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.”
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.
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.
Two hours before pitching his Insure Tennessee plan to the legislature, Gov. Bill Haslam's administration unveiled polls showing 60 percent of registered Republican voters support his plan.
After simulating legislative arguments for and against Insure Tennessee, Virginia-based North Star Opinion Research found 60 percent of the polled participants said they supported the plan, 24 percent opposed it and 16 percent were undecided.
Before providing the arguments, however, 44 percent of Republican voters supported Insure Tennessee, 16 percent opposed it and 40 percent were undecided, according to the survey results. The query was conducted Jan. 21 through 26 with 600 voters statewide and an oversample to reach 400 total Republicans.
The polls also showed that 53 percent of registered Republican voters said they would be more likely to re-elect a candidate that supported Gov. Haslam's plan.
The report issued by North Star, a firm commonly used by Republican Sen. Lamar Alexander, advised Haslam's administration to clearly separate his plan from Pres. Barack Obama and Obamacare, which had notably less support at only 9 percent.
"Republicans not only like Gov. Haslam, they trust him and his judgement. Consequently, his name and the plan should be constantly linked: Governor Haslam's Insure Tennessee plan," the report recommended.
Despite the polls showing voter support, many lawmakers are skeptical of Insure Tennessee, particularly whether the state can cut off Medicaid coverage for the newly insured after the pilot program ends.
The Senate side has three committees for the governor's Insure Tennessee legislation to pass through. In order: Select Committee on Commerce, Select Committee on Health and Welfare then Finance, Ways and Means Committee. Each member sits on one committee. Here's the roster.
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