Medicaid officials.

Republicans voted it down.

Expand TennCare coverage to working poor: House Amendment 5165, presented by Rep. Larry Miller, D-Memphis, District 88, would expand negotiations to include TennCare health insurance for working families in Tennessee, whose incomes are below 138 percent of poverty line. Generally speaking, these are the Tennesseans who would gain health coverage through Medicaid expansion—a measure supported by 66 percent of Tennesseans.

Republicans voted it down.

Protect nursing home coverage for elderly Tennesseans: House Amendment 5212, presented by Rep. Jason Hodges, D-Clarksville, District 67, said his measure would protect Medicaid coverage for elderly Tennesseans who live in nursing homes. More than six out of 10 nursing home residents in Tennessee are Medicaid recipients. The legislation “doesn’t guarantee we’re protecting our elderly,” Hodges said.

Republicans voted it down.

In questioning the bill sponsor, Rep. Jernigan said one of the chief concerns of a Medicaid block grant system is funding unexpected coverage increases if circumstances change, for instance, a surge in eligibility surge during an economic downturn. “Would we have to use state dollars at that point to make it up?” Jernigan said.

The bill sponsor Rep. Timothy Hill, R-Blountville, District 3, said, “the concern you’re bringing is a classic concern and a valid concern.” But rather than building guidelines for Tennessee’s negotiators, Hill said, it should be addressed during negotiations.

As of January 2019, there were nearly 32,000 TennCare enrollees in Sullivan County, where Rep. Hill lives. Holler at him HERE.

As a reminder, Block Grants would actually mean cuts to TennCare, don’t do anything about covering uninsured Tennesseans or saving rural hospitals, and are currently illegal and opposed by Children’s hospitals.

Here’s more on WHY. Meanwhile we lose $4 Million every day we don’t expand medicaid.

You can watch the full House Insurance Committee meeting here.

How they voted:
House Insurance Committee, March 5; Voice Vote, Ayes prevail:
Rep. Ron Travis, R-Dayton, District 31
Rep. Mark Hall, R-Cleveland, District 24
Rep. Scott Cepicky, R-Culleoka, District 64
Rep. Ron Gant, R-Rossville, District 94
Rep. Johnny Garrett, R-Goodlettsville, District 45
Rep. Timothy Hill, R-Blountville, District 3
Rep. Matthew Hill, R-Jonesborough, District 7
Rep. Justin Lafferty, R-Knoxville, District 89
Rep. Dennis Powers, R-Jacksboro, District 36*
Rep. Tim Rudd, R-Murfreesboro, District 34
Rep. Cameron Sexton, R-Crossville, District 25*
Rep. Robin Smith, R-Hixson, District 26
Rep. Mike Sparks, R-Smyrna, District 49
Rep. Bryan Terry, R-Murfreesboro, District 48
Rep. Jason Zachary, R-Knoxville, District 14

Voting No:
Rep. Jason Hodges, D-Clarksville, District 67
Rep. Darren Jernigan, D-Old Hickory, District 60
Rep. Larry Miller, D-Memphis, District 88
Rep. Dwayne Thompson, D-Cordova, District 96

Bill Sponsors:
Rep. Timothy Hill, R-Blountville, District 3
Speaker Glen Casada, R-Franklin, District 63
Rep. Matthew Hill, R-Jonesborough, District 7
Rep. Ron Gant, R-Rossville, District 94
Rep. Clay Doggett, R-Pulaski, District 70
Rep. Jason Zachary, R-Knoxville, District 14
Rep. Dan Howell, R-Cleveland, District 22
Rep. Bruce Griffey, R-Paris, District 75
Rep. Paul Sherrell, R-Sparta, District 43
Rep. David Byrd, R-Waynesboro, District 71
Rep. Chris Todd, R-Jackson, District 73
Rep. Scott Cepicky, R-Culleoka, District 64
Rep. John Crawford, R-Kingsport, District 1
Rep. Rush Bricken, R-Tullahoma, District 47
Rep. Mike Carter, R-Ooltewah, District 29
Rep. Bryan Terry, R-Murfreesboro, District 48
Rep. Robin Smith, R-Hixson, District 26
Rep. Michael Curcio, R-Dickson, District 69
Rep. Dale Carr, R-Sevierville, District 12
Rep. Andrew Farmer, R-Sevierville, District 17
Rep. Jay Reedy, R-Erin, District 74
Rep. James “Micah” Van Huss, R-Gray, District 6
Rep. Clark Boyd, R-Lebanon, District 46
Rep. Bud Hulsey, R-Kingsport, District 2
Rep. Iris Rudder, R-Winchester, District 39
Rep. Debra Moody, R-Covington, District 81
Rep. Andy Holt, R-Dresden, District 76
Rep. John Ragan, R-Oak Ridge, District 33
Rep. Cameron Sexton, R-Crossville, District 25

FALSE ALARM: Lt. Gov. Mcnally Almost Backs Medicaid Expansion By Mistake

On the Tennessean’s Grand Divisions podcast with Joel Ebert and Natalie Allison this week, Tennessean writer Natalie Allison asked what bills will be most controversial this session, and after listing Medical Marijuana and school vouchers Lt. Gov. Randy Mcnally went on to mention Medicaid Expansion:

Mcnally told the Tennessean:

“On Medicaid Expansion… Senator Bailey is working on some different ideas to take and work with the governor on and try to get an amendment through that would address the population that’s below 138% of the poverty level. And address it on a sliding scale voucher type thing, health savings accounts, there’s a number of different options that we haven’t really fleshed out yet.”

“Under 138% of the poverty level” is where Medicaid expansion would draw the line. What Mcnally was talking about sure sounded a lot like Medicaid expansion. So Natalie Allison asked him about that:

“So will Republicans be pushing a bill to expand Medicaid in some instances, or…?”

Still sounding a bit confused, Mcnally went on:

“Well we’ll be I think looking at an effort to… a lot depends on what we think we can through CMS, but we’re looking at an effort to address the population that probably was most in need of insurance but was left out of health care… Our hope is it’s not expansion of Medicaid, it’s not Obamacare, and that’s – we’re just trying to take care of sick people that lack insurance mainly because they’re incomes are not at a rate that they can afford it.”

So it’s not Medicaid, or Obamacare, it just attempts to do the exact things Medicaid Expansion under Obamacare was trying to do… JUST FOR THE LOVE OF GOD DON’T CALL IT MEDICAID EXPANSION OR OBAMACARE.

This might be a good time to point out that Medicaid Expansion is popular in Tennessee.

Still confused because Mcnally was sounding pretty pro-Medicaid expansion, the Natalie Allison pressed further:

So… you’re saying it’s not Medicaid expansion?”

At this point Senator Jack Johnson swoops in, noticing Mcnally is flailing and maybe almost about to support something that would actually help a lot of people, which would be truly awful.

Sen. Johnson:

 “It absolutely is not… I want to be very clear about that, it’s not a proposal to expand medicaid. It’s a proposal to give us more flexibility with our existing medicaid dollars, ok? And if we’re given that flexibility we believe we can generate savings that will generate additional dollars with which we might be able to cover some additional people, or provide better services- better quality services. That’s one conversation and that needs to stay in its lane right there. Any conversation of drawing down additional federal dollars is a totally different conversation, ok? And I think maybe during some of this those two things have gotten interwoven.”

So if you’re one of the hundreds of thousands of Tennesseans without coverage, good news – maybe what they’re proposing might cover some other people if they can scrounge up some loose change somewhere, but as for the $26 Billion over 10 years the federal government wants to send us to cover you, that’s a still big NO THANK YOU — because who wants that?
They know they need to seem like they’re trying to help people get the care they need – but actually helping people would be a bridge too far.
Basically their block grant proposal is to take the money that is supposed to go towards health insurance for low-income people in a lump sum, and trust that the guys who up until now haven’t seemed to care that vulnerable Tennesseans can’t get the care they need will A) make sure it goes to the right place, and B) Be able to make those dollars go further somehow.
That’s some plan.
The Tennessean reporters then went on to commiserate about how confusing the whole thing was. Natalie Allison:
“All the reporters sitting there were pretty confused. We thought he was saying Republicans were going to launch a medicaid expansion effort this session. We eventually realized that wasn’t the case and went on to talk about the block grant program.”
She then pointed out that it remains to be seen how they would actually secure coverage for those currently in the coverage gap:
“When we asked them how they were going to pay for that, there isn’t really a clear answer… the bill itself is pretty vague.”
As Rep. John Ray Clemmons and Gloria Johnson say in the video below, the Republican-proposed block grants may not even be legal, won’t cover anyone new, and won’t help rural hospitals.
It doesn’t fix the problem.
It’s time to expand Medicaid like most of the country already has. It would help a lot of people, and pay for itself. Let the Republicans call it whatever they want, let’s just do it.
Holler at Governor Lee if you agree.