Haslam: Medicaid expansion ‘a clunker’

Friday, January 31, 2014, Vol. 38, No. 5
BILL DRIES | The Daily News

Tennessee Gov. Bill Haslam says he understands critics of his decision so far not to accept a federally funded expansion of Medicaid in Tennessee. But Haslam said the terms of the increased funding wouldn’t provide better outcomes for users or providers.

“It’s all this federal money. It will help hospitals and it will give people better health coverage. All of that is true,” Haslam said in an exclusive interview on the WKNO-TV program “Behind The Headlines.” “The flipside is Medicaid already takes up a huge portion of our budget. As we expand that, that will make a bigger issue. The expansion didn’t provide a way to have better health outcomes. It just increased the number of people we covered. I honestly think we can do it better.”

Haslam continues talks with Obama administration officials about terms under which Tennessee may accept an expansion of Medicaid, which in Tennessee is known as TennCare.

As in other states, the federal offer remains for federal funding to pay 100 percent of the cost of the expansion for the first three years and then 90 percent of the cost in the next three years.

Haslam conceded that he is hearing from a lot of hospitals across the state – public and private – who are urging him to accept the expansion. Shelby County Mayor Mark Luttrell is among the local leaders who early on told Haslam he should accept the expansion.

Haslam has said he is willing to talk terms with the White House. But he also has never described those ongoing talks as reaching any breakthrough. And none is expected to be announced next month when Haslam delivers his State of the State address. Haslam has said the terms of any Medicaid expansion in Tennessee would have to be approved by the Tennessee Legislature.

“The country needed health care reform, we really did. I think President Obama, when he was first sworn in, he had an incredible opportunity to come up with, to really change health care,” Haslam said in the interview from the state capitol in Nashville. “We can’t keep going up on health care costs escalating faster than the economy. We can’t keep going where so many people don’t have access to health care. The problem was real.”

But Haslam faults the Obama administration for pushing through a “bad plan” with Democratic majorities at the time in Congress.

“So they are saying, ‘Here’s a clunker. Do you want this clunker? Oh, by the way, the clunker is free for a while, then you have to pay for it,’” Haslam said. “And they left people like us in bad positions. What I’d like to do is do what they should have done in the beginning. Have Medicaid where it truly has incentives for better outcomes for healthier lives on both sides – for the user and for the provider.”

As Haslam begins the last year of his four-year term of office and runs for a second term, he also talked about life with Republican supermajorities in both chambers of the Tennessee Legislature.

“We have 132 people that ran for office and were elected with their own objectives and agendas. So, you need to understand – people can think this is what the House Republicans are doing or the Senate Democrats. But the truth is you have 132 people, all with a little different mindset,” he said of differences among Republicans. “If you ask me would I rather have a Republican majority or not, I’ll take the majority. We’ve passed a lot of big legislation that it’s helped to start with a certain number of people on your side.”

And Haslam defended Achievement School District superintendent Chris Barbic, who told an education forum in Nashville last week that diversity shouldn’t be the sole responsibility of charter school operators.

“Anybody that knows him knows he has literally committed his life to working in a very diverse environment,” Haslam said of Barbic. “The idea that somehow Chris doesn’t care about helping everybody realize their potential, regardless of where they are from is just dead wrong and an incredible disservice. I think what Chris was saying was just that – schools reflect their neighborhoods. Charter schools want to be a part of increasing diversity and more important … creating opportunity. But the fact that they are serving neighborhoods, charter schools shouldn’t bear all the burden of integrating that neighborhood.”