Hospital association backs Medicaid stopgap

THA director frustrated Ramsey can't separate Obamacare from need to help uninsured

The organization representing the state’s hospitals is in talks with Republican senators who want to lure uninsured people with primary care issues out of emergency rooms and into community care centers. 

The idea a band of lawmakers with medical backgrounds are considering would focus on providing care to the state-estimated 145,000 working poor who are ineligible for TennCare but make too little money to qualify for discounted health insurance on the federal health care exchange.

“We’ll do what we can do to come up with something creative,” said Craig Becker, executive director of the Tennessee Hospital Association. 

As envisioned, the measure would take financial pressure off hospitals which have written off some $700 million in costs from emergency room visits from people unable to pay, said Becker. The plan would work by establishing partnerships among various health providers in the state, such as county health departments, medical schools, federal and faith-based clinics and health consortiums to provide the working poor primary care and chronic disease management.

Some hospitals already have similar partnerships with community health care providers, so the biggest question in piecing together legislation is finding a way to financially support it, said Becker who said he likes the idea although it may “seem far out and far fetched.” 

With state revenues down more than $170 million so far this fiscal year, Capitol Hill lawmakers are bracing for a tight budget year, which could complicate passage of the legislation if lawmakers can draft a plan the legislature would support.

“Where does the money come from will always be the question,” said Becker.

Meanwhile, there is no new movement in effort to find a unique way for Tennessee to reap the benefit of federal dollars offered to expand Medicaid, the governor told reporters Thursday.

Lt. Gov. Ron Ramsey, who is opposed to expanding Medicaid, told reporters hospitals should go back to the Obama administration to straighten out reimbursements for covering health care for the poor, saying “I wasn’t in on this deal” under the Affordable Care Act to take on more costs. 

Becker, who said hospital systems are frustrated legislators can’t “separate their feelings for Obama” versus coverage for hundreds of thousands of Tennesseans, said adding health care coverage will lead to people having better health.

“To bring coverage to help Tennessee get out of the bottom quartile of health statistics would be well worth it to me,” he said. “You can point the finger at us if you want.”