Haslam on the difficulty of pleasing Legislature, DC on Medicaid compromise

In the face of criticism from the state Senate’s leading Republican, Gov. Bill Haslam said the key setback in striking a deal expanding Medicaid here is matching up what Tennessee lawmakers will pass and Washington will approve.

“I’m not going to waste their time or our time with a proposal that is either not going to go anywhere in Washington or not going to go anywhere in Legislative Plaza,” Haslam told reporters Wednesday. “We have a very difficult needle to thread here.”

Earlier this week, Lt. Gov. Ron Ramsey said the governor is “wasting his time” trying to pin down a plan to offer healthcare to more low-income people on Tennessee's own terms using federal dollars from the Affordable Care Act. He said problems in Washington implementing the federal healthcare exchanges have convinced him the state should wait about two years before deciding whether to move forward.

In March, Haslam decided to pass up $1.4 billion from the federal government to expand the state's TennCare program to an estimated 180,000 Tennesseans, saying the state can't afford to make the Medicaid program available when Washington begins to phase some of the costs of expansion back to the state. Instead, he said he'd see a unique plan for Tennessee.

When asked by reporters if trying to satisfy both the legislature and Washington in a new plan was “almost an impossible task,” Haslam said “that probably speaks a little to the difficulty, quite frankly.  

“I admit it’s a difficult task to find something that we think works for us and that will get approved by them. I don’t think it’s the right thing to do just to throw in the towel, either.”

Health and Human Services Secretary Kathleen Sebelius told reporters last week she has spoken with the governor several times about a Tennessee plan, but has “not seen specifics from the governor’s office.”

Haslam said he has had “specific conversations” with the department, and expects to pitch a plan to the federal government “in a short period of time” outlining what the administration thinks could be acceptable to both parties.