But one of the first such deal-makers was Tennessee Gov. Bill Haslam, who announced right before Christmas that he had a verbal commitment from the Obama administration to expand Medicaid subject to some changes.
But Mr. Haslam’s announcement was only the first step. Thanks to a law passed last year, Tennessee lawmakers must sign off on any expansion of Medicaid. On Monday the legislature will convene in a special session to debate the governor’s plan, called Insure Tennessee. Their decision could have a big influence on what other Republican states might do.
Tennessee’s plan would make eligible for Medicaid an additional 400,000 Tennesseans earning about $16,000 a year, as well as an additional 125,000- 150,000 who are already paying for health insurance through their employer. Enrollees would have two options: traditional Medicaid with meager premiums and copays, and a so-called private option under which they would receive a subsidy to pay for insurance through their employer.
Certain provisions in his Medicaid proposal—such as requesting enrollees contribute toward their own coverage and offering premium assistance—have led Mr. Haslam to sell it as “market-driven” and “outcome-based.” Yet, these provisions are already available in the Medicaid program. Despite this free-market gloss, there is nothing fundamentally different between Mr. Haslam’s plan and the type of Medicaid expansion ObamaCare architects envisioned in 2009.
Insure Tennessee faces many of the same pitfalls as any expansion of Medicaid, and includes some additional problems of its own. Here are five important things to know:
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