Haslam, CHS' Smith not ruling out Medicaid expansion just yet

Tennessee expansion a tough sell, but not impossible

Two major players in Tennessee health care suggested Wednesday that Medicaid expansion in the state still has potential, but compromise won't be easy.

On Community Health Systems' earnings conference call, Chairman, President and CEO Wayne Smith said he considered Tennessee on the list of non-expansion states that may turn toward the federal money after public opinion shifts. The federal government will pay for 100 percent of expansion costs through 2016, after which the state must pay 10 percent.

"[Medicaid expansion] will be more acceptable after you get through this midterm election, and I think there's some hope there," Smith said. "Tennessee is a good state as well that will probably do something, of some kind, in the future."

Smith said he expected opinions on accepting Medicaid funding will shift after expansion states continue to develop and non-expansion states get through their midterm elections.

"Most Republicans, as I understand it, are concerned about the Tea Party knocking them off early," Smith said.

Gov. Bill Haslam, who has rejected expansion so far, said later in the day that he still considers future expansion realistic, but expects it to be a hard sell.

"Getting something passed will not be — even if it's something that we get approved by [the U.S. Department of Health and Human Services] and we say we think it's good for Tennessee — will not be an easy sell at all," he told reporters.

Through a bill passed in April, Haslam will have to obtain legislative approval to accept expansion funds, even if he reaches a deal with HHS. But even with that additional hoop to jump through, Haslam said he still considered expansion realistic.

"I literally wouldn't be wasting my time on it if I didn't think it was," he said. "The question is what the is the financial impact on the state. I have to be convinced that we can come up with something that, both in terms of controlling provider costs and in terms of making certain there's incentives for really, truly good outcomes, that we can accomplish both those things in Tennessee."