Emily Vo lights a luminary before a prayer vigil sponsored by the Tennessee Justice Center on the steps of the Tennessee State Capitol in support of Insure Tennessee on Monday, Jan. 11, the eve of the opening of the General Assembly. Gov. Bill Haslam’s proposal to expand Medicaid coverage to provide health insurance to more than 200,000 Tennesseans has failed to move forward in the Legislature over the last two years. Photo by Rick Musacchio
Although Insure Tennessee, Gov. Bill Haslam’s plan to expand Medicaid coverage to more than 200,000 people, has foundered in the state Legislature, supporters of the program haven’t stopped working to win its approval.
“We want legislators to know this problem is not going away,” said Michele Johnson, a parishioner at Christ the King Church in Nashville and executive director of the Tennessee Justice Center. “It’s too important to the state’s economy … and it’s the morally right thing to do.”
The Tennessee Justice Center, a non-profit law firm providing free legal services and working to help families get access to health care, hosted a prayer vigil on the Capitol steps on Monday, Jan. 11, the evening before the opening of the General Assembly, and a rally at the Legislative Plaza on the Legislature’s opening day.
More than 450 Insure Tennessee supporters lined the tunnel leading to the Senate and House of Representatives chambers on Tuesday, Jan. 12, as legislators walked past, Johnson said. The supporters got a mixed response, she said; some legislators wouldn’t make eye contact, others looked annoyed, but some looked happy to see them, Johnson said.
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 to more than 200,000 people in the so-called Medicaid gap:
• 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 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.
|About 120 people attended the prayer vigil on the steps of the Tennessee State Capitol in support of the Insure Tennessee proposal, which would expand Medicaid coverage in the state. The vigil and a rally the next day, Jan. 12, at Legislative Plaza was sponsored by Tennessee Justice Center.|
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 vast majority of people who would be eligible are working,” Johnson said.
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.
“We are losing millions of dollars from the federal government that we can put back into the Tennessee economy to take care of the health care of working people,” said Jennifer Murphy, executive director of the Catholic Public Policy Commission, which represents Tennessee’s three dioceses before the Legislature.
Johnson said the federal government has set aside $1.77 billion for Tennessee to expand Medicaid coverage that the state so far has declined to accept. Haywood Park Community Hospital in Brownsville closed in 2014, and hospital officials said the facility was affected by cuts in federal program reimbursement that were based on the assumption more people would have private insurance to pay for their health care, in part, through Medicaid expansion.
Johnson believes a loss of jobs because of the refusal to expand Medicaid might convince legislators to reconsider Insure Tennessee. “It comes down to leadership,” Johnson said. “If it gets to the House floor the votes are there. Getting it to the House floor will take leadership.”
“We’re hopeful, not because we’re in fairyland, but because we’ve been talking with people all summer” explaining the proposal, Johnson said.
Murphy and the CPPC will be following several other issues during the upcoming session of the General Assembly.
A bill creating Opportunity Scholarships, Gov. Haslam’s plan to provide vouchers for low income families to use to pay tuition at private schools for their children, is still alive and is expected to get another look from the Legislature this year, Murphy said. The bill has passed in the Senate for the last two years, but has stalled in the House Finance Committee, she said. “We’re still about two votes short of passing it in the committee,” Murphy said.
Catholic school superintendents in all three dioceses support the bill, Murphy said. “We really want to see that passed.”
The CPPC also will be talking to legislators about the refugee resettlement program after several have expressed concerns and have proposed limits on the program.
Another issue the CPPC will be following is regulation of the predatory lending industry, which charges as much as 400 percent interest on payday loans, Murphy said.