|Nashville Bishop David Choby shakes hands with Gov. Bill Haslam after Haslam’s press conference on Monday, Dec. 15 where he announced plans to expand health insurance coverage to some of the most low-income Tennessee residents. Bishop Choby and Saint Thomas Health officials, who were on hand for the announcement, praised the plan to expand health care coverage to the poor and vulnerable. Photo by Jed DeKalb
Gov. Bill Haslam’s proposal to expand health insurance coverage to more than 200,000 uninsured Tennesseans received positive initial reactions from Bishop David Choby and leaders of Saint Thomas Health.
“I think it’s a balanced approach and one that points to shared responsibility of providing health care, particularly for the most poor and most vulnerable,” said Bishop Choby, who was on hand for the governor’s announcement of the program on Monday, Dec. 15, along with several leaders of Saint Thomas Health, including its President and Chief Executive Officer.
“So far, we’re very happy and very pleased and very grateful,” said Nancy Anness, MSN, APN, BC, vice president of advocacy, access and community outreach for Saint Thomas Health. “I’m very grateful because our leadership in our state has heard the cry of the poor. Now we are all joining together and doing something in service for those in need and those most vulnerable.”
Gov. Haslam’s proposal, called Insure Tennessee, would be a two-year pilot program that would use additional federal funds and contributions from the state’s hospitals to expand coverage under two plans:
• The Volunteer Plan would provide vouchers to working Tennesseans who make less than 138 percent of the federal poverty line and cannot afford to participate in their employer-offered health insurance plan. The vouchers can be used to pay insurance premiums and other out of pocket costs but won’t necessarily cover all of the costs for the private plan. The income cutoff would range from $16,104 for a single person to $32,913 for a family of four.
• The Healthy Incentives Plan would be open to people without insurance who make up to 100 percent for the federal poverty line. They would be eligible for Health Reimbursement Accounts through TennCare, the state’s health insurance program for low income people. Participants would earn money by making healthy choices, such as using preventive services and disease management programs and using emergency rooms visits appropriately. The money could be used to help pay the co-pays and other out-of-pocket expenses of their insurance coverage.
The plan would be paid for with additional federal funds made available through the Affordable Care Act provision that allowed states to expand Medicaid coverage for the uninsured who make too much to qualify for Medicaid but not enough to qualify for subsidies to buy insurance through the health insurance marketplace established by the law.
The federal government will pay up 100 percent of the expanded coverage for several years before it eventually decreases to 90 percent. Under the governor’s proposal, when the federal government no longer pays 100 percent of the program’s cost, Tennessee’s hospitals would pick up the difference.
The governor’s plan must first be approved by the State Legislature. He announced he will call a special session of the Legislature to consider the proposal for January or February.
If he wins legislative approval he will then submit a request for a waiver from the federal government to use Medicaid expansion funds in a way different than outlined in the Affordable Care Act.
Saint Thomas Health officials will be meeting with legislators to ask them to support the plan, Anness said. That will be part of an ongoing effort to advocate for access to health care and health insurance for everyone, she said. “Part of our call to action is health care that leaves no one behind.”
For many of the people who would qualify for the program, it would be the first time they would have health insurance and access to health care and preventative care and treatment for chronic diseases and illnesses, such as diabetes, Anness said.
Helping people manage their chronic illness will reduce the cost of their care and improve the quality of their life, Anness said.
“One thing that’s appealing about the governor’s approach is there’s an effort being made to look into this expanded availability of insurance in a way that everyone participates in making health care more accessible and more affordable,” Bishop Choby said.
Federal government funds will finance much of the expansion and the state’s hospitals will cover any shortfall, he noted, while participants will be required to contribute by making healthier choices.
“Gov. Haslam has done a good job trying to … thread the needle … by promoting personal responsibility and addressing cost in that there will be no cost to the state,” Anness said.
The program would also benefit health care providers and hospitals who would serve more people with insurance and there would be more health care related jobs created, she added. It also would be a particular benefit for hospitals in rural areas which might be forced to close without expansion of health care coverage, according to Anness.