March 24, 2021 – Tennessee Lookout by: Sam Stockard – Republican Lt. Gov. Randy McNally is opening the door to President Joe Biden’s plan to offer states more money for coverage of the working uninsured.
A McNally spokesman said Tuesday the lieutenant governor believes the proposal within the American Recovery Act, which would increase Medicaid payments by 5 percentage points and bring $1.2 billion extra to Tennessee over two years, should be studied.
“While the broad strokes have been released, the details still need to be fleshed out,” McNally spokesman Adam Kleinheider said in a Tuesday statement. “Before the state can make any decision about how to proceed, more information about what flexibility would be offered and how an expansion would interact with our block grant is needed. While Lt. Gov. McNally remains concerned about the long-term liabilities an expansion would create, he is open to taking another look at it in light of the administration’s proposal.”
Tennessee has an estimated 300,000 people in a coverage gap between TennCare, the state’s Medicaid program, and the Affordable Care Act, even though some counts put that number much higher. The state has continually rejected Democrats’ efforts to expand Medicaid to that population, even though the federal government has been offering more than $1 billion annually for years to put them on the rolls. McNally’s first expressed his outlook on Monday.
Tuesday Senate Minority Leader Jeff Yarbro and state Rep. John Ray Clemmons, both Nashville Democrats, held a press conference urging Republican legislative leaders, who hold supermajorities in the House and Senate, as well as Gov. Bill Lee, to take up the federal offer.
“Bill Lee and the Republican supermajority have officially run out of excuses,” Clemmons said. They pointed out red states such as Wyoming and Alabama are “jumping at the chance” to take the federal funds, even though they would receive less than Tennessee. “If a CEO of a private corporation turned down 100% financing … the CEO would be fired in a week,” Yarbro said.
Republican leaders have consistently said they are leery of getting involved in Medicaid expansion because the federal government could reduce its share of the payments at any time, leaving Tennessee with the financial burden. Under the state’s current program, the feds pay about 65% and the state puts in 35%. For the expansion population, the feds would pay 90%.
Yarbro pointed out the amount the federal government is willing to pay for the first two years would cover the state’s 10% for more than five years. “It’s just there for our taking,” Yarbro said.
Instead of pursuing Medicaid expansion, Gov. Bill Lee’s Administration this year obtained a modified block grant, which was approved by the Trump Administration just days before the former president left office. Under that plan, the state would tap into shared savings to offer TennCare enrollees more services and potentially add some residents to the plan.
The Legislature adopted that plan this year, even though more than 90% of those who addressed the matter during public hearings opposed it, including the Tennessee Justice Center, an advocate for the needy and uninsured.
Michele Johnson, executive director of the center, said Tuesday the organization is “grateful” that McNally is taking a “serious” look at accepting the federal funds. “He joins other leaders in non-expansion states who understand that it would be unwise not to consider accepting billions of dollars from the federal government that would cover 300,000 Tennesseans, shore up rural economies, and keep healthcare providers in business. This expansion will have a real impact on the health and economic wellbeing of Tennesseans,” Johnson said in a statement.
Yarbro and Clemmons point out the injection of new money into rural areas will bolster the economy and help healthcare facilities to continue operating. The state has lost about 13 hospitals to closure or major cutbacks over the last decade.