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In the aftermath of the 2012 elections, Republicans in Tennessee enjoy supermajority control of the General Assembly (26R & 7D in Senate; 69R, 29D, & 1I in House) and also hold the governorship. Time for Team Red to Take Back Our Country, which in 2013 still means undermining the Affordable Care Act. So, naturally a bill has been introduced by Rep. Jeremy Duram, that would block the expansion of Medicaid in Tennessee-- one of the major mechanisms by which the ACA extends the number of those with access to heathcare. Should be a cinch to pass in the increasingly reactionary home of Al Gore.

But turns out blocking this provision is just not popular among Tennesseans. Even though neither Obama not Obamacare enjoy much popularity in the state, even Republican voters are apparently reluctant to forgo the sweet sweet milk flowing from the government medicaid teat. Not too hard to see why, considering that with over 1.2 million enrollees as of Dec 2012, Tenncare (the Tennessee medicaid program) covers about 18% of the state's 6.5 million residents already.

But no need for Republican politicians to take their constituents' opinions into account when ideology is on the line, right? 56% support for expanding Tenncare shouldn't stand in the way of partisan aspirations.

Hold on there, bucko. Turns out, it's not just people's health and well-being at stake, there's big money on the table. As Moody's recently pointed out, Tennessee is an epicenter of the corporate for-profit hospital industry. These companies stand to loose a lot if the General Assembly blocks Tenncare expansion, and they are making it known:

Craig Becker, president of the THA, noted that hospitals in the state stand to lose $5.6 billion at a time when 58, mostly rural, facilities are already losing money every year.

“I can't wrap my head around those numbers,” he said. “This is a tax on hospitals. Why should we send those tax dollars to California, New York or Vermont, or even New Jersey?”

A tax! On upstanding corpirate citizens, no less. To the benefit of --gak-- New Jersey!

Not that it would necessarily bother Republican legislators too much, but their bill could also be potentially crippling to the several not-for-profit hospitals affiliated with academic medical centers throughout the sate. These institutions are facing loss of federal funding that has traditionally supported hospitals that care disproportionately for uninsured. After all, if everyone is going to have access to health insurance, why bother reimbursing academic hospitals for taking care of the uninsured?

Too early to know how this will all play out, but there are signs that gov. Bill Haslam (a Repub of the Big Money variety) might be swayed by the economic argument to do the right thing. Not at all clear that he would veto the republican bill if it passes both houses (as seems likely), but at least he's on record against it.

Originally posted to Sunny Volanakistan on Mon Mar 18, 2013 at 02:42 PM PDT.

Also republished by Three Star Kossacks.

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