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.”
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.
Dr. Reginald Coopwood, president and CEO of Regional Medical Center at Memphis and a former professor of surgery at both Meharry Medical College and Vanderbilt University School of Medicine, has been named chairman of the Tennessee Hospital Association.
Coopwood (on left in photo) has a strong Nashville background. He once served as chief executive officer of the Metropolitan Nashville Hospital Authority and in 2000 became the first appointed chief medical officer for Nashville General Hospital at Meharry, a position he held until his selection as CEO in 2005.
Coopwood is chairman of the American Hospital Association’s Metropolitan Hospitals Governing Council. He also is a member of the American College of HealthCare Executives.
Relatedly, the THA has named Mark Medley, president and CEO of hospital operations for Franklin-based Capella, its chairman-elect of the board. Medley (on right in photo) will become chairman during the 2014 annual meeting in Nashville.
Joe Landsman, president and CEO of the University of Tennessee Medical Center, is now THA immediate past chairman. He also will serve as speaker of the association’s house of delegates in 2014.
Craig Becker serves as president of the Brentwood-based THA.
With the clock ticking down before a number of big reimbursement changes kick in Oct. 1, the Tennessee Hospital Association is engaging in equal parts advocacy, alarm bell ringing and CYA. The industry group on Monday said the payout cuts — some from the Affordable Care Act, others from broader budget measures adopted last year — will endanger some facilities' and cost each Tennessee county an average of 250 jobs in the coming year.
“We’ve said all along that cost containment is essential to the long-term best interest of our country, but the speed and manner in which these drastic changes are imposed will make the difference between life and death for some hospitals,” Becker said.
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“Frankly, in our circles, nobody talks about wanting to repeal Obamacare,” says Craig Becker, executive director of the Tennessee Hospital Association. “They want to see individual coverage. That’s really been our Achilles heel.”