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Governor Bill Haslam, during the National Governors Association Education, Early Childhood and Workforce Committee meeting in Washington, D.C., on Sunday, February 26, 2012.
Tennessee Gov. Bill Haslam
The Obama administration is pushing Republican governors to consider the Arkansas model for Medicaid expansion, which allows Medicaid money to be used to purchase private health insurance. But there are apparent limits to what the administration will allow. Sarah Kliff explains:
Tennessee wanted to pursue a plan like that of Arkansas, one where it would use the Medicaid expansion dollars to buy private insurance coverage. And while Arkansas received a preliminary go-ahead from HHS, Gov. Bill Haslam had a quite different experience: He says that Health and Human Services would not support his plan to expand Medicaid and, as a result, he will not move forward. [...]

But some of the other points in the Tennessee proposal might have raised eyebrows in the Hubert Humphrey Building. The governor proposed “co-pays for those who can afford to pay something.” As for what that would mean in practice, Andy Sher at the Chattanoga Times Free Press reports that the governor wanted Medicaid beneficiaries to pay the same cost-sharing as other exchange enrollees.

Medicaid experts I’ve spoken with have made it clear that such an approach wouldn’t fly: Even if they receive private coverage, the Medicaid agency would need to ensure they aren’t spending more out of pocket than they would in the public plan.

Medicaid has always had strict rules on what Medicaid recipients pay out of pocket, and issued new rules for people above the poverty line who would be newly eligible. Arkansas recognized that and incorporated it into the plan they have conditional approval on. For its part, HHS says that it's still willing to work with Tennessee on a plan, but Haslam doesn't seem interested: "We don’t think our proposal is dead…We think we have a realistic proposal that will work for them and for us."

Originally posted to Joan McCarter on Thu Mar 28, 2013 at 10:30 AM PDT.

Also republished by Three Star Kossacks and Daily Kos.

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