Sometimes the surprise deviations from public speakers’ express intentions are at least as revealing — and sometimes more so — as the main purpose they are speaking to. A case in point from this week’s public meeting of the Shelby County Commission:
Mick Wright, one of four Republican members of the Commission, was addressing the matter (which took up ample time on Monday) of how and whether to pursue a proposed $350 million outlay for a new hospital facility for Regional One (formerly The Med). Wright is a serious conservative on both fiscal and social matters but one who looks for workable connections with the body’s Democratic majority.
On Monday, he put forth a series of amendments, some of them involving funding “matches” with state or federal sources, that would broaden the availability of revenue for the hospital project and would cushion the financial blow on local taxpayers. Wright ticked off various possibilities and made a tangential reference to the prospect, hitherto disfavored by the General Assembly’s GOP supermajority, of a long-tendered federal bounty, estimated in the billion-dollar range annually, linked to the state’s acceptance of Medicaid expansion.
This funding is already accounted for in the federal budget and would require no immediate fiscal reciprocity by Tennessee, though in the long run the state would have to pay for a modest percentage of the expanded coverage. Its financial responsibility would, in this as in most other aspects of the state-federal relationship, be far less than the amount of revenue received by Tennessee.
In a jargon favored by many conservatives, one positing a dichotomy of “makers and takers,” Tennessee is very much a taker.
After some initial hesitation, former Governor Bill Haslam, a Republican, launched an initiative, entitled “Insure Tennessee,” that would have accepted Medicaid expansion, but in votes that were virtually lockstep on the part of legislative Republicans, the plan was turned down. A similar fate has greeted occasional efforts to revive variants of the plan, including one from former GOP House Speaker Beth Harwell.
Meanwhile, several hospitals serving areas of Tennessee have failed and numerous others including Regional One, have been in financial jeopardy.
In his brief and fleeting mention of Medicaid expansion to his Commission colleagues on Monday, Mick Wright was by no means calling for a renewal of the idea. He was merely cataloguing out loud a number of theoretical ways in which a local $350 million effort on behalf of a new Regional One facility could be assisted.
Nevertheless, it would be interesting to know what the current thinking of the state’s governing Republican hierarchy might be on the matter. On Monday, the Commission resolved after much discussion to refer the issue of hospital financing back to committee.
