Updated Wednesday at 9:00 p.m.
It appears the first vote on Gov. Bill Haslam’s Medicaid expansion proposal may also be the last. On Wednesday afternoon, the Senate Health Committee went solidly against the plan, dubbed Insure Tennessee.
Sen. Doug Overbey (R-Maryville) made a final, personal plea to members, telling them that they should at least vote to let the full Senate get a chance to weigh in.
“I did put my heart into it because I felt that strongly that it’s the right thing to do," Overbey said following the 7-4 vote. "I wish I had been able to convince a majority of the committee.”
The Insure Tennessee plan would have covered 280,000 people who are currently uninsured. But several lawmakers have argued that there are too few details in writing with the federal government.
Haslam said he's "disappointed" that the legislature rejected his proposal, noting that part of the reason it took so long to negotiate a deal with the Obama administration was because he knew he'd have to sell it to lawmakers.
The plan had two parts. One would help low-income workers pay for their employer-sponsored insurance. The other would expand Medicaid but add new incentives to stay healthy. Topping it off, hospitals were going to cover the state’s share of the cost.
“I said from the very beginning that it would be difficult to get something that we could get agreed to in Washington that we could get passed here," he told reporters a half hour after the special session adjourned. "I think you saw today a measure of just how difficult that is.”
Asked if he would try to push his plan during the regular session of the legislature, Haslam said that seemed "a little pointless." He also said it was unlikely that the federal government would agree to some of the changes legislators requested, but he said he was willing to try.
“There’s this picture a lot of folks have, unfortunately, that these are all people who are somehow looking to get a deal off the government," Haslam said. "Well, maybe there are some like that. But there are a whole lot of people that really need healthcare, and not getting it in a preventative way hurts them, and it hurts the rest of us too.”
Rural Support Falls Through
Haslam had been hoping rural Republicans might be persuaded to get behind the proposal, especially since some of their hospitals have been hardest hit by the lack of Medicaid expansion.
Sen. Janice Bowling (R-Tullahoma) was thought to be a swing vote. She gave Insure Tennessee a lot of thought over the past two weeks. But, ultimately, she decided too many questions had been left unanswered about how the program would work.
“Back in the district, they call it 'a pig in a poke,'” she told WPLN.
Rural hospitals and health providers pleaded with lawmakers to pass Insure Tennessee. Many say they’re struggling with the cost of treating the uninsured and that Haslam’s plan would help them close that financial gap.
Sen. Mike Bell, who represents the small, East Tennessee town of Riceville, said the medical community’s position was clear.
“But regular citizens who were not employed in the health care industry? From the emails I got, probably five to one against it,” Bell said.
It was the word of the day for Democrats and doctors, hospitals and health advocates. They blamed the seven members of the Senate Health Committee who voted 'no' for preventing the rest of the legislature from weighing in.
“The Senate let 7 people decide for 6.5 million people that 300,000 people wouldn’t receive health care," said House Minority Leader Craig Fitzhugh. "That’s not the way it’s supposed to work.”
Health-related interest groups issued statements left and right. Physicians called it a “missed opportunity.” Hospitals, who had agreed to pay for the state’s portion of expanding Medicaid, said they hoped the legislature would consider other ways to provide health coverage for the hundreds of thousands who are currently uninsured.
The Tennessee Justice Center, which helps people wade through the bureaucracy of subsidized coverage, said the rejection is a “tragic loss” for families, many of whom probably don’t even know they qualified.
The Beacon Center and Americans for Prosperity took credit for defeating Medicaid expansion in Tennessee. But the conservative groups also said they were willing to work toward what they call a “free market solution that will truly benefit low-income Tennesseans.”
Does Insure Tennessee Have A Future?
While Haslam is leaving the door cracked open to resurrect Insure Tennessee - or something like it - later this spring, he may have to find new allies willing to stick their necks out on the issue.
Majority Leader Gerald McCormick championed Haslam’s Insure Tennessee plan in the legislature. He made it clear he wouldn’t do it a second time.
“Someone else can introduce it," he said. "I don’t plan on introducing it again. I’ve had my fill this week.”
Polls show most Tennesseans didn’t know much about Insure Tennessee – if anything.
McCormick doubts there will be much political fallout from its quick defeat.
“Most people are worried about taking their kids to ball practice and working their jobs, and I don’t think they pay as much attention to us as we think they do," McCormick said. "They might notice it. I think it’s a one day story.”
Lawmakers return to Nashville next week to take up the state’s other business. Common Core and abortion are expected to be among the hot topics. With a busy spring ahead for lawmakers, Insure Tennessee may fade quickly into the past.