“All we hear from Sen. Lamar Alexander is crickets…again. When issues back home arise, Sen. Alexander refuses to step in and fight to get results. This affects families and their livelihood and is happening in Senator Alexander’s backyard, in his home town, yet we haven’t even heard a peep out of him,” says Representative Joe Carr.
From Tom Humphrey:
Gov. Bill Haslam is working with Tennessee congressmen to assess the feasibility of using state government resources to reopen the Great Smoky Mountains National Park and three other areas closed by the partial federal government shutdown, a spokesman said Thursday.
Just over half of Tennessee’s state agencies will feel some impact if the partial shutdown of the federal government stretches on for more than 10 days, according to the governor’s office.
The state health department would have to reduce staffing for its Women, Infants and Children program after 10 days, and the issuance of handgun permits and commercial driver licenses with hazmat endorsements would be affected due to required background checks, according to the administration.
As Gov. Bill Haslam hinted at yesterday, the Department of Human Services expects a long-term shutdown would mean a shortage in federal funds for food stamps, which would require the department dip into state funds. Payments to managed care organizations under the Medicare program could also be "distrupted," according to the governor's office.
The state’s Economic and Community Development Department would see delays in reimbursements for federally-funded programs, and if the shutdown persists, infrastructure grants to community could be impacted, the state reported.
Eleven other agencies said they expect no impact by the shutdown. Here's the full rundown for all state agencies, per the governor's office.
Federal Government Shutdown Summary
No impact: 11 departments
Some impact: 11 departments (Only if shutdown is longer than 10 days)
Significant impact: 1 department
Finance and Administration
Intellectual and Developmental Disabilities
Some federally-funded food programs may be affected if shutdown lasts longer than one month
Commerce and Insurance
Consumers needing help with the exchange may not be able to reach federal call center staff. This may cause a significant influx of calls to our Insurance consumer assistance section. Additionally, (if shutdown is lengthy) Medicare payment to Tennessee MCOs may be disrupted.
Economic and Community Development
Reimbursements may be delayed for federally-funded programs. If lengthy, grants to communities for infrastructure will be affected.
Impact on technical assistance. If lengthy, funding to districts may experience delays.
Environment and Conservation
Slower review of permits that require federal review and slower processing of federal grants.
WIC (Women, Infants and Children) program can only sustain a shutdown to approximately October 10th. A prolonged shutdown could affect personnel as much of the federal funding Health receives covers administrative costs.
Labor and Workforce Development
If longer than 7-10 days, OSHA would need to be funded with state dollars. If prolonged shutdown, staffing would need to be adjusted.
Mental Health and Substance Abuse Services
Funding available for the next three months. If prolonged, federal funds would end by approximately January 2014.
Weekend drills and annual trainings will not be conducted. Students who are in schools will be recalled. Monthly pay may be affected depending on length of shutdown.
[nothing listed by Haslam administration]
Safety and Homeland Security
Possible impact on the issuance of handgun permits and commercial driver licenses with hazmat endorsements due to background checks.
SSA and SNAP programs can only sustain themselves for a limited period without federal funding. Federal funds would expire within 10 weeks, with some variations and some state funds still remain. SSA indicated that they would restore any state funds that are used to cover FFY 14 expenses. DHS would need to make staffing adjustments downward according to funding streams.
While Gov. Bill Haslam expects reports from his commissioners by day’s end detailing how a pending federal government shutdown would affect Tennessee, he said Congress' considering of such a move is the wrong thing to do.
“Let me say this, I don’t think it’s an appropriate action for the federal government to have gotten to this point,” said Haslam when asked if "this is an appropriate action for the House Republicans to be taking."
The governor said, “I’m one of those who believes the government has to quit spending way more than it’s bringing in, but this is not the way to do that. Just to have an arbitrary shutdown in government that’s going to impact services, like I said in a non-discriminant way, is not the way to do it.”
If a spending plan is not passed by midnight Monday, federal government agencies and programs considered non-essential will close.
Locally, Haslam said the state is worried the shutdown could halt the federally-funded SNAP program that provides food stamps. He said he expects the reports from his department commissioners this afternoon.
The musical alter ego of local money manager Jon Shayne is back to his econo-songwriting ways with "The Great Unwind," his take on the policy questions facing the Federal Reserve. As usual, Merle combines insight and education into the song, which sums up the central dilemma this way: "Are we on the mend or near the end of fiat money as we know it?"
SEE ALSO: Merle's other hits
Shares of Healthways bucked Wednesday's Fed downdraft big time thanks to an ebullient note from William Blair analyst Ryan Daniels. Russ Britt at MarketWatch writes that Daniels pretty much wrote off one of the major negative factors that has prevented Healthways from regaining most of the ground it lost during and after the recession. There is no longer a concentration risk from working with big insurers such as Cigna as Healthways lands more smaller clients, companies that are more likely to rely on the range of services the Franklin-based company brings to the table. Daniels' note lifted Healthways (Ticker: HWAY) shares more than 8 percent to $15.18, their highest level in nearly two years.
Corrections Corp. of America may soon be saying good-bye to a few big contracts, but Kevin Campbell at Avondale Partners said Wednesday that the outlook for private prison managers is still rosy. One new reason, he said, is immigration reform: The plan now being debated in the Senate would, according to the Congressional Budget Office, increase the nation's prison population by 14,000 people per year by 2018. It's a fair assumption that a large number of those new inmates will be housed by private operators such as CCA. Campbell conservatively estimates that adjusted funds from operations at CCA (Ticker: CXW) could grow between 20 cents and 30 cents per year. The company's executives have said they expect to post 2013 AFFO of about $2.80.
Editor's note: This is the third post from the Nashville Health Care Council's 2013 Leadership Health Care Delegation to Washington. Click here for other entries from this year and last.
Attendees of Leadership Health Care’s 2013 Delegation to Washington, D.C., were treated to a keynote speech by David Wasserman, house editor for The Cook Political Report. Founded in 1984, The Cook Political Report provides analyses of Presidential, U.S. Senate, House and gubernatorial races. In addition to his current role, Wasserman served as an analyst for the NBC News Election Night Decision Desk in 2012, 2010 and 2008, and has appeared on a number of networks.
Wasserman hosted a lively discussion with the group on political forecasting trends and gave the audience insight on the current political landscape and what’s in store for the 2014 and 2016 elections. After the event had wrapped up, Wasserman took a few minutes to further discuss health care policy, including the big choices many Republican governors need to make in the next year and a half.
Editor's note: This is the first in a series of posts from the Nashville Health Care Council's Leadership Health Care Delegation to Washington. Look for more information from the trip in the coming days.
The prospects for reforming entitlement programs led the conversation during the first day of sessions in the Nashville Health Care Council’s Leadership Health Care 11th annual delegation to Washington, D.C. Health care policy and political experts spoke to 80 delegates from Nashville and across the country about the budgetary dynamics that are creating pressure for long-term entitlement reform and what, if any, changes we might expect in the coming years.
“There’s no way you can look at the long-term fiscal health of the country and think you can avoid taking on entitlements,” said Gail Wilensky, economist and senior fellow with Project Hope and the former administrator of the Health Care Financing Administration.
Wilensky, pictured above, said the country spent 5.6 percent of GDP on entitlement programs last year, which is nearly three times what we were spending in 1985, and projections show that by about 2030 or 2035 entitlement program spending will grow to between 9.5 percent and 10.5 percent of GDP on Medicare and Medicaid alone. When you add in Social Security, entitlement programs will account for about 17 percent of the U.S. economy.
The main challenge of entitlement reform, Wilensky said, is Medicare. She and members of a later panel discussion about entitlement reform agreed that any reforms to Medicare will need to do more than simply reduce reimbursements to health care providers. Reforms will need to include changes that affect the actual Medicare beneficiary, such as increasing the eligibility age from 65 to 67.
“It’s pretty straightforward” why entitlement programs have not had any meaningful reform to date while other programs have seen obvious funding reductions, said Joseph Antos, the Wilson H. Taylor Scholar in Health Care and Retirement Policy with the American Enterprise Institute. “Other programs tend not to provide direct income support to individual voters.”
In the near term, cuts will probably continue to be more “hidden” within reduced payments to providers, said Stuart Butler, Distinguished Fellow and director of the Center for Policy Innovation at the Heritage Foundation. “But the fact is, that does have an effect, and over the long haul it will start to hollow out those programs,” Butler said. “And that may be the only way you can do it, rather than an explicit decision to make fundamental change to the program.”
Some of the larger, more fundamental changes that should perhaps be on the table, according to the panelists, include income-related premiums for Medicare, restructuring Medicare cost sharing, repositioning Medicare as more of a “true insurance program” where individuals with the highest incomes pay the full cost of premiums and individuals only get a benefit when something goes wrong.
In a separate presentation on the state of affairs in Washington, Michael Ramlet, principal of public affairs firm Purple Strategies, said a lot of the discussions about changes to Medicare are purely hypothetical.
“I don’t think there will be any major moves in the Medicare environment; it’s not a place right now where there’s a lot of compromise.”
Ramlet explained that discussions in Washington are instead focused on issues such as the nuts and bolts of how to run insurance exchanges — the number of individuals who will be enrolled, the levels at which they will participate in exchanges, how much premiums will cost, how to make the “Herculean lift” of allowing multiple federal agencies share the data necessary to make exchanges work.
“This is where 2014 will be really interesting,” he said. “We’re trying to do a big technical lift, where at the same time you know insurance plans are changing a lot, and no one really knows what’s going to happen.”
From left: Joseph Antos of the American Enterprise Institute, Stuart Butler of The Heritage Foundation and Paul Van de Water from the Center on Budget and Policy Priorities