Gov. Haslam wants to use federal dollars for private insurance f

Gov. Haslam wants to use federal dollars for private insurance for uninsured

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By SAMANTHA MANNING and ALEXIS ZOTOS
6 News Reporters

KNOXVILLE (WATE) - Gov. Bill Haslam unveiled his plan for health care reform for the state on Wednesday.

The governor said he wants to leverage federal dollars to provide uninsured Tennessee with coverage through private companies, rather than expanding Tenncare under the Affordable Care Act.

"I believe Tennessee can also be a model for what true health care reform looks like; reform that will take significant steps to save the state and the nation from the unsustainable path we are on now," Gov. Haslam said.

Under his plan, federal dollars would be used to purchase private health insurance for Tennessee whose income is at or below 138% of the federal poverty line, or about 175,000 residents.

The plan would also reform the payment structure for providers, putting the focus on health outcomes rather than just paying for the service provided.

Tennessee Republicans expressed their support for the plan following Wednesday's announcement.

"I applaud Gov. Haslam's decision to reject Obama's medicaid expansion," Speaker Ron Ramsey said in a news release. "Without bold reform of the Medicaid program tailored to Tennessee's unique situation, there can be no compromise on this issue."

The Tennessee Hospital Association also said it supports Haslam's plan.

"Tennessee hospitals are disappointed the governor couldn't get the information he needs from CMS (Centers for Medicare and Medicaid Services) to move forward at this time with coverage of the expansion population," Tennessee Hospital Association President Craig Becker said.
 
"The governor has asked CMS to allow Tennessee to bring those who would be eligible for the Medicaid expansion into the health insurance exchange and provide them private coverage, thereby leveraging federal funding to transform healthcare in Tennessee without expanding the Medicaid rolls. Tennessee hospitals believe this is the correct approach for Tennessee," Becker said.

But Democrats in the state say the announcement is effectively a "no" to Medicaid expansion.

"We expected clarity today on Medicaid, but all we got was confusion," Senate Democratic Caucus Chairman Sen. Lowe Finney said. "Our rural hospitals and the uninsured will be the ones to suffer."

"What is ultimately going to happen is we'll have 300,000 Tennessee without insurance," Knoxville Rep. Gloria Johnson said. "We're going to give up a billion dollars."

Others are have mixed feelings about the proposal.

University of Tennessee College of Nursing associate professor Carole Myers said while she was disappointed the state isn't participating in Medicaid expansion, she believes the governor's plan still leaves the door open for reform.

"We need to accept what he said, that he's pursuing some other alternatives and hopefully be part of that discussion and deliberations and look at those," Myers said.

One of the big issues of all of this is the uncertainty for the uninsured.

One man says he was banking on the expansion to grant him the insurance he desperately needs, but now he doesn't know where he'll stand under the governor's plan.

"I just feel disposable right now," said Mark Beele, a Tazewell resident.

52-year-old Beele has a form of cirrhosis, a consequence of chronic liver disease.

"I've got liver damage, kidney damage, my platelet levels are dangerously low," explained Belle.

His disease makes it impossible for him to work, meaning he has no insurance to pay for his hefty medical bills.

Beele says with the passage of the Affordable Care Act, he thought his problems might be solved, but he's frustrated by Gov. Haslam's decision.

"It's unbelievable, knowing that it's there and we can't get it, because of somebody's decision they make," Beele said.

Beele says he's still uncertain in the end how the Tennessee plan will affect him but he says something must be done, and he's hopeful however the plan works, that it will give relief to the thousands like him.

"If there is anyway possible," Beele pleaded. "There are several thousands of people like myself that feel we are left out in the cold and we can still be productive citizens."

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