Haslam questions fed health care funding review
The federal government's review of how much money it spends to help pay for the hospital costs of low-income people in Tennessee and other states that didn't expand Medicaid feels like a threat to Gov. Bill Haslam.
"The way they're approaching this feels awfully heavy handed: OK, well if you don't do that, then we're going to restrict the pool of money that we give you for indigent care," Haslam told reporters Thursday.
Federal officials recently reached out to several states about reducing the amount of federal money that goes toward uncompensated care, or care provided to uninsured people who can't pay for it. The officials also contacted Arizona, California, Florida, Hawaii, Kansas, Massachusetts, New Mexico and Texas. Florida, Kansas, Texas and Tennessee have not expanded Medicaid.
Ben Wakana, spokesman for the U.S. Department of Health and Human Services, told The Tennessean that a state's decision on Medicaid expansion will be one factor the agency considers in the review.
In theory, a state that expanded Medicaid would need less federal money to cover people who don't have insurance because more people would be covered.
Haslam tried to implement Insure Tennessee, a health insurance expansion program that uses federal Medicaid funding. But the General Assembly rejected the plan twice, and the prospect of it passing in future sessions is still unknown.
Tennessee receives half a billion dollars in federal funds every year to help hospitals with uncompensated care, with several state sources adding another $250 million.
In Tennessee, many hospitals pay a voluntary tax to also help cover the costs of uncompensated care. That money is in addition to the $750 million that comes from federal and local sources.
If the federal funding is allowed to end, the assessment will end as well, leaving hospitals with a large hole in funding charity care, said Craig Becker, president of the Tennessee Hospital Association.
That still doesn't cover all the uncompensated care costs in the state. Tennessee hospitals provided $2 billion in charity care in 2013.
The talks with the federal government are in the early stages, and it's preliminary to predict whether funding will be reduced. Funding for uncompensated care would be part of the state's negotiations with the federal government to extend its TennCare agreement, said Sarah Tanksley, spokeswoman for the state Health Care Finance and Administration agency.
"We have to better understand whether (the review) is the gun-to-the-head, or whether they're saying, 'These funds are drying up whether you expand or not.' And that's a fair question," said Senate majority leader Mark Norris, R-Collierville.
TennCare director Darin Gordon learned of the federal review on April 16 when he spoke with Victoria Wachino, director for Medicaid and CHIP services at the federal Centers for Medicaid and Medicare Services. They talked about how uncompensated care gets paid for in Tennessee, said Tanksley.
The state regularly needs to renew agreements with federal health officials to keep receiving money for uncompensated care and to keep operating TennCare, the state's version of Medicaid. The state's TennCare waiver expires on June 30, 2016. The agreement to receive money for uncompensated care expires at the end of2015.
Reach Dave Boucher at 615-259-8892 and on Twitter @Dave_Boucher1. Reach Holly Fletcher at 615-259-8287 and on Twitter @hollyfletcher.
Editorial board continues focus on Insure Tennessee
On Wednesday The Tennessean Editorial Board invited Lt. Gov. Ron Ramsey and House Speaker Beth Harwell to meet with our members and talk about Insure Tennessee's failure in the 2015 session and its future. Their staffs have acknowledged the invitations, and we await confirmation of their acceptance.
- David Plazas, opinion engagement editor and editorial board chair, The Tennessean