A plan to expand Medicaid to cover an additional 280,000 low-income Tennessee residents failed in a key committee vote Wednesday, bringing a quick end to a long debate spearheaded by Gov. Bill Haslam (R).
After nearly two years of negotiations, Haslam called the legislature into special session to consider the plan, dubbed Insure Tennessee. The plan would have offered vouchers to those earning up to 138 percent of the federal poverty level to help purchase employer coverage. Others would have been able to sign up for plans similar to health reimbursement accounts.
Haslam began discussions with Republican lawmakers reluctant to take federal money back in 2013. He announced his support for the modified plan, which he said had tentative approval from the federal Department of Health and Human Services, after winning reelection in 2014. And in recent weeks, he stumped across the state to build public support.
But after all that work, it took just over two days for the state Senate Health and Welfare Committee to vote, by a 7 to 4 margin, against Insure Tennessee.
“We made a decision today but we didn’t do anything about, to answer the problem. And the problem is there are hundreds of thousands of Tennesseans who need health care, who could get that in a way that doesn’t cost the state anything,” Haslam said after the vote. “We have health-care costs that are out of control both in our state and across the country.”
Even if the Senate panel had voted to expand Medicaid, the plan’s path was full of landmines. House Speaker Beth Harwell (R) said earlier Wednesday she didn’t think Insure Tennessee could pass the full House, and its passage through the House Insurance and Banking Committee was far from assured. Even some Democrats voiced skepticism of the expansion.
State Sen. Rusty Crowe (R) told The Tennessean he was concerned about a lack of a signed agreement between state and federal officials.
Legislative leaders don’t expect the Medicaid expansion proposal to return during the regular session, which begins Monday.
“I said from the very beginning it would be difficult to get something that we could get agreed to in Washington, that we could get passed here. And I think what you saw today is a measure of just how difficult that is,” Haslam said.
Haslam was one of a handful of Republican governors who were pushing to accept federal money to expand Medicaid. Governors in Wyoming, Utah and North Carolina are all working with skeptical lawmakers to pass their own plans, though all are fashioning their plans as alternatives to traditional Medicaid expansion. Indiana Gov. Mike Pence (R) announced an agreement with HHS to expand Medicaid last month.
Twenty-eight states and the District of Columbia have expanded Medicaid under the Affordable Care Act, including eight states that did so under Republican governors.