GOP Alters Cover Tennessee Bill to Eliminate Risk
The Senate has approved a change to Gov. Phil Bredesen’s Cover Tennessee health care proposal to eliminate all risk for the state, a move administration officials said could eliminate any private insurers from participating in the plan.
The amendment was brought by Sen. Jim Bryson, the governor’s likely Republican challenger in this fall’s election, and approved along party lines.
Bredesen’s plan would subsidize basic health insurance for lower-income working Tennesseans. At a $150 premium per month, the state would pay $50 while employers would have the option of contributing another $50.
State Finance Commissioner Dave Goetz said the state must assume some of the risk to get the program off the ground.
Bryson, a Franklin Republican, said his amendment would prevent uncontrollable cost overruns like those experienced by TennCare, the state’s expanded Medicaid program. Bredesen last year cut 170,000 people from TennCare and cut benefits for thousands more.
The amendment would place all insurance risk on contractors, meaning the state would not be responsible for any unexpected costs.
Goetz said the bill already contains language to control costs.
“This is explicitly not an entitlement, which is the hole down which we got dragged with all the TennCare programs,” Goetz said.
Nevertheless, the Senate voted 17-14 to approve the amendment.
“I think it needs to be very clear to the people of this state that if we don’t pass this amendment we’re writing a blank check,” said Sen. David Fowler, R-Signal Mountain, who ultimately was the lone senator to abstain from voting on the amendment.
Goetz argued that the commercial insurance market has not been successful in adding policies from the state’s population earning no more than 2.5 times the federal poverty rate, $24,500 for an individual, $50,000 for a family of four.
The state’s assumption of risk is necessary because “sometimes the private market is not very creative,” Goetz said.
“We can be a market facilitator,” the commissioner said.
Senate Minority Leader Jim Kyle argued that there has to be incentives for private companies to get involved.
“We’re going to say for the privilege and honor of providing this, you’re going to take all the risk, Now what kind of partnership is that?” asked Kyle, D-Memphis.
Bryson was skeptical of that reasoning.
“What we’re hearing now is the government is more creative than the private sector, and I find that hard to believe,” he said.
The Senate later delayed further action on the bill until Wednesday after Sen. Jim Tracy, R-Shelbyville, motioned to split the proposal into four separate parts.
Bredesen’s Cover Tennessee proposal also includes insurance plans for uninsured children, a high-risk insurance pool for the chronically ill, a pharmaceutical program and a health education initiative for children.
“They clearly want to have parts of the bill they can say they voted for,” Goetz said of the move to divide the bill. “But when you cut the heart out, the innovative part, you really haven’t done much.”
The plan as introduced is expected to cost more than $300 million over three years.
Goetz called the Senate vote “deeply disappointing.”
“What’s unexplained is why Senate Republicans are willing to deny health care to hundreds of thousands of people in Tennessee,” Goetz said, pledging to work to get the original version passed by the House.