Tennessee Governor Goes for Medicaid Expansion

Calling his proposal Insure Tennessee, Gov. Bill Haslam said yestereday he is requesting an amendment to the state’s TennCare demonstration project for a two year pilot project to cover as many as 200,000 low-income individuals under the Medicaid expansion available through the Affordable Care Act, according to numerous press reports.

“The Insure Tennessee plan is a conservative approach that introduces market principles to Medicaid, provides health care coverage to more Tennesseans at no additional cost to taxpayers, and leverages a payment reform initiative that is working to control health care costs and improve the quality of care.  I believe this plan is a critical first step to fundamentally changing health care in Tennessee,” the governor said in a press release posted on his website.

Newly eligible Tennesseans would have the choice of two types of coverage. They could use a defined contribution to purchase insurance available from their employer, as well as cover some or all of their out-of-pocket expenses for deductibles and copays. This option is called the Volunteer Plan.

The Healthy Incentives Plan is the second option. Premiums would be limited to 2 percent of the poverty level. Copays would also be charged for certain services and pharmacy benefits. A Healthy Incentives for Tennesseans (HIT) account would be established to which members could add credits for undertaking certain healthy behaviors. The HIT account could be used to pay for premiums and copays.

A special session will begin Feb. 2 to approve the proposal. The Tennessean reports that legislative leaders hope to conclude their work on the proposal in a week.

Tennessee hospitals have pledged financial support for the proposal – agreeing to an increase in their state assessment, so that even when the state must provide matching funds (after Dec. 31, 2016) the state budget will not be impacted.

Click here for a summary of the proposal.

Click here for the waiver amendment to be submitted to the federal government.