Supreme Court to hear insurance subsidy case this week

Coverage gap would increase if court rules to cut tax credits
Mar 2, 2015 7:00 AM

Ramsey: Kelsey’s insurance exchange bill not necessary

A bill that would block the state from setting up an insurance exchange is nothing more than a political statement by Sen. Brian Kelsey, Lt. Gov. Ron Ramsey said Thursday.

“I don’t think that bill’s needed. Once again, sometimes you have overkill,” Ramsey told reporters. “The basic premise of that, if the Supreme Court rules this way or the Supreme Court rules that way and if ‘that’ happens we’re going to do ‘that’ — that’s not the way you pass legislation,” Ramsey said.

Senate Bill 72 is built around a lawsuit now before the U.S. Supreme Court, King v. Burwell, that challenges whether the Internal Revenue Service can write rules to extend subsidies to people who buy insurance through the Affordable Care Act’s federal exchanges. Should the court find the IRS cannot write rules, Kelsey’s bill prohibits Tennessee from operating its own exchange and blocks the state from putting money for an exchange in the state’s budget.

“That’s more a political statement than it is good government,” said Ramsey.

Ramsey said he has faith Gov. Bill Haslam would come to the legislature first should he want to install a state exchange. An estimated 229,000 people in Tennessee selected health care plans on the federal exchange, according to the U.S. Department of Health and Human Services, posing a “big problem” if the federal exchange can’t be used and there’s no state exchange to turn to, Ramsey said.

“I just told him where I was. He rolled it for three weeks after that. That might tell you something,” Ramsey laughed.

Kelsey rolled the bill in the Commerce and Labor Committee Tuesday until March 10, saying he is waiting to meet with the administration about the legislation. 

Feb 27, 2015 7:00 AM

HHS: 229K Tennesseans signed up on federal health insurance marketplace

State enrollment increased 51% in second exchange period
Feb 18, 2015 1:27 PM

HCA makes the case for subsidies

Local hospital chain files brief in pending Supreme Court case, says ACA is working as intended
Feb 17, 2015 1:00 PM

Analysis: Citation needed

Lawmakers did not have enough information during Insure Tennessee session
Feb 9, 2015 7:00 AM

AFP comment on Insure Tennessee vote

Here's what Andrew Ogles, state director of the Tennessee chapter of Americans for Prosperity, said in response to this afternoon's vote that ended the push for Gov. Bill Haslam's Insure Tennessee plan: “We couldn’t have done this without our grassroots activists showing up to hold their legislators accountable. This is truly a victory for the Tennessee taxpayers. We commend the Senators voting to defeat this measure and other legislators who led the fight. Thank you for listening to your constituents and voting to stop Obamacare’s Medicaid expansion in Tennessee.”

Feb 4, 2015 4:13 PM

THA: Hospitals will continue to work for coverage solutions

Hospital executives from around the state were among the biggest proponents of Gov. Bill Haslam's Insure Tennessee proposal, which met its end in a Senate committee Wednesday afternoon. In a statement issued soon after, Tennessee Hospital Association President and CEO Craig Becker said the industry's leaders will continue to push for a broader health insurance net.

Here's the statement in full:

“THA and its members are extremely disappointed by the action today of the Senate Health Committee. For more than two years, hospitals in this state have advocated and worked hard to find a way to provide healthcare coverage for the uninsured of Tennessee.

“I commend Governor Haslam for bringing forward this proposal. It offered a practical, commonsense solution that worked for our state. THA is also grateful to Sen. Doug Overbey and Rep. Gerald McCormick for their support in carrying this proposal.

“Hospitals, along with community and business partners, have fought tirelessly in recent months to urge support for Insure Tennessee by state lawmakers and I am proud of our efforts.

“Unfortunately, seven members of the Senate Health Committee decided that this plan did not benefit the public health of our state. This decision was made after two days of compelling testimony that reinforced how Insure Tennessee would improve the lives of hardworking Tennesseans and how the plan would strengthen communities, support hospitals and make Tennessee a better place to live. Ultimately, seven legislators made a decision that prevented the full General Assembly from having the opportunity to debate this extremely important issue.

“We are hopeful that members of the General Assembly will continue to consider ways for Tennessee to provide coverage to the hundreds of thousands of uninsured in our state who have no option for coverage. Hospitals believe this is right for our state and will continue to work with the Haslam administration and General Assembly to find coverage solutions for Tennessee’s uninsured.”

Feb 4, 2015 3:55 PM

HHS: 193K+ Tennesseans signed up for health insurance on federal exchange

More than 193,000 Tennesseans have signed up for health insurance coverage on the federal exchange, according to data released by the U.S. Department of Health and Human Services Wednesday.

Of the 193,207 enrollees, 57,871 were from Nashville, Murfreesboro and Franklin. By way of comparison, 151,352 Tennesseans signed up for coverage on Healthcare.gov during the first enrollment period, which ran from October 2013 through April 2014. Numbers for the current period, which ends Feb. 15, also include those who signed up last year and were automatically re-enrolled.

HHS also reported that 83 percent of Tennessee enrollees qualified for subsidies for coverage, and nearly 7.5 million Americans have signed up or been re-enrolled nationwide.

Click here for Nashville enrollment information by ZIP code.

Feb 4, 2015 2:00 PM

Lawmakers talk hospital budgets during Insure Tennessee debates

Legislators questioned touting Insure Tennessee as a salve for struggling hospitals in the state Tuesday, as the Medicaid expansion special session began in the Insurance and Banking and Health Committees.

Though both meetings were informational and no votes were taken, lawmakers heard testimony from the Tennessee Hospital Association, the Beacon Center, providers and other stakeholders as they evaluated Gov. Bill Haslam's plan. In the Insurance and Banking Committee, Rep. Roger Kane, R-Knoxville, asked whether hospitals' revenue challenges were simply a free market issue, and the facilities either needed to close, or reopen as different, less costly points of care.

"I recognize that you all are in a tough time right now," said Rep. Glen Casada, R-Franklin. "I'm just not sure this is the lifeline you're looking for."

Representatives from the Beacon Center, a conservative think tank, also testified before both committees that Medicaid expansion does not address declining revenues at hospitals, because bad debt is an issue in commercial insurance payments as well as from the uninsured.

"Hospitals claiming they are about to close have been doing so for many years," said Justin Owen, Beacon Center president and CEO.

However, hospital stakeholders tend to disagree. Tennessee Hospital Association President Craig Becker testified that state hospitals will lose $7.9 billion over 10 years if Insure Tennessee is not approved. Hospitals across the country lost 'disproportionate care payments,' which helped cover the uninsured, when the Affordable Care Act passed and Medicaid expansion was expected in every state. When the Supreme Court ruled that expansion was voluntary, it left hospitals in non-expansion states without either source of funding.

"Without this funding, our costs continue to go up anyway," said Susan Peach, president of LifePoint Hospitals subsidiary HighPoint Health System. "We're federally mandated to take care of these patients in our emergency rooms without pay."

Becker and Mary Layne Van Cleve, THA COO, provided additional information on state hospital revenues and the hospital assessment fee, which will be used to fund the state's share of Insure Tennessee after federal funding drops to 95 percent in 2017. 

Presently, about 100 hospitals in the state pay a fee of 4.5 percent of net patient revenue to help cover TennCare costs that were cut during the Recession. The fee can increase to 6 percent, which many consider almost guaranteed if Insure Tennessee passes.

"I feel that it will be raised to fund this," Peach said. "We've analyzed that and we're willing to fund it because we are in fact funding [uncompensated care] already."

The Insure Tennessee special session continues Wednesday morning with a hearing in the Finance, Ways and Means Committee, and the House will reconvene Wednesday afternoon.

Feb 4, 2015 7:00 AM

Haslam: Insure Tennessee is right move for state

Governor pitches Medicaid expansion to wary legislators
Feb 3, 2015 7:00 AM