Joe Biden

Sohn: Will Joe Biden’s evaluate save TennCare protection?

It has been a given — virtually from the start of talks about TennCare III — that something the Volunteer State would do about exchanging a Medicaid well being care waiver for a Trump administration well being care “block grant” would find yourself costing us more cash and giving Tennessee’s working poor much less protection.

It was a given as a result of our Republican super-majority leaders merely refused to even entertain the concept of increasing Medicaid below the Reasonably priced Care Act, also referred to as Obamacare — even when the federal authorities pledged to pay for 90% of that enlargement with federal tax {dollars} we already pay.

Twice, conservative former Gov. Invoice Haslam tried to go that enlargement route with a Tennessee twist. And twice the Tennessee Normal Meeting nixed it.

However in late 2019, Haslam’s successor, Gov. Invoice Lee, adopted the short-sighted fiscal conservative route of Tennessee’s Normal Meeting and sought to grow to be the primary state to present the Trump administration one of many issues it wished most: to slash Medicaid spending by supplanting it with “block grants” — a method congressional conservatives repeatedly had tried to implement with out success.

Within the Trump administration’s closing days, the federal authorities authorized a 10-year renewal of TennCare — the state’s Medicaid program that makes use of a mix of state and federal funds to supply medical health insurance protection to about 1.4 million low-income households and kids, pregnant girls and disabled Tennesseans.

Different states had given the block grants concept the chilly shoulder. It appeared that the tough half for these Washington conservatives was persuading states to just accept fewer federal {dollars} long run than they get below the ACA.

Tennessee, nonetheless, ponied proper up, trotting out the argument that states can do it higher in the event that they’re given “flexibility” with how that cash is spent. And if we lower your expenses, we get to maintain a few of the financial savings.

There is a catch, after all. “Flexibility” below the proposed program — known as TennCare III — is code for what-can-the-program-not-cover.

Saving cash with block grant “flexibility” virtually inevitably means chopping new large holes in our well being care security internet. Holes like redefining pre-existing situations. The state could not say TennCare will not cowl bronchial asthma or diabetes, for instance, however would possibly as an alternative say the insurance coverage for these of us who rely upon TennCare may not cowl the identical gear or the most effective medicines, as required by the present TennCare contract.

Final week, Gov. Lee, in his State of the State deal with, touted the state’s newly authorized Medicaid block grant program as a victory, however he warned: “Let me be clear: if partisan assaults that decision for this block grant to be rescinded prevail, the state is not going to get these shared financial savings {dollars} that we plan to make use of to enhance well being look after weak Tennesseans.”

(READ MORE: Way forward for state’s new TennCare program in limbo below Biden administration)

By “partisan assaults” he means the chief order signed by President Joe Biden on Jan. 28 to strengthen Medicaid and the ACA. Biden’s order suggests this system because it stands now could also be short-lived, and the brand new president is asking for a evaluate of “demonstrations and waivers which will scale back protection.”

Lee might not be happy — nor are Tennessee’s lawmakers who’ve been making an attempt to fast-track the implementation of TennCare III — however Tennesseans and taxpayers must be.

As a result of Trump and Tennessee’s GOP super-majority nonetheless need to erase something that hints on the ACA, our state has been racing to put in a program that may let the federal authorities off the hook for its ACA assure of a unbroken 2-1 Medicaid spending match — regardless of how a lot our prices rise because of issues like pandemics, twister accidents or an increase within the variety of enrollees who lose their non-public insurance coverage due to job losses. As a replacement, we’ll take a block grant that perpetually caps the quantity of federal {dollars} we will use for Tennessee well being care. And we’ll hope for financial savings.

Below Lee’s TennCare III block grant association, Washington will ship again to us $7.9 billion of our tax {dollars} yearly. If our prices enhance (as they all the time have), that is for us to make up on the state degree. If our prices go down (and when have they ever?), we’ll share within the financial savings.

Michele Johnson, govt director of the Tennessee Justice Heart, mentioned Tennessee already has “one of many leanest Medicaid applications within the nation,” and she or he would not see how we will minimize any extra TennCare spending {dollars} out for “financial savings” with out hurting households.

“This is not about shared financial savings, as a result of Medicaid enlargement by now would have introduced us $8 billion. They’ve refused to take advance of that, so it is not concerning the cash — it is concerning the ideology,” she mentioned.

Speak about “partisan assaults.”

Possibly the Biden administration’s evaluate will save us.

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