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Friday, April 12, 2019

Medicaid block grant
Shouts and calls for order accented a debate in the Tennessee House Thursday over the potential future of healthcare for 1.3 Million Tennesseans. It came during a passionate debate about a bill that could change funding for the state's Medicaid program, TennCare. Once again, the issue of health care showed the great divide between the Republican supermajority in the House and minority Democrats. It was one of the more contentious debates of the year with Republican Speaker scolding members with his gavel and some sharp words. "Order!" cried Casada as he banged his gavel at least twice when he felt members wandered off the healthcare bill before them. "I will not tolerate any more off the bill," said the Speaker just before the House voted mainly along party lines for what is called the TennCare block grant bill. It directs Republican Governor Bill Lee to negotiate with Washington for what GOP lawmakers hope is better way of funding and running the state's $12-billion Medicaid program. It's a passionate issue with Tennessee lawmakers knowing 1.3 million lower income Tennesseans are on the program that operates now on system of the federal government nearly doubling every dollar the state spends. This year, the state is spending more than $4 billion on TennCare, which is matched by nearly $8 billion from the federal Centers for Medicaid and Medicaid Services (CMS). "To think we need to continue to rely on the federal government to tell Tennesseans how to run their health care is absurd," said Jonesborough Republican Rep. Matthew Hill. Republicans hope governor lee might get the nearly $8 billion in federal Medicaid money in the form of a block grant or one lump sum yearly. They hope for fewer strings attached than the matching plan Washington now has with states like Tennessee, but Democrats wondered how it would work. "I don't see any specifics that all Tennesseans are covered," said Memphis Democrat G.A. Hardaway. House Democrats for years have advocated for expanding TennCare to provide more coverage using available funds from the Affordable Care Act. Lee's predecessor Bill Haslam tried as governor to come up with an expanded Medicaid plan his fellow Republicans could support, but they never did After the measure passed Thursday, Speaker Casada summoned party leaders briefly to the House rostrum. The Speaker later told reporters there would be more decorum "going forward" in the Tennessee House. The Tennessee Senate has not yet debated the TennCare block grant bill. Governor Lee has indicated he has already had some discussions with federal Medicaid officials about the block grant idea.

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