State Sen. Roberts explains Insure Tennessee vote

As a member of the Senate Health and Welfare Committee that voted down Governor Bill Haslam's Insure Tennessee plan, I had a unique perspective on the plan and the reasons it did not pass.

Insure Tennessee was announced with a compelling marketing campaign. The campaign touted our popular Governor's plan to expand Medicaid coverage to up to 280,000 Tennesseans as an innovative 2-year pilot program incorporating free-market principles. Best of all, it would come with no new taxes and no cost to Tennessee.

The Governor called an extraordinary legislative session to pass the plan. Lawmakers arrived from across the state along with lobbyists, special interest groups, and concerned citizens. Lines formed in the hallways as folks waited to give their opinions to their elected officials. The atmosphere was full of energy as supporters and skeptics alike offered opinions on whether the Governor had come up with a uniquely-Tennessee plan to expand Medicaid at no additional cost to taxpayers.

As meetings and hearings began, crowds gathered to hear experts offer hours of testimony for or against the plan. Legislators asked questions and, at times, tempers flared.

Was it an impressive plan? Yes. Are there free-market principles involved? Yes. Would it benefit 280,000 Tennesseans without insurance? Yes. Could it lead to other Medicaid reforms? Yes.

Then how did Insure Tennessee, presented by a much-loved Governor many of us consider a friend, go down in resounding defeat after only one committee meeting? The answer is that members of the Senate Health and Welfare Committee ignored the circus, set aside the personalities, and focused on the facts.

There are several expressions that come to mind. "If it's too good to be true, it probably is" or "All that glitters is not gold." But the expression that applies best is, "The devil is in the details."

Insure Tennessee was prepared with a number of triggers that could discontinue the program after two years. If just one of those triggers occurred and ended the program, there was not only the pain of telling up to 280,000 Tennesseans their insurance is canceled, there was also the risk of losing our entire TennCare program which serves 1.3 million Tennesseans (primarily low-income pregnant women, children and individuals who are elderly or have a disability).

Simply put, we did not have a written guarantee in our contract with the federal government that we could end Insure Tennessee and go back to TennCare. TennCare operates with an annual budget of approximately $10 billion and covers approximately 20 percent of the state's population, 50 percent of the state's births, and 50 percent of the state's children.

Further, there was no mandatory timetable for the federal government to act if Tennessee discontinued the program. The risk of delay or inaction could devastate the Tennessee budget.

As legislators, were we willing to risk TennCare for a two-year pilot program that may end as soon as it begins? Each of us casting a vote gave significant attention to the reality that Tennessee's proposed contract with the federal government didn't have in writing the assurances we needed to protect 1.3 million Tennesseans should Insure Tennessee fail.

In the end, we voted on the legislation presented – not the legislation we wished was presented. We wish the contract included written guarantees to protect TennCare, but it did not and the risk was too great. At this point, we look forward to continuing the discussion that has been started on healthcare reform, free-market principles, and lowering costs to help our friends and neighbors in need.

Kerry Roberts represents Cheatham, Dickson, Hickman, Humphreys, and Robertson counties in the Tennessee Senate. He serves on the Senate Judiciary, Government Operations, and Energy, Agriculture and Natural Resources committees.