Tag: Governor Bill Haslam

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Healthcare Showdown In Nashville!

CREDIT: Justin Fox Burks

Forget the elephant in the room. Where Tennessee state government is concerned, the elephant is the room. Republican sentiment in virtually every county in Tennessee, and in each of the state’s three grand divisions, is so overwhelming that all meaningful debates now take place within the GOP super-majority itself.  

As was the case during the multiple historic decades of Democratic domination, one-party government invites fragmentation, a process during which what appears monolithic and unified right now could well split into a right, a left, and a moderate center (all things being relative) as the political spectrum inevitably reasserts itself.

Something of the sort may get underway, in fact, as soon as next Tuesday, February 3rd, with the convening of the special session called by Governor Bill Haslam to deal with Insure Tennessee, the Republican governor’s home-grown version of a Medicaid expansion plan.

Justin Fox Burks

Mark Norris

Given the tensions and current disagreement on the subject within the GOP caucus, the session could easily last longer than the week allocated for it in the resolution authored (dutifully but reluctantly) by state Senate Majority Leader Mark Norris of Collierville. But not if Norris, an all-but-formally declared opponent of the plan, and the rabidly anti-Obamacare members of the Republican caucus have their way.

Although much of the declared and potential opposition to Insure Tennessee is clearly political, much of it, too, is either based on (or rationalized from) financial claims — one of them, certain to be heard early and often in the special session, being an allegation that the federal government could renege on its promise to provide 90 percent of funding for a state’s Medicaid program after fully funding the first two years.

Brian Kelsey

This is a favorite argument of state Senator Brian Kelsey (R-Germantown), a sworn foe of Insure Tennessee and of Medicaid expansion by any other name. “I question whether the federal government is a reliable negotiator,” said Kelsey last week, repeating an assertion he and other opponents make frequently — though not (so far, anyhow) with appropriate chapter-and-verse citations of prior derelictions by the feds.

Kelsey goes further, also questioning the validity of a commitment to foot the bill for the remaining 10 percent by the Tennessee Hospital Association, whose financially distressed and overburdened member institutions are desperate for the $1 to $2 billion that could be funneled annually via Insure Tennessee to TennCare (the state’s version of Medicaid).

The senator does not question the hospitals’ bona fides (though he has called the Hospital Association a “special interest”). Rather, he refers to a proposal periodically made in the past by U.S. Senator Bob Corker that would abolish the kind of fees on health-care providers that, as amplified in accordance with the Hospital Association’s pledge, could provide the association’s annual funding share.

A problem with that: Corker’s office responded to the claim with a statement that the senator had “no current plans” to proceed with any such legislation. Corker added, “I assume governors will continue to take advantage of federal laws as they exist today.”

In an indirect and gingerly fashion Corker made it necessary for critics of Insure Tennessee to challenge his own good faith on the matter.

Nevertheless, and despite the governor’s attempts to dissociate Insure Tennessee from Obamacare in information sessions (read: lobbying visits) held in Jackson and Memphis last week, it is a root fact that, in Tennessee as in Republican states elsewhere, the use of the president’s name in describing the Affordable Care Act (ACA) can by itself be a deal-killer.

It is that fact that prompted Haslam, earlier this month, to make a special appeal to the legislature’s Democrats for support of Insure Tennessee. With rare exceptions, if any, he should get his wish. But Democrats are a marginal factor in the General Assembly of 2105, owning only five seats in the 33-member state Senate and 26 of the 99 seats in the House.

The showdown over Insure Tennessee will be decided within the ranks of the legislature’s Republicans. In an interview with the Flyer two weeks ago, Norris contended that the GOP caucus was possessed of an “open mind” on the governor’s Medicaid proposal —and that he had not ruled out either opposing it or, as is the case with most administration bills, sponsoring it.

Yet it seemed obvious, in the thicket of reservations he expressed about the bill (most technical or procedural or fiscal, some philosophical) that Norris is disinclined to support Insure Tennessee. And, whether it was prepared with his cooperation or not, an online ad bearing Norris’ likeness and stating vigorous opposition to Insure Tennessee has been appearing with some regularity of late on various websites.

In his Flyer interview, Norris summed up several possible objections to Insure Tennessee: its effect upon ongoing litigation concerning TennCare in federal court; the specter of swelling TennCare’s rolls to the point of fiscal untenability; and uncertainty regarding what the U.S. Supreme Court will do in King v. Burwell, a case challenging the legality of federally administered health-care exchanges under the ACA.  

(Significantly, Norris is one of 18 members of the state Senate — a majority — who has signed on to an amicus brief on the plaintiff’s side in the latter case.)

All of this, Norris said, speaking of himself in his institutional role, constituted “the situation the majority leader has to deal with so as to instruct and inform my caucus,” adding meaningfully, “That’s the pool from which the governor has to draw for his votes. … My job is to maintain credibility with my caucus and to provide them with factual and legal information to make their best judgment.” 

The obligation to “maintain credibility” with his caucus had, up until that point, anyhow, kept Norris, in the case of Insure Tennessee, from assuming his normal role as sponsor of legislation desired by the governor.

Indeed, with less than a week to go before the onset of the special session, there is widespread doubt as to the form that action on Insure Tennessee should take.

“Is it legislation or a joint House-Senate resolution?” Norris wondered. “It could be a concurrent resolution, with two tracks [in the House and Senate separately and simultaneously].” In that case, Norris said, pointedly, “Any member can file amendments, including ‘poison pill’ amendments.” 

As Norris’ indicated, there has been a great deal of Alphonse-and-Gaston shuffling within the leadership ranks of the two chambers regarding who should bear the onus of formally presenting Insure Tennessee for consideration.

Jackson Baker

Speakers Ron Ramsey and Beth Harwell will play important roles in the Senate and House, respectively, during the special session.

Lieutenant Governor Ron Ramsey, the speaker of the state Senate, has indicated he is open to the idea of supporting Governor Haslam’s proposal, but he, like Norris, has professed uncertainty on the matter of procedure, suggesting that the House and Senate should act separately on the matter, with the House going first.

That hasn’t sat well with Norris’ opposite number in the House, Majority Leader Gerald McCormick (R-Chattanooga), who has braved the possible discontent of his fellow Republicans by endorsing Insure Tennessee and promising to do what he can to get it passed.

Calling the idea of a go-it-alone process in the House “preposterous,” McCormick said, “If they [Senate leaders] don’t want to do it, then they just need to tell us and we’ll go about our business and go into regular session. But we’re not going to go through an exercise in futility if they’re not serious about considering this legislation.”  

McCormick has been frank in declaring that House votes for Insure Tennessee may be hard to come by.

As quoted in the Tennessean two weeks ago,  McCormick put the issue succinctly, “It’s a government program and we’re expanding it. And as Republicans, we don’t like to expand government programs, period. But then you go back to the common-sense part of this … really the only practical way to provide these services … is to expand the Medicaid program.”

The debate in GOP ranks calls to mind the situation that another Republican governor in recent times found himself. The proactive way in which a term-limited Haslam has begun his second and final four-term term is reminiscent of the situation that former Governor Don Sundquist found himself in, circa 1997.

As is the case with Haslam, Sundquist confronted a gap between perceived policy needs and the revenues necessary for the state to act upon them. The ever-burgeoning rolls of TennCare, a program Sundquist resolved to support, were a part of the problem, but there was, at least in the then-governor’s mind, a structural weakness in the state’s revenue base that retarded other policy initiatives, as well.

The problem, as Sundquist saw it, lay in the inherent limitations of the state’s reliance on sales tax revenues, which, by definition, were subject to economic cycles. There was another problem, too: the inherently regressive nature of a sales tax. 

As Sundquist put it in 2011 in an interview with this writer for an article in Memphis Magazine: “Nobody disagrees that we ought to be a low-tax state, but we have to have a fair-tax system that is not regressive, and when you’ve got the people who make the least amount of money paying sales tax on food and clothing, it’s not fair. Then you’ve got all these professionals who are paying virtually nothing. Oh, they’ll tell you, ‘We pay a tax, a fee for our licenses.’ Just bull!”

Sundquist’s first solution back then was a proposal for a business tax, but, as opposition to that proposal grew, most of it from his own Republican ranks, he bit the bullet and proposed what he called a “flat tax” on income — one that would be offset by corresponding decreases in one’s federal income tax and could not be raised except by two-thirds majorities of both the state House and the state Senate.

Sundquist had Republican loyalists willing to back his proposal but not nearly enough to stem the tide of discontent, not only in GOP legislative ranks, but at the grass-roots level. The “I.T.,” as opponents of a state income tax derisively called it, was finally dropped from legislative consideration, on the very brink of passage, in the wake of a July 2001 riot on the state capitol grounds by what numerous observers called a “mob.”

(It is perhaps no accident that Norris, in his recent Flyer interview, used the expression “it,” which he spelled out with the initials “I-T,” to describe Haslam’s Insure Tennessee proposal.)

The long and the short of it was that the concept of a state income tax became untouchable by members of either party, and the sales tax was forever enshrined as the basic source of state revenue. The aforesaid Senator Kelsey attended to the “I.T.’s” formal burial recently by spearheading the constitutional amendment prohibiting it that was passed by a statewide vote in November.

And, as a consequence of his tax proposal, Sundquist became anathema in state GOP circles, though he had been backed by such traditional Republicans as Memphis’ Lewis Donelson and by a variety of business-minded groups.

Jackson Baker

for a unanimous endorsement of Insure Tennessee.

Significantly, Haslam, too, has support from such sources. The state Chamber of Commerce has backed his Insure Tennessee proposals, and Phil Trenary of the Greater Memphis Chamber is an especially strong advocate. Equally telling was a 12-0 vote of endorsement of the governor’s plan by the Shelby County Commission two weeks ago. The sponsor of that vote was Terry Roland of Millington, one of the most vocal and consistently conservative of the commission’s six Republican members.

For Roland and the other supporters of Insure Tennessee on the commission and elsewhere locally, the matter is a no-brainer: Memphis’ Regional One Health facility, which is responsible for the lion’s share of indigent medical care in Shelby County and in adjoining West Tennessee, Arkansas, and Mississippi, is in sore need of the funds Insure Tennessee would provide.

Spokespersons for other major health-care facilities as well, including the Baptist and Methodist hospital systems, have lobbied persistently for Haslam’s plan.

Even so, passage of the measure will be touch-and-go. Speaking before a local Republican women’s group earlier this month, several local Republican legislators appeared to vie with each other in citing reasons not to pursue Insure Tennessee. State Representative Curry Todd forecast that the coming special session would become a “bloodbath,” and relatively moderate House member Steve McManus expressed a fear that Medicaid expansion under Insure Tennessee would become a costly “Hotel California” that the state could enter into but never leave.

Ironically, the governor’s plan has what Haslam has advertised as a fail-safe against such a prospect. As proposed, Insure Tennessee, which would provide health-care coverage for at least 200,000 currently uncovered Tennesseans, would involve no increase in state funding whatsoever. The funding for the first two years — again, estimated to be between $1 and $2 billion — would be borne by the federal government.

Should there be a default, intentional or otherwise, by either the federal government or the Tennessee Hospital Association, which are pledged to assume 90 percent and 10 percent of the subsequent funding burden, respectively, Insure Tennessee would sunset automatically, the governor insists.

That fact, a funding formula free of new state obligations, allows for one of the two most important distinctions between his current predicament and that which faced Sundquist, whose tax-reform plan called for raising additional state revenue, even if offset by federal income-tax reductions for individual taxpayers.    

The other distinction between Haslam’s situation and Sundquist’s is that the latter was dealing with substantial Democratic majorities in both legislative chambers, a fact tilting both bodies toward at least the concept of governmental intervention as a remedy for social problems. Haslam confronts a Republican super-majority in both chambers, including Tea Party members and other arch-conservatives opposed to the very idea of governmental expansion, regardless of the paying formula.

The fact of that anti-government bias will be the chief obstacle for Haslam to overcome in the special session, which Norris and other Republicans want to hold to a single week. 

But it will also be a factor in the regular session to come, when there will be mounting opposition to the administration’s support for Common Core educational standards (decried as creeping federalism by Tea Party members and opposed also by state teacher’s organizations for other reasons) and its defense of the endangered Hall Income Tax on annuities (which Haslam regards as important to maintain, given the state’s existing revenue needs).

There will be legislative pressure, too, to move further on imposing new restrictions on abortion than Haslam might prefer, though the governor gave at least formal assent to the passage of Constitutional Amendment 1 on last November’s ballot, which gives license to renewed anti-abortion measures.

Does this last feature seem to contradict the stated bias of so many members of the GOP super-majority against stepped-up governmental activity? Maybe so, but it won’t affect the realities of what happens in Nashville in 2015, any more than logical inconsistencies on approaches to Insure Tennessee will.

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Editorial Opinion

Support Insure Tennessee

No one can say that we were lax in urging Governor Bill Haslam to find some way to come to terms with the Affordable Care Act (ACA). Tennessee, with its large lower-income population and a financially threatened hospital network, needs to take advantage of the billion or so federal dollars that come annually with Medicaid expansion.

Had the Governor made his peace early on with the ACA (or Obamacare, as Republicans prefer to call it), he might have been able to get his plan across in quick order and relatively uncomplicated fashion. He chose to procrastinate, however, possibly to keep the restive Tea Party component in the Republican-dominated legislature at bay. He proclaimed the existence of something called “The Tennessee Plan,” which, he said, was in the process of creation and which, when complete, would form the basis of a waiver request with the Department of Health and Human Services.

We would later learn that there was — at that time — no such plan, not even much of a skeleton for it. And meanwhile the GOP majority, goaded on by determined ultra-conservative foes of Medicaid expansion (and perhaps even of Medicaid itself) like Germantown state Senator Brian Kelsey, took advantage of the delay to pass legislation that requires approval by both houses of the General Assembly for any state involvement whatsoever with the ACA.

Haslam, it seemed, had put himself — and the state, especially its working poor and its medical providers — in a box from which there was no escape.

Well, who is to say that the age of miracles has passed? The governor, at length, did come up with a plan called “Tennessee Promise,” with a two-track modus operandi that would allow participants either to accept vouchers for use with private insurors or to come within TennCare (Tennessee’s version of Medicaid) with an obligation to make modest co-pays and premium payments. It seemed a genuine compromise between the ideology of the marketplace and governmental intervention to meet an obvious social need.

And Haslam’s plan possesses a “fail-safe” provision that allows for automatic discontinuation of the state’s program in case of default by either the federal government, which promises to provide 90 percent of funding after the first two (fully paid) years or the Tennessee Hospital Association, which has pledged to take care of the remaining 10 percent.

This last provision should have invalidated the oft-expressed doubts by critics of Medicaid expansion in Tennessee that the state would veer into ultimate insolvency by committing itself to the federal funding, but it hasn’t. The critics have merely shifted ground a bit, crying rhetorical crocodile tears and claiming that either the feds or the Hospital Association or both will weasel out in two years’ time and leave the impoverished masses once again without coverage.

To call this claim “disingenuous” is to give it too much credit. The population on which this bogus concern is lavished is without coverage now. Even in the critics’ implausible scenario, something now is far better than nothing, ever.

All sophistries aside, Haslam’s plan is entitled to full and bipartisan support in the February 2nd special session. We urge its passage, the sooner the better.

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Politics Politics Beat Blog

Shelby GOP Legislators Express Doubts About “Insure Tennessee”

CREDIT: JB

JB

State Reps. Ron Lollar and Jim Coley meet with members of the Republican Women of Purpose.

For what it’s worth, Governor Bill Haslam’s “Insure Tennessee” plan for Medicaid (TennCare) expansion may not go down that well with Republican legislators from Shelby County. Speaking at a luncheon meeting of the Republican Women of Purpose on Wednesday at the ballroom of Southwind TPC, several of them weighed in on the matter.

Predictably, perhaps, state Senator Brian Kelsey, an opponent of Medicaid expansion per se,  insisted Republicans needed to “shrink the size of government., not…expand the size of government” and cast doubt as to whether the federal government would or the state Hospital Association could pay its pledged share in two years’ time.

State Rep. Jim Coley lamented the plan’s “dependence on the federal government” and said he “hope[d] to persuade the Governor this is not the most appropriate plan.”

State Rep. Steve McManus said it might not be so easy to opt out of the plan after two years as Haslam suggests. He contends that the U.S. Department of Health and Human Services might withhold Medicaid funds entirely as retribution. “It’s like Hotel California,” he said, meaning that once you check into the plan, you can never leave.

State Rep. Curry Todd prophesied “a lot of bloodletting” in the special session regarding the plan, scheduled to begin February 2.

Coley and Todd were alarmed about the prospect of both a state and a federal gasoline tax and implied criticism of Senator Bob Corker for proposing the latter.

*On other matters, state Rep. Ron Lollar said he was “concerned about our leadership welcoming President Obama to Knoxville on Friday” and further concerned “about what we’re buying into” as a result. While most of the legislators expressed reservations about Common Core, state Rep. Mark White made a point of saying he was open-minded on the subject, that it was important to assert educational standards.

*Another issue brought up by the legislators — especially Kelsey and White – was the possibility of de-annexation legislation. Southwind has just been annexed by Memphis. (On Thursday, incidentally, a Tennessee Court of Appeals ruled that Chancellor Jim Kyle, who recently denied a restraining order on the annexation, should not have heard the case because of leftover litigation he was still handling on behalf of the City of Memphis.)

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Politics Politics Feature

It Was What It Was

The year 2014 began with a call for unity from several of the political principals of Memphis and Shelby County — remarkable circumstances given that just ahead was another one of those knock-down, drawn-out election brawls that characterize a big-ballot election year.

Speaking at an annual prayer breakfast on January 1st, 9th District Congressman Steve Cohen called for an end to bipartisan bickering in Congress and touted the achievements of the Affordable Care Act (ACA) (aka Obamacare). Shelby County Mayor Mark Luttrell asked for civility in county government, and Memphis Mayor A C Wharton, amid a good deal of wrangling over city pension reform, among other matters, said something similar and declared, “I’m through with whose fault it is!”

Surely no one is surprised that few of these hopes were fully realized in the course of 2014.

Not that some concrete things didn’t get done. The nervy national website Wonkette crowned Tennessee state Representative Stacey Campfield (R-Knoxville) “S***muffin of the Year,” and, lo and behold, the voters of Knox County would come to a similar conclusion down the line, voting out the incumbent madcap whose most famous bills had come to be known, fairly or otherwise, as “Don’t Say Gay” and “Starve the Children.”

State Senator Brian Kelsey had mixed results, losing again on a renewed effort to force Governor Bill Haslam into a big-time school voucher program and in a quixotic attempt to strip Shelby County of two of its elected judges but getting his props from those — including a majority of Tennessee voters — who supported his constitutional amendment to abolish an income tax in Tennessee for all time.

All four constitutional amendments on the state ballot would pass — including one to strip away what had been some fairly ironclad protections of a woman’s right to an abortion and another to transform the selection and tenure procedures for state appellate judges. Another little-noticed amendment guaranteeing veterans the right to hold charity raffles also passed.

The battle over the key three amendments all reflected a growing concern that Republican-dominated state authority had begun to enlarge its control over local governments and individual citizens alike, not only in the nature of the constitutional amendments but in the legislature’s effort to override local authority in matters including firearms management, public school oversight, public wage policy, and the ability of localities to establish their own ethical mandates.

Shelby County Democrats, who had been swept by the GOP in 2010, had a spirited primary election, with most attention focusing on the mayor’s race between former County Commissioner Deidre Malone, incumbent Commissioner Steve Mulroy, and former school board member and New Olivet Baptist Church pastor Kenneth Whalum Jr.

When votes were counted on May 6th, Malone emerged to become the head of a Democratic ticket that would challenge several well-established Republican incumbents. Democrats’ hopes were high at first, but two of their expected election-day stalwarts began to suffer self-destructive moments at an alarming rate.

The two were lawyer Joe Brown — the “Judge Joe Brown” of nationally syndicated TV fame; and County Commissioner Henri Brooks, a former legislator who had an abrasive way about her but who had recently won laurels as the watchdog on Juvenile Court who had forced the Department of Justice (DOJ) to mandate a series of reforms.

Both District Attorney General candidate Brown, through his celebrity and what was thought to be his ability to bankroll much of the Democratic ticket’s activity, and Juvenile court Clerk candidate Brooks, riding high on her DOJ desserts, were thought to be boons, but they rapidly became busts.

Brown, it turned out, had virtually no money to pass around, even for his own campaign efforts, and he got himself arrested for contempt in Juvenile Court. When, late in the campaign, he launched a series of lurid and seemingly unfounded attacks upon the private life of his opponent, Republican D.A. Amy Weirich, he was dead in the water.

Brooks engaged in successive misfires — browbeating a Hispanic witness before the commission; assaulting a woman she was competing with for a parking spot; and, finally, turning out not to have a legal residence within the commission district she represented.

The bottom line: Shelby County Democrats — underfunded, under-organized, and riven by internal rivalries — were overwhelmed once again on August 7th, with county Mayor Mark Luttrell, Weirich, and Sheriff Bill Oldham leading a Republican ticket that won everything except the office of county assessor, where conscientious Democratic incumbent Cheyenne Johnson held on against a little-known GOP challenger.

All things considered, the judicial races on August 7th went to the known and familiar, with almost all incumbents winning reelection on a lengthy ballot in which virtually every position in every court —General Sessions, Circuit, Criminal, Chancery, and Probate — was under challenge.

Meanwhile, 9th District Congressman Steve Cohen, who had dispatched a series of Democratic Primary and general election challengers since his first election to Congress in 2006, faced what appeared in advance to be his most formidable primary foe yet in lawyer Ricky Wilkins. Cohen won again — though only by a 2-to-1 ratio, unlike the 4-to-1 victories he was used to.

The final elections of the year, including the referenda for the aforementioned package of constitutional amendments, would take place on November 4th.

But for the amendments, there was no suspense to speak of. Two Democrats running for the U.S. Senate — Gordon Ball and Terry Adams, both Knoxville lawyers — had run a spirited and close race in the primary, but winner Ball ran way behind Republican incumbent Senator Lamar Alexander, despite Alexander’s having barely eked out a primary win over unsung Tea Party favorite Joe Carr.

Haslam, the Republican gubernatorial incumbent, easily put away Charlie Brown, an unknown quantity from East Tennessee who had won the Democratic primary mainly on the strength of his comic-strip name.

Throughout the year, there had been persistent wrangles in City Hall between Wharton and members of the city council over dozens of matters — including pension and health-care changes, development proposals, and failures to communicate — with the result that influential councilmen like 2014 council Chairman Jim Stickland and Harold Collins were possible rivals to Wharton in a 2015 mayoral race that might draw in a generous handful of other serious candidates.

Toward year’s end, though, Wharton pulled off a series of coups — announcing new Target and IKEA facilities and appearing to finesse the pension and school-debt matters — that underscored his status as the candidate to beat.

In Nashville, Haslam seemed to have achieved the high ground, finally, with his espousal of a bona fide Medicaid-expansion plan, “Insure Tennessee,” and a determination to defend the Hall income tax and at least some version of educational standards. But battles over these matters and new attacks on legal abortion loomed.

We shall see what we shall see.

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Politics Politics Feature

A Surprise Consensus in Tennessee Government

Events in Tennessee state government were on center stage this week, with the convening of the Tennessee General Assembly just around the next turn of the calendar.

The big political/governmental news of the week was, beyond doubt, Governor Bill Haslam‘s announcement of a provisional agreement with the federal government on an alternative Tennessee plan for Medicaid expansion in Tennessee.

The plan, which Haslam called “Insure Tennessee,” would, he said, “leverage” Medicaid-expansion money under the Affordable Care Act (ACA) in a two-year “pilot program” that would provide coverage for the currently uninsured and prepare them for eventual “transition to commercial health coverage.”

Haslam said the agreement with the federal government was “verbal” at this point, but that a formal request for waiver from standard ACA requirements would follow, with expectations of approval.

Under the terms of legislation passed in the last session of the Tennessee General Assembly, any agreement reached between the governor and the federal government on Medicaid expansion must be approved by both houses of the legislature. Haslam said he would work diligently to achieve that approval in a special session to be held in January, in advance of the regular 2015 session of the General Assembly.

If approved, the plan apparently would, like standard Medicaid expansion, make the state eligible for millions of dollars in new funding under the ACA, a result that the state’s hospital executives, many of them facing critical shortages, have been aggressively lobbying for.

Initial response to the plan on the part of Tennessee’s public officials was overwhelmingly positive on both sides of the party line, with Tennessee’s two Republican U.S. Senators, Lamar Alexander and Bob Corker, quickly conferring their approval, as did the state’s ranking Democrats, 5th District Congressman Jim Cooper of Nashville and 9th District Congressman Steve Cohen of Memphis (though Cohen was one of several Tennessee Democrats to deplore the GOP-dominated state government’s long delay in responding to the proffer of substantial federal funding.

At stake has been millions of dollars in potential aid to fund medical coverage for indigent patients through TennCare, the state’s version of Medicaid (itself, ironically, established a generation ago through a waiver agreement with the federal government during the administration of the late former Governor Ned Ray McWherter).

Several of Tennessee’s hospitals have been experiencing severe financial difficulties, and they, along with prominent members of the state’s business establishment, have been lobbying hard for a change of mind by Haslam, who, confronted by widespread hostility by his fellow Republicans in the legislature to what they called Obamacare, had declined to accept funding for Medicaid expansion in 2013.

Haslam said at the time that he would attempt to reach an agreement with the Obama administration for an alternative Tennessee expansion plan that deviated from strict ACA requirements. He had subsequently been in protracted negotiations with officials of Health and Human Services and the Centers for Medicare and Medicaid Services (CMS) to obtain such a waiver.

At his announcement/press conference on Monday, Haslam told reporters that federal officials had basically pre-approved a waiver for the plan — which must first, however, be approved by both houses of the Tennessee legislature under terms of a restrictive statute passed last year.

The chances for that happening were decidedly enhanced by what seemed an open-minded response to the Governor’s plan from Lieutenant Governor/State Senate Speaker Ron Ramsey.

Said Ramsey on Monday: “When a state has an opportunity to take power away from the federal government and institute real conservative reform, that is an opportunity that must be taken seriously. Governor Haslam has negotiated a deal, which returns tax dollars back to Tennessee while using conservative principles to bring health insurance to more Tennesseans. I look forward to sitting down with my fellow legislators to take a hard look at what has been negotiated to make sure that the final deal, which must be approved by the legislature, is in the long-term financial interest of Tennessee.”

Insure Tennessee does indeed cater to Republican free-market shibboleths. It proposes to use the additional federal Medicaid funds to broaden coverage for the state’s uninsured through their employers’ existing health insurance plans or by requiring modest co-pays and premiums for those accessing the aid through TennCare. The plan allows for a reduction in the latter costs if recipients pursue preventive measures and other “healthy choices.”

Democratic legislators indicated a willingness to fall in line with the governor. Typical was the response of the Democratic state House leader, state Representative Craig Fitzhugh (Ripley), who promised to “stand with” Haslam and expressed “my personal thanks to Governor Bill Haslam and the Obama administration for working together on this plan.” 

And, as noted previously in this space, Democrats are in a position to provide Haslam with backup in the governor’s professed intention to resist efforts to repeal the Hall Income Tax on the part of GOP ultra-conservatives  — several of whom, no doubt, will endeavor to thwart or amend the Insure Tennessee plan during the forthcoming special session.                

• Given the disproportionate extent of GOP control in the General Assembly — 28 of 33 members of the state Senate, 73 of 99 in the state House — it would be misleading to use the word “bipartisan” in anticipation of the coming legislative session, but optimists would surely be within their rights to hope for a greater degree of political moderation than has been the case in the past several sessions.

One possible indication of that was the easy reelection (57-15) in the House Republican Caucus last week of state Representative Beth Harwell (R-Nashville) as House Speaker over state Representative Rick Womick (R-Rockvale), a Tea Party Republican. Yet another was a vote in the state Senate Republican Caucus to replace Germantown conservative Brian Kelsey on the Fiscal Review Committee with the relatively moderate Maryville Republican Doug Overbey. 

And even Kelsey, a possible thorn in Haslam’s side on the Medicaid and Hall Income Tax issues, struck a moderate note in his announced co-sponsorship with Democratic state Representative John DeBerry (D-Memphis) of a measure that would require law enforcement agencies in Tennessee to adopt policies outlawing racial profiling.

Moreover, there had been a decisive (47-17) vote by the state Republican Executive Committee the week before to reelect as state GOP chairman the establishment-oriented Chris Devaney over Tea Party-leaning Joe Carr, the outgoing state representative from Lascassas who unsuccessfully challenged incumbent Lamar Alexander for the U.S. Senate.

 

•  Tennessee Democrats, meanwhile, were engaged in an effort to decide on a new state chair for their party, to succeed Roy Herron, who is stepping down. All five contenders for the chairmanship — which will be awarded by the state Democratic Executive Committee in Nashville in January — were in Memphis on Saturday making their pitch before an audience of state committee members and other interested Democrats at LeMoyne-Owen College.

Appearing, in sequence, were Mary Mancini of Nashville, former executive director of Tennessee Citizen Action and a recent candidate for a state Senate seat;  Terry Adams, the Knoxville attorney who ran a close second to fellow Knoxvillian Gordon Ball in this year’s Democratic primary for U.S. Senate; Gloria Johnson, also of Knoxville, a long-term party activist and current chair of the Knox County Democrats, who was narrowly unseated from the state House this year by a Republican opponent; Lenda Sherrell of Monteagle, who unsuccessfully challenged 4th District GOP Congressman Scott Desjarlais; and Larry Crim of Nashville, chairman of the nonprofit Democrats United for Tennessee and a recent candidate for the U.S. Senate nomination.

Categories
Editorial Opinion

Light in the Legislative Tunnel

Okay, so what happened to gridlock? In Washington, there was the passage of the so-called “Cromnibus” spending bill, which provides safe passage for $1 trillion in federal expenditures through 2015. No showdowns, no filibusters or cloture battles, no threats to shut down the government.

Granted, there are some objectionable provisions, and Senator Elizabeth Warren (D-Mass.) inveighed valiantly (but in vain) against one of them — a proviso that seemingly opens the door for big financial institutions covered by the Federal Deposit Insurance Corporation to resume the trading in derivatives swaps that contributed so much to the Big Crash of 2008-9.

But congressional Democrats didn’t want another shutdown battle and, for a change, neither did Republicans, who may, after their virtual sweep at the polls this year, simply want a chance to prove they can actually govern. There is still a gridlock of sorts. The word “cromnibus,” incidentally, is an amalgamation of “continuing resolution” and “omnibus.” The former term, often abbreviated as “CR,” denotes a decision to continue with the previous year’s spending and authorizations in lieu of an agreement. But only one aspect of this year’s omnibus bill had to be dealt with in that manner — funding for the Department of Homeland Security (DHS), which the GOP held up so as to leverage DHS funding next spring against President Obama’s executive actions on immigration.

Still, the end-of-year spending bill hearkens back to what, in comparison to gridlock, were the good old days of bipartisan wheeling and dealing, mutual backscratching, and backroom deals. That’s what constitutes “progress” in our time.

And in Nashville … After two years in which the state’s new Republican super-majority successfully blocked acceptance of millions of dollars in annual funding for Medicaid expansion under the Affordable Care Act (ACA), the GOP’s acquiescent  but well-intentioned Governor Bill Haslam has somehow wriggled his twisted arm free and cut a deal with the feds! And even Ron Ramsey, the arch-conservative state Senate speaker and lieutenant governor who has more or less directed legislative policy during Haslam’s tenure, has professed himself open-minded about the plan that the governor is calling “Insure Tennessee.”

Never mind that Insure Tennessee may or may not be an ideal way of coping with the problem of uninsured Tennesseans or of applying the substantial federal subsidies that come with acceptance of this aspect of ACA. The plan’s complicated methodology has a Rube Goldberg-like look to it — one that will, we hope, get spelled out via debate during the special legislative session Haslam has called for in early January.

The point is that if the GOP’s legislative super-majority, which has granted itself veto power over any proposed version of Medicaid expansion, can be brought to accept Insure Tennessee, and, if the feds do follow through with a waiver for Haslam’s alternative, there are real benefits. Most importantly, TennCare, the state’s version of Medicaid, would get a badly needed infusion of operating funds, enough to help rescue Tennessee’s hospitals, so many of which are teetering on the edge of insolvency.

Make no mistake: Neither in Washington nor in Nashville is right-wing tunnel vision over with. In some ways it may be just beginning. But maybe there is light at the end of the tunnel — something worth groping toward, anyhow.

Categories
Letter From The Editor Opinion

Death by a Thousand Cuts

Hey, remember Ebola? The disease that was going to kill us all in the weeks leading up to the November elections? Remember that guy who died in Houston? And that nurse who rode on an airplane, endangering the entire traveling American public? And that other nurse who rode her bike around New York state, infecting millions? Remember Senator Lindsey Graham’s adorable hysterics? Remember how the national media, particularly Fox News, tried to scare the crap out of us, day after day after day? Pay no attention to the experts! Block all air traffic from Africa! Quarantine everybody for 40 days! Thanks to Obama and Harry Reid, we’re all going to die!

Yeah.

Then, like magic, the day after the mid-term elections, the crisis ended. Being something of a cynic, I predicted what would happen in an October 30th column titled, “The Ebola ‘Crisis’ Isn’t.” The usual right-wing commenters took their shots: “When a community organizer president, a lawyer Ebola czar, and the ultra liberal editor of an entertainment weekly tell you there’s nothing to worry about, you can rest assured there’s not.” And, “The Flyer editor’s a doctor now … smart dude!”

No, I’m not a doctor, but I’ll take doctors’ and scientists’ opinions over those of Sean Hannity and various anonymous nuts, any day.

And speaking of nuts … what’s really nuts is what’s about to happen to Tennessee’s health-care system. Earlier this year, Governor Bill Haslam issued a directive to all state department heads to cut their budgets by seven percent. Last Friday, TennCare released its proposed new budget, which slices $165 million in spending. That number actually represents around $400 million in lost revenue, due to the subsequent loss in matching federal spending.

From The Tennessean: “The proposed budget eliminates grants to safety net hospitals, ends funding for programs for babies born with health problems, halts coverage of hospice services, and limits in-home assistance for the elderly to those poor enough to qualify for Supplemental Security Income. Doctors and other health providers would get hit with a 4 percent reimbursement reduction. Other cuts include funding for medicines and mental health services.”

Dave Chaney, a spokesman for the Tennessee Medical Association, said, “For more than 20 years, physicians have accepted very low rates to take care of patients, and the rates keep being cut as the cost of providing care goes up and the program continues to add people and covered services. That’s an unsustainable trend.” No doubt.

And of course, it’s all made even worse by the state’s ideology-driven refusal to participate in any variation of the Affordable Care Act. That foolishness is costing the state millions more in lost, no-risk health-care funding. Unfortunately, there’s no known cure for stupid.

Maybe it would help if we could drum up some Ebola cases in Chattanooga.

Categories
Politics Politics Feature

Harold Collins On Verge of Declaring for 2015 Memphis Mayor’s Race

The 2015 Memphis mayor’s race can be considered underway, at least informally, following the announcement this week that city Councilman Harold Collins has formed an exploratory committee to consider seeking the office.

Collins has made two hard-hitting public appearances in the past week. In the first of these, at the Frayser Exchange Club last Thursday, Collins characterized recent outbreaks of mob violence by youths as “urban terrorism” and called for more direct action against offenders than is currently the practice at a Juvenile Court undergoing reforms at the behest of the U.S. Department of Justice.

Participants in “serious crimes,” which Collins defined as including mob actions like those at Poplar Plaza last month and in the vicinity of Crump Stadium last Friday night, should face a prosecutor, a judge, and the prospect of jail “within 24 hours,” the councilman said.

Councilman Harold Collins

In a meet-and-greet at the Evergreen Grill Monday night, Collins repeated that formulation and made an aggressive pitch as well for an enhanced summer jobs program for disadvantaged youth, as well as expanded mental-health programs.

He also charged that Mayor A C Wharton’s 

current administration had done little to acquaint small-businesses owners with the fact that city funding had long been available to help them expand and prosper. “They’ve done a terrible job of getting the word out,” he said.

Collins went on to allege that, following the election of Wharton as mayor in 2009, “Nothing changed except on the seventh floor,” which is where the mayoral offices are.

Others known to be considering races for mayor next year, besides Wharton and Collins, are city councilmember Jim Strickland, former councilmember Carol Chumney, current Shelby County Commissioner Steve Basar, and former Commissioner James Harvey. The names of Councilman Myron Lowery and former Memphis School Board member Kenneth Whalum have also received mention.

  

• Proponents and opponents of the various state amendments have been engaging in a good deal of arithmetical calculation, based on a unique formula called for in the state Constitution.

It works this way: An amendment is deemed to have passed if it nets a number of votes equal to a majority of the votes cast in the governor’s race. Similarly, an amendment fails if the votes for it total less than a majority of the votes in the gubernatorial race.

As it happens, this year’s race for governor is, by universal consent, a shoo-in for Republican incumbent Bill Haslam. The state’s weakened Democratic Party emerged from its virtually unnoticed August 7th primary with a nominee, retired East Tennessee contractor Charlie Brown, whose only claim to fame was the similarity of his name to that of a cartoon character and whose resources for a serious race are essentially nil. And Haslam is otherwise confronted by an array of generally unknown independents.

The situation is hardly a recipe for a massive voter turnout in the gubernatorial race, so that the threshold of success for each of the four proposed constitutional amendments begins at a fairly low level. That fact makes any prediction regarding the outcomes of the amendment votes uncertain.

Amendment 1, which would cut into the blanket protection of abortion rights  provided by a state Supreme Court decision of 2000, declaring the state neutral on abortion, and restricting privileges to those enabled by federal judicial authority, is by all odds the most controversial and the most intensely contested.

Addressing a Vote No on 1 rally held at the Racquet Club last week by the Tennessee Democratic Party, 9th District congressman Steve Cohen held forth on the threshold issue, telling the pro-choice activists in attendance that bypassing the governor’s race would work against their interests and increase the chances of passage for the amendment.

It was urgent, therefore, said Cohen, that they should vote in the governor’s race. Cohen offered his own preferred candidate — John Jay Hooker, an octogenarian Nashville lawyer who, at intervals in the previous century, had been a serious Democratic prospect for governor but who, many fits and starts later, is best known these days as a litigant for direct election of state appellate judges (a matter which, as noted below, is at the heart of another amendment on the November ballot). 

“Do what I’m going to do. Vote for John Jay!” said Cohen.

Speaking to reporters after yet another rally, this one held at the Kroc Center on Monday on behalf of Amendment 2, Governor Haslam addressed the converse possibility — that proponents of this or that amendment might be advocating a de facto boycott of the governor’s race in order to lower the voter threshold for their amendment.

“I obviously don’t like that,” Haslam said. “I think it’s important for people to understand all four of the amendments and to vote for anything on the ballot.”

At the rally, a panel consisting of Haslam and former state Supreme Court Justice George Brown of Memphis, with lawyer Monica Wharton serving as moderator, had made the case for Amendment 2, which the governor said was necessary to provide “clarity and predictability” on the matter of appointing appellate judges.

As Haslam noted, the amendment would make it “clear in the law that what we’re doing now does fit the definition of the Constitution, adding one step, that the legislature can approve or disapprove” an appointment, giving the governor a chance to respond within 60 days. At present, the state employs the so-called “Tennessee Plan,” allowing gubernatorial appointments of appellate judges, who are then subject to yes-or-no retention elections at eight-year intervals. 

Both Brown and Haslam suggested that appellate judges were in the position of impartial referees in athletic contests. Playing to local sensitivities, Haslam said, it wouldn’t do for a referee in a Grizzlies game to have “a Kevin Durant jersey” on under his striped shirt.

Haslam made a bit of fresh news when he told reporters afterward that he supported all four of the amendments on the November ballot, including Amendment 1, which he characterized as allowing the state’s laws on abortion “to match what the federal laws are.”

• The great Charlie Cook, whose widely syndicated “Cook Report” is one of the most respected political tout sheets in the country, made an appearance at Rhodes College, Monday, under the auspices of the school’s political-science and history departments.

Speaking in Barrett Library on the subject of “Why is D.C. Dysfunctional?” Cook outlined the current dismal approval rates of President Obama and congressional Republicans in opinion polls and said, “Nobody’s happy.” He noted that Republicans were progressively losing support with minorities, younger Americans, and women — all categories whose proportion is growing in the electorate — and suggested that the GOP would be well advised to “shut the hell up” about social issues.

Democrats have their problems, too — including a growing public unease concerning the leadership of Obama, particularly in the realm of foreign policy, which has attained an unusual degree of importance with voters, Cook said.

The GOP can expect modest gains in both House and Senate this year, but not enough to affect the enduring state of gridlock, predicted the noted analyst.

He was cautious about predictions concerning 2016 presidential prospects, though he did say there was “a 25 to 30 percent chance” that, despite expectations, Hillary Clinton would not seek the Democratic nomination. 

Cook, whose wife is from Memphis, is a frequent visitor to the city.

Categories
Politics Politics Feature

Looking for Lamar Alexander

CREDIT: Jackson Baker

Gordon Ball, the Democratic nominee for U.S. Senator, was in Memphis last week, and he sat down for a lengthy interview on his campaign and his hopes for an upset victory over incumbent Republican Senator Lamar Alexander.

As Ball noted, Alexander had eked out his renomination on August 7th, polling slightly less than 50 percent of the total vote in a Republican primary in which he was opposed by state Representative Joe Carr, a Tea Party supported Middle Tennessean, and George Flinn, the multi-millionaire Memphis physician/businessman.

Carr, who finished strong with 40 percent of the total vote, had gone unmentioned for most of the primary campaign, Ball noted, but toward the end of the race, Alexander had begun making formal attacks on his main challenger by name. “When he started mentioning Joe Carr, it was a sign that things were getting tight for Lamar,” Ball said.

Ball has challenged Alexander to a debate but doesn’t expect that to happen. “Lamar’s going by the incumbent’s playbook. He’s not going to debate me. He will never mention me, unless it gets close.”

From that standpoint, the Democratic nominee can take heart from a response to his candidacy this week by the state Republican Party, which has not only mentioned him but has incorporated his name in a brand-new website entitled ObamaBallAgenda.com.

According to the site, Tennessee faces a veritable liberal onslaught this fall in the form of various nationally sanctioned candidates and causes. And, “at the top of the ticket, will be a man who would be one more vote for Barack Obama’s harmful agenda — Gordon Ball. Mr. Ball, a liberal personal injury lawyer from Knoxville, will only serve to empower Obama and strengthen Washington’s stranglehold on our economy.”

Ball sees the relationship between himself and the national Democratic Party quite differently. Noting the disinclination of the Obama presidential campaign to pump much in the way of resources into Tennessee during the 2008 and 2012 races, the Knoxvillian said, “I think the national Democratic Party has written Tennessee off. That’s not good for the state.” But he shrugged and said, “That’s all right with me. We’ll run without them.”

A corollary to what Ball sees as a lack of interest in Tennessee from national party sources is the fact that the Tennessee Democratic Party itself is not exactly in the pink of political health. Rather famously, the party has, within the past decade, lost control of the governorship and the General Assembly, becoming little more than a token minority in both the state House and the state Senate. 

And, for the second time in the past two statewide elections, Tennessee Democrats have failed to mount a serious challenge in a major statewide race. In 2012, the party suffered the embarrassment of seeing Mark Clayton, an off-brand candidate with alleged membership in an anti-gay hate group, become its nominee against GOP Senator Bob Corker in an almost unnoticed Democratic primary.

And in 2014, via yet another back-burner primary, the Democratic candidate who emerged as the party’s nominee for governor, to oppose well-heeled incumbent Republican Bill Haslam, is one Charlie Brown, a retired construction worker from Oakdale, Tennessee, whose victory in a large but largely anonymous primary field owed much to his name, redolent of a well-known comic-strip character and alphabetically first on the Democratic primary ballot. 

With the wry grin that seems an innate part of his persona, Ball commented, “I wish I had his name recognition.”

But the fact is, Ball represents what both Democrats and Republicans recognize as a serious political possibility. He and fellow Knoxville attorney Terry Adams conducted a primary race that, in the quality of its rhetoric and intensity, was something of a throwback to the now vanished time when Democrats ruled the state. Their race went down to the wire, with Ball, considered the centrist in the race, prevailing on August 7th with 36.5 percent of the Democratic primary vote, against 35.6 percent for Adams, an unabashed liberal.

The two Democrats had actually agreed on most issues — including a need for an increase in the minimum wage, support for parity pay for women and the pro-choice position on abortion, provision of equal opportunity for the gay community, and full-throated backing of the Affordable Care Act (Obamacare) and of Medicaid expansion in Tennessee, where, Ball says, some 160,000 people can’t get medical care and 28 hospitals are in danger of closing for lack of the ACA-provided Medicaid-expansion funds.

He and Adams had differed most notably on Ball’s espousal of a flat tax, which Adams considered regressive and counter to the needs of working people and a possible barrier to his post-primary support of Ball. Again, the Ball shrug — indicating, in this case, flexibility on the issue. “We need tax reform. I don’t think anybody disagrees. I just want to be in middle of that debate. And I’m for whatever helps the middle class remain strong and viable and that can raise money to pay off our $17 trillion debt.”

In any case, Adams wasted little time climbing aboard the Ball bandwagon and now serves as his former opponent’s East Tennessee co-chair.

One edge that helped Ball in his primary campaign was the wealth amassed during a long and successful legal career. To a certain degree, he can self-finance, as he did during the primary, shelling out some $400,000 for TV ads. He knows, however, that Alexander himself is flush and suspects that Governor Bill Haslam, scion of his family’s Pilot truck-stop fortune and beneficiary of a hugely successful GOP fund-raising campaign, will help the GOP out-spend him.

The point gnaws at Ball. “I’m going to make a strong statement,” he said: “This state is controlled by the Haslam family. Think about it. They own Bob Corker. They own Lamar Alexander. And they have the governor’s seat. Now what else do they want? … It’s just not right that one group of people controls this state. If you don’t think that’s happening, you’re living on another planet.”

Citing polls by Rasmussen and The New York Times that show something like a 47 percent to 32 percent edge for Alexander, Ball predicts the kind of shrinking in the incumbent’s margin that occurred late in the Republican primary, and partly for the same reason — distrust for the incumbent among Tea Party Tennesseans.

“We don’t agree on every issue, obviously, but they see Lamar as being for Common Core [in education] and amnesty [on the immigration issue]. They’re against Common Core and amnesty, and so am I.”

Ball is buoyed by hopes of making inroads among such disaffected Republicans and by what he sees as a largely united Democratic Party (though certain well-known Democrats like former Nashville Mayor Bill Purcell and former Congressman John Tanner — “lobbyists now,” Ball says dismissively — are backing Alexander.)

He has worked up a good case of scorn for Alexander, whom he once supported and whom he now sees as having fallen ito irrelevance from what had been a valuable public career. “How do you go from a job that pays $150,000 to being worth $40 million?” he asks rhetorically. “He just needs to take his money and go home.”

Ball gibes at the incumbent Senator, who back in 1978, dressed in a plaid shirt, had based his campaign for Governor on a walk across the state.”  Things — and Alexander — have changed, Ball maintains.

“He said in the primary that citizens of the state of Tennessee could ask him questions if they saw him walking down the street. Well, I’ve been in Tennessee for 65 years, and I’ve never seen him walking down the street. If I ever do see him, I’ve got some questions for him.”

Categories
News The Fly-By

Governor Nero

His full name was Nero Claudius Caesar Augustus Germanicus. But, in recorded world history, the tyrannical Roman Emperor “Nero” is infamously known for having “fiddled while Rome burned.” Nero’s apparent indifference was actually motivated by his own selfish purpose, which was to have the prolific fire clear land so he could build a new palatial estate. It did just that, but it was also responsible for taking thousands of lives in the process. Strangely enough, even before and after the great catastrophe, historians have noted the narcissistic Nero, for the majority of his 14-year reign, still managed to enjoy an inexplicable popularity among the common people of Rome.

Of course, no one would even begin to compare the despicable Roman dictator to the affable and fair-minded Tennessee Governor Bill Haslam, except in the sense that both have enjoyed surprising popularity for what many might view as no apparent reason. Yet, when it comes to the thousands of Tennesseans who lack health care, Haslam’s dallying on addressing their needs by delaying the presentation of a plan on expanding Medicaid coverage is as damaging to the uninsured as Nero’s great fire was to the demise of common Romans.

Late last week, Haslam coyly hinted he may be nearing the release of a unique “Tennessee” plan for expanded health-care coverage for the more than 100,000-plus people who’ve slipped through the cracks of the state’s TennCare system.

All of us, including those lucky enough to have some type of medical insurance, know someone who doesn’t have any: A single mother of three; an elderly friend on a fixed income; a family that worries that every bout of flu-like symptoms is going to lead to a health condition that might worsen and require medical care.

In reporting on Haslam’s negotiations with the federal government, I spoke last week with one of Memphis’ foremost health-care experts, Scott Morris, CEO of the Church Health Center. He labeled as “immoral” the fact that “states on the west side of the Mississippi River, such as Arkansas, now have established health-care exchanges, while those living east of the river continue to struggle without care.”

Not all states have put on their political blinders to the opportunity that’s being offered by the Affordable Care Act. In Kentucky, where previously 600,000 people were uninsured, more than 400,000 have enrolled for Medicaid under the state’s “Kynect” program. The rest are choosing among state-approved insurance plans and can compare monthly premiums and other costs like co-pays. In the process, 17,000 new medical jobs are projected to be created, with a positive economic impact to the state of nearly $16 billion over the next six years. Despite all the negative propaganda spread by those opposed to the exchanges, the federal program pays 100 percent for a state’s coverage expansion for the first three years and gradually reduces to 90 percent by the year 2020. What’s provided judicial cover on the issue for reluctant state participants, such as Tennessee, is the United States Supreme Court’s 2013 ruling that governors and lawmakers could opt out of widening their Medicaid rosters. The Tennessee General Assembly immediately jumped on the loophole and passed a measure assuring they will have final approval of any expansion plan.

All of this squarely puts the onus of leadership on this issue on our state’s version of Nero. Haslam most assuredly will be returned to the governorship in November, but his record on taking decisive stances in his first four years has been spotty at best, despite his popularity numbers. He voiced only words of caution in the titanic Memphis and Shelby County school merger issue. As numerous gun carrying bills floated through the legislature, his public opposition was passive. On health care, he’s babbled what I’ve often called benign “Haslamese.” He wants to help the uninsured, but it’s got to be cost effective and it has to pass what will be formidable opposition in the legislature. If he indeed does come up with a plan, it won’t be easy to pass. Haslam will have to use the bully-pulpit of his elected position, and his popularity, to do the right thing, or at least try.

I ask you, governor, what is your legacy now? What do you want it to be?

Nero “fiddled” and Rome burned. Men, women, children — black, white, and brown — in Tennessee are trapped in the fiery hell of having to ignore pain and suffering and serious diseases with no way to afford medical coverage. Governor, quit fiddling, and please do something to help.