Tennessee Gov. Haslam Deploys the Arkansas Medicaid Method

Published March 27, 2013

Tennessee Governor Bill Haslam announced today that he’d be expanding Medicaid by not expanding Medicaid under President Obama’s health care law.

If that sounds confusing, it should, considering the way Haslam himself framed it:

Republican Gov. Bill Haslam today said he will not pursue an expansion this year of the state’s version of Medicaid, called TennCare, under the federal health care law.

In an address to a joint convention of the General Assembly, Haslam blamed the Obama administration for problems related to the Affordable Care Act, or Obamacare.

But he said he is continuing to work on a plan that he believes would enable Tennessee to add an estimated 170,000 low-income residents to a plan that provides private insurance. The federal government hasn’t accepted that proposal.

Republican Speaker Ron Ramsey of Blountville applauded Haslam’s decision to reject Obama’s Medicaid expansion.

“Without bold reform of the Medicaid program tailored to Tennessee’s unique situation, there can be no compromise on this issue,” he said.

But compromise is exactly what Haslam is going for – seeking an Arkansas-like proposal which would have to be approved by HHS, shifting those who would’ve been able to access Medicaid under the expansion to instead get their coverage subsidized through the federal exchange.

Haslam said that, if federal officials would go along with his plans, Tennessee can be “a model for what true health care reform looks like; reform that will take significant steps to save the state and the nation from the unsustainable path we are on now.”

The governor insisted to reporters after the speech that he will continue to negotiate with the federal government.

“This isn’t the end of the story,” Haslam said. “Quite frankly, a couple of days ago we thought we had this worked out.”

Haslam’s approach is likely to confuse both sides on what comes next: we have no clear estimate of the costs, but it seems clear the Arkansas approach continues to garner attention from those states which are choosing to implement.