No Medicaid expansion unless Tennessee can use private payers

Another state--Tennessee--has opted out of the reform law's Medicaid expansion. Gov. Bill Haslam, who tried to follow in the footsteps of Arkansas Gov. Mike Beebe and use federal funds to buy private insurance coverage, couldn't reach a deal with the U.S. Department of Health & Human Services, at least for now.

Although he accused HHS of having "lack of clarity" in its communications with his office, Haslam said the agency hasn't completely rejected his proposal to privatize Medicaid. "Of our request to Medicaid, we got one or two yes's, one or two no's, and a whole lot of I don't know," Haslam told reporters, according to the Nashville Scene.

He said the hang-up was HHS wanted to put too many conditions on how he spent the Medicaid expansion money, reported The New York Times.

For example, he said HHS wanted the private insurers offering Medicaid coverage to provide additional benefits beyond what other consumers shopping for a health plan through the health insurance exchange would receive. Plus, Tennessee would have been required to follow Medicaid guidelines on copays and appeals that aren't otherwise applied to private insurance companies, the Memphis Daily News reported.

But despite the lack of agreement between the state and federal officials, Haslam said "this isn't the end of the story."

If Haslam can successfully persuade HHS to give the green-light on his private Medicaid expansion proposal, he could call a special session of the legislature to expand Medicaid.

To learn more:
- read the New York Times article
- see the Memphis Daily News article
- check out the Nashville Scene article