Gov. Bill Haslam says he's continuing to keep tabs on the debate in Congress over health care.
He's one of many governors who've said they're concerned about the measures Republicans in the House and Senate are considering to rein in one big part of the health care system — Medicaid. But Haslam worries Congress could eventually pass the tab for covering the poor onto states like Tennessee.
Medicaid has loomed large in the debate over replacing the Affordable Care Act. Most states expanded their systems, as called for by the ACA, and the federal government promised to foot the bill through at least 2020.
But many conservatives in Congress believe Medicaid spending is ballooning out of control, and one of their solutions is to limit its growth.
Haslam says he can appreciate the logic, even as he worries about what would happen next.
"Until we get medical inflation in line with the rest of inflation, eventually health care is going to be our whole government," he says. "My concern is, is that burden going to be solely on the states?"
Meaning, if the federal government caps Medicaid, state governments are going to have to step up their spending.
Haslam says he's urging Tennessee's Republican senators, Lamar Alexander and Bob Corker, to give states more "flexibility" in how they run Medicaid.
But many people worry states would cut Medicaid spending too, if given the chance. That could leave the poor — and the doctors and nurses who treat them — with no source of funding for health care.