Tag: Insure Tennessee

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Opinion Viewpoint

Fix Tennessee’s Healthcare System

Tennesseans have a strong sense of pride when it comes to valuing things like hard work and personal responsibility. People who work hard to provide for their family and contribute to their community help make Tennessee great. So, while it’s unfortunate that too many of Tennessee’s working poor are struggling to access affordable healthcare coverage, it’s encouraging to know there is a robust discussion being led by House Speaker Beth Harwell’s 3-Star Healthy Project Task Force aimed at addressing this problem.

Adam Nickas

Right now, hundreds of thousands of Tennesseans, of which more than 67,000 are residents of Shelby County, are living without access to care, falling into what’s called the “Medicaid gap.” These individuals earn too much to qualify for TennCare, our state’s Medicaid program, but too little to afford healthcare coverage on the federal insurance exchanges. These are people trying to make an honest living — three-quarters of them have worked in the last year.

Memphians never hesitate to give a helping hand, instead of simply a handout, to hardworking folks, and improving access to health care for this population does exactly that. The task force, which was established in April, is focused on finding sensible and financially responsible solutions to Tennessee’s healthcare problem. In just a few weeks, the task force will present their recommendations to the Centers for Medicare & Medicaid Services (CMS) in Washington, D.C. 

In 2015, Governor Bill Haslam proposed a health-care plan, known as Insure Tennessee, to the Tennessee General Assembly. This program was designed as a for-Tennessee, by-Tennessee plan that promoted personal responsibility, imposed no new taxes, and would result in significant economic gains for our state. While the legislature did not accept the original proposal, there has been progress with the announcement of the task force to prepare a solution that increases access to affordable coverage for Tennessee’s uninsured population.

There are two critical items we hope the task force considers as they continue their work.

It’s important that any recommended solutions be comprehensive in scope. Limiting the scope of access to coverage to a segment of the Medicaid gap population leaves thousands of hardworking Tennesseans without access to affordable healthcare. A path to comprehensive coverage for this population is needed in order for the state to fully realize the economic gains from increased insurance coverage. A Tennessee study found that Insure Tennessee would create more than $1.1 billion in new health-care spending, $909 million in new income, and 15,000 full-time equivalent jobs for Tennessee residents.

One of the key drivers of these potential economic benefits is the fact that a comprehensive solution would help reverse deep cuts to Medicare reimbursement rates for Tennessee hospitals that were a result of the Affordable Care Act (ACA). The numbers tell a striking story: Our hospitals are projected to lose $292 million this calendar year and $8.2 billion by 2024. With the closing of three hospitals in Tennessee since the beginning of 2016, we have all become acutely aware of the negative impact of those closures. Hospitals are economic engines within our communities, providing over 35,000 jobs in Shelby County and 630,000 jobs across the state. A plan that increases access to affordable healthcare can help to offset these cuts and protect our hospitals.

That’s why any recommendation from the task force must secure approval from federal officials. Without that approval, millions of dollars will continue flowing out of Tennessee and into states like California and New York. To be clear, the money being cut from our hospitals isn’t going to another Tennessee program. It is going to states that have implemented similar efforts to cover those in the Medicaid gap, and we need to bring these tax dollars back home.

The 67,000 Shelby County residents, some of whom are veterans who bravely served our country, carpenters who are building homes in our communities, and waiters and waitresses who serve us at local restaurants, deserve a solution.

Governor Bill Haslam’s 2015 proposal for Insure Tennessee provides a strong blueprint for a solution, as it would extend coverage to an estimated 280,000 of our hardworking friends and neighbors currently struggling in the Medicaid gap.

As the task force presents its recommendations in Washington later this month, we hope they bear in mind our recommendations so that their proposal aligns with Tennessee values and leads the way to a responsible, healthy future for our communities.

Adam Nickas is the executive director of Tennesseans for a Responsible Future, a nonprofit organization that supports efforts to improve the health and prosperity of Tennesseans through the promotion of sound health-care policies.

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Politics Politics Feature

Healthcare “Road Show” Off to a Good Start

CREDIT: Jackson Baker

There has been no shortage of skeptics about the bona fides of the health-care task force recently appointed by state House Speaker Beth Harwell (R-Nashville) to look into the matter of an alternative to Governor Bill Haslam‘s “Insure Tennessee” proposal for federally funded Medicaid expansion, which was dead on arrival upon its presentation to the General Assembly in last year’s sessions of the General Assembly.

Criticism came from both left and right. Early on, state Democratic Party chair Mary Mancini seemed to dismiss it out of hand in a press release titled “A Task Force Called Meh,” in which she said, “It doesn’t have any actual policy or concrete meeting dates. It doesn’t have the will to actually, you know, do anything. … Once again we are a witness to the failure of the Republican majority to lead.”

Nor was everybody in the state Republican Party exactly blissful about the task force’s creation. At a meeting of the National Federation of Independent Business in Memphis last week, two key GOP state Senators were less than enthusiastic. “It remains to be seen how serious this is as a task force,” said Brian Kelsey (R-Germantown), the state Senate’s Judiciary chair. “I find it curious that the House now has this road show,” said state Senator majority leader Mark Norris (R-Collierville), referring to a series of public hearings the task force has begun statewide.

(Both GOP Senators, it should be noted, were vehement opponents of “Insure Tennessee.”)

To be sure, the task force has evolved since Harwell put it together in early April. Back then, it consisted of four House members, all Republicans: Cameron Sexton of Crossville, the task force chairman, who chairs the House Health Committee; Steve McManus of Memphis, chair of Insurance and Banking Committee; Roger Kane of Knoxville; and Matthew Hill of Jonesborough.

Since then, the Speaker, acquiescing to pressure to diversify the group, has added state Rep. Karen Camper (D-Memphis) and one member from the state Senate, Richard Briggs (R-Knoxville), a physician. Crucially, perhaps, both Camper and Briggs were supporters of “Insure Tennessee.”

The reconstituted task force began holding its public hearings in Nashville last week and intends to hold several more before preparing legislative recommendations, which chairman Sexton says he hopes to have ready by June.

On Monday afternoon, three members of the task force — Sexton, Camper, and McManus — were on hand at the University of Memphis University Center, where they were joined by panelists and audience members representing a diverse group of respondents, including hospital spokespersons, representatives of ad hoc health providers, and prospective patients.

In the spirited discussion that ensued for two hours, there was some evidence that, the critics of left and right notwithstanding, the task force might indeed be up to something serious. A key moment came at the very close of things, when McManus, who in 2015 had adopted an adverse position on “Insure Tennessee” and chaired a brief hearing of his committee to an inconclusive end, responded to some passionately expressed testimony by uninsured and under-insured attendees, mostly low-income people who had invested some hope in the prospects for Medicaid expansion through “Insure Tennessee.”

“We’re going to have something for you,” McManus said, in an emotional statement of his own. Asked later if he thought his group would give serious reconsideration to some version of the governor’s plan. “Absolutely, we will,” he said, adding, “Let’s face it. Back then the matter was a political football.” Meaning that its coupling with the Affordable Care Act, better known among Republicans as “Obamacare,” had doomed the proposal to partisan treatment by the General Assembly’s GOP super-majority.

Typical of a potential sea change among Republicans was a lament by panelist Ron Kirkland, a Jackson physician who ran for Congress in the 8th District GOP primary in 2010, that more than $1 billion annually in Affordable Care Act (ACA) funding had been lost to the state by its failure to endorse “Insure Tennessee.” As Kirkland put it, “We’d have been jumping up and down if that much money was available to the [West Tennessee industrial] mega-site!”

And numerous of the medical-community representatives noted that Medicare funding allotments for Tennessee had been scaled down under the ACA with the idea of fleshing them out again with the Medicaid-expansion component of the Act. Subsequently, the Supreme Court’s ruling that the latter component was not mandatory upon individual states had allowed Tennessee and various other states to opt out of Medicaid expansion, with the unintended consequence of reducing overall medical funding.

Overall, the discussion on Monday seemed pointed more toward solutions of this and other dilemmas than to recapitulating various rhetorical talking points. Perhaps this is one road show that might lead to something real and tangible on the main stage of Tennessee government.

• “Give a mouse a cookie…”: Given the factional divisions on the Shelby County Commission, such as they are, it is a rare thing indeed that Heidi Shafer, the East Memphis Republican who so often speaks for what is arguably the Commission’s dominant coalition, should quote with approval Steve Basar, a fellow Republican but one who often sides with another, predominantly Democratic group.

But so Shafer did on Monday, in the course of her current effort to retard — or at least subject to serious vetting — a proposal to assist the office of District Attorney General Amy Weirich with backup to help process the future use of body cameras by local law enforcement, primarily the Memphis Police Department.

A condensed version of the Basar remark cited by Shafer would go something like this: “Give a mouse a cookie, and he’ll ask for a glass of milk. Then he’ll want another cookie.” And this de facto little aphorism was employed by Shafer as a warning against what she called “mission creep” in the matter of funding Weirich’s office.

The fuller argument, as she and other skeptics have developed it in two of the Commission’s mid-week committee sessions and two of the body’s regular public meetings, boils down even further to a fairly simple formulation: “Why us?” — the idea being (a) that the impetus for use of body cams came from the MPD and city government, and (b) the District Attorney General’s office is a creature of state government, not county government.

Ergo, why should county government have to foot the bill?

That argument has found enough buyers so far to have stymied the initial proposal for a fuller funding of the D.A.’s office in the amount of $143,378. By the time of Monday’s meeting, the issue of direct new funding was off the table — replaced by an offer from the administration of Shelby County Mayor Mark Luttrell to shift residual money in the county’s fund balance to provide “temporary support staff for body camera rollout.”

That support would total out, as finally agreed to by the Commission on Monday, to about $25,000 from the fund balance. And that amount, as Shafer reminded an acquiescent administration CAO Harvey Kennedy, would have to be shared with the Public Defender’s office, which, according to state law, is entitled to funding equivalent to 75 percent of any sums appropriated to a District Attorney General’s office.

Enough stop-gap money will be shifted to endow three temporary employees for the D.A.’s office, along with two for the Public Defender’s office, for a period of roughly a month to assist with body-cam rollout.

To stick with the aforementioned Basar analogy, that compromise solution is less a cookie than a crumb, and it’s a clear signal that, with stiff funding increases sought by the Sheriff’s Department, and even stiffer ones sought by Shelby Couty Schools, the D.A.’s office will face difficulty during forthcoming budget negotiations in getting much more for the body-cam matter.

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Politics Politics Feature

Second Efforts

CREDIT: Jackson Baker

The de-annexation bill that was temporarily stalled in the state Senate on Monday of this week was, as this week’s Flyer cover story (p. 14) documents, the subject of concerted resistance activity on the part of Memphis legislators, city council members, and representatives of the Greater Memphis Area Chamber of Commerce.

Many of the same legislators were part of another never-say-die effort, this one mounted by the House Democratic Caucus, which got behind an effort by House Democratic leader Craig Fitzhugh (D-Ripley) to enable a non-binding resolution for a statewide referendum on Governor Bill Haslam‘s moribund Insure Tennessee proposal.

That proposal, which would have allowed some $1.5 billion in federal funds annually to further Medicaid expansion in Tennesee, has been so far bottled up by the Republican super-majority in the General Assembly. And Fitzhugh’s resolution itself was routed off to the limbo of legislative “summer study” as a result of a procedural gambit employed by Representative Jeremy Durham (R-Franklin), who was formally ousted from his House leadership positions recently because of allegations involving improper activities involving interns and female staffers.

Memphis representatives Joe Towns, Larry Miller, and G.A. Hardaway were among those speaking on behalf of reactivating Insure Tennessee legislation at a press conference last week in Legislative Plaza.

 

• Ninth District Congressman Steve Cohen began the week as a part of the entourage that accompanied President Obama on his history-making trip to Cuba, where the president furthered the official Cuba-U.S.A. relations he reopened last year.

The trip was the second one to Cuba for Cohen, who also was part of a delegation accompanying Secretary of State John Kerry to the Caribbean island nation in 2014. The Memphis congressman obviously went to some considerable effort to get himself involved with both missions. Why Cohen’s more than usual interest in the matter?

Well, first of all, the congressman has long advocated a normalizing of relations with Cuba, which became estranged from the United States during the height of the Cold War when Cuban ruler Fidel Castro instituted what he termed a communist revolution and cozied up to the Soviet Union, then a superpower antagonist to the U.S.

Cohen has favored rapprochement and an end to the still-active trade embargo on political and economic grounds, pointing out that the Cold War, at least in its original form, is long gone and that American enterprises, in Memphis as well as elsewhere, stand to prosper from improved relations between the two countries.

And there is the fact that, when Cohen was growing up, his family lived in Miami, the American city closest to Cuba and one containing a huge number of exiles from that nation.

But there’s more to it than that —as those Memphians know who were privy to an old AOL email address used by Cohen, one that employed a variant on the name of former White Sox baseball star Minnie Miñoso, who happened to hail from Cuba.

The backstory involving Cohen and Miñoso was uncovered this week for readers of the Miami Herald by reporter Patricia Mazzei in a sidebar on Obama’s trip to Cuba.

Mazzei related the essentials of a tale familiar to those Memphians who were readers of a Cohen profile that appeared in the Flyer‘s sister publication, Memphis magazine, in 2001. After noting that the young Cohen, who had always aspired to an athletic career himself, had been afflicted by polio at the age of 5, Mazzei goes to observe: “His parents, lifelong baseball fans, took young Steve, hobbled with crutches, to see Mom’s hometown Chicago White Sox at a Memphis exhibition game. Steve made his way near the field to plead for autographs.

“That’s when a pitcher, Tom Poholsky, handed him a real Major League baseball. It wasn’t from him, Poholsky told him. It was from an outfielder who couldn’t give the boy the ball himself because this was Memphis, in 1955, and the outfielder was black. The first black White Sox, in fact.

“His name: Minnie Miñoso. A native of Perico, Cuba.”

The young Cohen was struck by the fact that Miñoso, who for obvious reasons became something of a personal idol for him, had been so inhibited by restrictions that were part of an outmoded way of life, and his lifelong emotional attachment to the great Miñoso, who died only last year, ensued.

“I learned from Miñoso about civil rights, and I learned from Miñoso about Cuba, and I learned from Miñoso to be nice to kids,” Cohen said to Mazzei, who disclosed also that the congressman had toted a Miñoso-embossed White Sox baseball cap to Cuba on the Kerry trip with the aim of getting it to current Cuban president Raúl Castro.

He brought several more such caps with him to hand out here and there on the current presidential trip.

Jackson Baker

Roasted, toasted, and pleased about it all at a Democratic fund-raising “roaster” last Saturday honoring: (l to r, seated) Shelby County Commissioner Walter Bailey, former state Senator Beverly Marrero, and former City Councilman Myron Lowery. Standing is longtime former public official Michael Hooks, who applied the barbs to Bailey. The affair was held at the National Civil Rights Museum.

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Politics Politics Feature

A Two-Man Mayor’s Race?

CREDIT: Jackson Baker

As this week’s second-quarter deadline for financial disclosures approached, it was a near certainty that Mayor A C Wharton and City Councilman Jim Strickland would lead the rest of the field in funds received by a large margin. The Memphis mayoral contest could not yet be considered a two-man race, but both candidates had defining moments that set them apart.

The horrific events in Charleston, South Carolina, two weeks ago, still resonated and cried out for a dramatic response — in Memphis, no less than elsewhere in an outraged nation. To give him credit, Wharton had provided one last week when he proposed to end a long-simmering controversy and demanded the removal from what is now Health Sciences Park a statue of Confederate General Nathan Bedford Forrest mounted on his warhorse, as well as the graves of the general and his wife.

The statue, which had stood in that prime downtown acreage for a century, would be remanded to the custody of the presumably still-extant Forrest Monument Association, which had originally placed it there, and the remains of the Forrests could be returned to Elmwood Cemetery, the vintage resting place from which they had long ago been disinterred and transplanted to the Union Avenue site.

It would not do, said Wharton, for African-American children to picnic in the shadow of a man who had been accused of numerous offenses on the wrong side of history, including pre-Civil War slave trading, an alleged massacre of black Union troops during the war, and the post-war founding of the Ku Klux Klan. 

At the moment of the mayor’s announcement, he appeared resolute and forceful and, most important, sincere. He had caught the spirit of the moment, it seemed, and there seemed to be little downside. Public reaction to the name changes of Forrest Park and two other Confederate-themed parks in 2013 had ranged from enthusiasm to acceptance, with resistance largely confined to memorial societies — such as the Sons of Confederate Veterans, an organization that many thought had precipitated that crisis and broken a tenuous truce with an indiscreetly bold (and unauthorized) granite sign proclaiming the name “FORREST PARK.”

The mood of two years ago was nothing compared to the universal revulsion, in Memphis as everywhere else, that came in the aftermath of the horrendous murders of nine African-American members of a bible-study class by a deluded fanatic who wrapped himself in Confederate imagery. The feeling was summed up in a single word: enough!

That African Americans, in particular, could be expected to back the mayor’s action was a given — though it would surely be wrong to suggest that dividends at the polls on October 8th constituted a significant motive. In any case, Councilman Strickland, widely considered Wharton’s main opponent, wasted no time in conferring his approval of the mayor’s proposal. “I’m for it!” he said decisively, just before making something of a watershed speech last Thursday at Overton Square’s Zebra Lounge at a meet-and-greet that targeted black voters.

Jackson Baker

Jim Strickland at Zebra Lounge

Could Strickland, well-financed and known to be strong along the Poplar Corridor and in recently annexed suburbs like Cordova, garner enough African-American votes in a majority black city to be elected? Jerry Hall, the veteran black operative who introduced Strickland at Zebra Lounge, raised the question rhetorically and then answered it: “Hell, yes!” Memphis needed to move beyond issues of race, said Hall. “We need a new direction in City Hall.”

In his speech, Strickland laid out his most detailed recipe yet for that new direction. “We have a tsunami of a challenge on the horizon,” the challenger said, and he gave it a name: population loss. Strickland promised to reverse an exodus that had accounted for a net loss of 12,000 residents in the first decade of this century, despite annexations. He would be a “strong mayor who will run an efficient and effective city government.”

Strickland proposed a three-pronged strategy for establishing and maintaining a safe, clean, and desirable place for people and businesses: 1) drastic reduction of violent crime through resurrection of Blue Crush policing of trouble spots and “zero tolerance”; 2) elimination of blight and repair of infrastructure; and 3) strictly holding officials accountable.

If all that sounded a bit abstract, Strickland floated some new specifics: a privately supported fund that would help allay the costs of expunging criminal records of citizens resuming productive lives; a residential “PILOT” program granting tax breaks for people undertaking urban infill; and publication of city administrators’ performance records.

A bit technocratic, perhaps, but it expanded on Strickland’s reputation as a budgetary maven and gave him a larger theme of general competence to juxtapose against Wharton’s undoubted flair in using his mayoral bully pulpit.

There was still time for other candidates — notably Councilman Harold Collins, County Commission chair Justin Ford, and Memphis Police Association head Mike Williams — to make a move, but with every passing week, the bar gets moved a little higher.

• Meanwhile, the sheer drama of successive news-waves — abetted by a pair of U.S. Supreme Court decisions — kept shifting public attention. The sense of a racial crossroads lingered, but a court decision in King v. Burwell eliminated a threat to the Affordable Care Act and highlighted local and statewide efforts to revive Governor Bill Haslam‘s so-far-stymied Insure Tennessee plan. These included a showcase press conference in Raleigh featuring state Democratic Party chair Mary Mancini with legislative Democrats and local health-care advocates.

And the LGBT community had its rainbow moment, basking in a second SCOTUS decision legalizing same-sex marriage in all 50 states, and given further mainstream momentum via the endorsement of President Obama, who, having articulated the nation’s outrage and sorrow over the horror in Charleston, was having a major moment himself.

Governor Haslam came to town on two occasions: on Friday to grace the opening of a new Nike distribution center, and on Monday to announce a half-million-dollar grant for tech training and to help Youth Villages celebrate successes in its work with former foster youth.

During both visits, the governor made it clear that he intended to push ahead with Insure Tennessee (though not with an immediate special legislative session) and that the state would comply with the Supreme Court’s ruling on same-sex marriage. His reluctance on the second score, however, was underscored on Monday with a statement supporting “protection” of pastors who opt out of performing same-sex ceremonies for religious reasons.

Haslam endorsed the idea of removing a bust of General Forrest from the state capitol and said he saw no impediment to Wharton’s plans for Health Sciences Park. Others noted, however, that state law seemed to contain obstacles to the removal of the graves without the express permission of the Forrest family, and state legislation passed in 2013 on behalf of war memorials may complicate any attempt to remove the general’s statue.

“We’ve got lawyers working on it,” Wharton said on Saturday when asked about such obstacles during a drop-in at a Democratic Party breakfast at the IBEW building on Madison.

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Politics Politics Beat Blog

Democrats, Others Urge New Special Session on Insure Tennessee

CREDIT: JB

JB

L to r, participants at Thursday’s press conference were Harris, Miller, Parkinson, Coffield, Kyle, Stewart, Coffield, and Roberson.

With what turned out to a providential act of timing — within an hour or two of Thursday’s latest Supreme Court decision upholding the Affordable Care Act — a group composed of state Democrats and local advocates of Governor Bill Haslam’s proposal for Medicaid expansion under the Act made a pitch in Raleigh for a new special legislative session to reconsider that proposal, Insure Tennessee.

The primary spokesperson for the group was state Democratic chair Mary Mancini of Nashville, and for obvious reasons her focus was on Democratic support for Insure Tennessee and partisan Republican attempts to obstruct it in a February special session of the legislature this year, as well as during the regular session itself.

Expressing pleasure at the brand-new Supreme Court decision, Mancini said, “passing Insure Tennessee becomes even more important now.” She noted that the aborted plan would have provided affordable health-care coverage for 280,000 currently uninsured persons statewide and “68, 000 right here in Shelby County.”

Pointing out that Haslam, a Republican himself, had been unable to garner support for his plan from the members of his party, Mancini said she and her fellow Democrats had persistently called on the Governor “and the Republican leadership” to support another special session, “and they have refused.” She accused Republicans of “focusing on politics rather than providing what the majority of Tennesseans want.”

Alluding to revelations (not always welcomed by the legislators in question) that a significant number of Republican General Assembly members who acted to stonewall Insure Tennessee were beneficiaries of blue-ribbon health insurance plans provided by the state, Mancini asked, “And why are they more concerned with hiding access to their own affordable health-care plans they get than they are with helping other Tennesseans get the same access?”

Other members of the predominantly Democratic Party group of presenters made such other points as that as many as 220 Tennesseans might have died during the last year for lack of an affordable health-care plan and that other matters of importance included jobs and the survival of hospitals, many of which have been over-burdened with emergency-room care for indigent patients.

State Representative Larry Miller, sponsor of the House resolution for Insure Tennessee (one which, like the Senate version, was blocked before it could get to the floor), promised to “name names” of local legislators deserving special blame for obstructing Insure Tennessee, and he did so, mentioning state Senator Brian Kelsey and state Representative Steve McManus.

State Senator Sara Kyle was equally blunt. “Stop being selfish!” she said, as a message to those Republicans who had bottled up the Insure Tennessee resolution in committee. “It’s a moral issue,” she added.

State Senator Lee Harris, the Senate’s Democratic leader, who had made a well-received appearance the evening before at a meeting of the Germantown Democrats, where he had addressed similar themes, made an effort to move the issue beyond pure partisanship.

Pointing out that polls show a clear majority of Tennesseans favoring Insure Tennessee, regardless of their party, Harris said the appeal for a new special session should by rights be directed to “a very narrow audience” of resisters, “a very small group of leaders on the other side of the aisle and extremists who have dominated the debate.”

Harris absolved “rank and file Republicans,” reminding his hearers that the plan’s author, Governor Haslam, was also a Republican, and he added a hat-tip for John Roberts, the GOP-appointed Chief Justice who had voted with the majority on Thursday to uphold the ACA against a lawsuit, King v. Burwell, that challenged it on largely technical grounds.

Another effort to bridge the gap between Democrats and Republicans was made by Ed Roberson, the current director of Christ Community Health Centers, a onetime Democrat who has been a financial officer in several prominent Republican campaigns over the past couple of decades.

Identifying himself as a Republican, Roberson professed solidarity with the others on Insure Tennessee and called it “unacceptable” that Tennessee should rank 44th in the nation in health-care and that Memphis should have been called the “unhealthiest” city in the country in one nationwide survey.

Roberson’s participation provided at least a measure of ecumenism to Thursday’s press conference, as did his presence side-by-side with Ashley Coffield, local director of Planned Parenthood — an organization that has often been at odds with Roberson’s over their different attitudes toward legal abortion but which in many instances provides overlapping medical care.

Participants at the press conference were Mancini, Harris, Miller, Kyle Coffield, Robinson, state Rep Mike Stewart of Nashville, and state Rep. Antonio Parkinson, whose local Raleigh office provided the venue.

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Editorial Opinion

Tennessee Report Cards

Ours is an age when “outcome-based” is increasingly attached to public-policy initiatives and testing of various sorts is very much in vogue, not only in education but as a measure of success or failure in other ways as well.

This week, Tennesseans can consult brand-new studies to see how the state is doing in K-12 public education and how it could be doing in health care.

First, a freshly released Rutgers University study, entitled “National Report,” grades the 50 states on the extent of their financial commitment to public education. At a time when officials of the Haslam administration and the governor himself cite various other studies as proof of the success of their education initiatives, the Rutgers report tells another story.

While the report awards Tennessee a “B” for the equity of its fund distribution — i.e., in giving poor districts a fair share of the financial pie — it gives the state a flat-out “F” in determining the size of the funding pie itself. 

In measuring teacher compensation against pay for other vocations in the labor market, for example, the report has this to say: “Wages are least competitive in Missouri, North Carolina, Arizona, Georgia, Tennessee, and Virginia, where teachers make around 30 percent less. Wage competitiveness worsens as teachers advance in their career.”

Keeping in mind that the ability of Tennessee’s teachers to change their economic lot for the better was undermined by the General Assembly’s abolition of their collective-bargaining rights in 2011, a long-term improvement would seem to be disproportionately dependent on the good will of state political authorities.  

On the issue of health care, a couple of reports issued during the past week by the White House eschew the course of fault-finding with Tennessee per se in favor of underscoring what the state is giving up by its failure to participate fully in the benefits of the Affordable Care Act (ACA).

What the White House makes clear in a “Fact Sheet” released this week is that Tennessee — despite itself, frankly — is reaping enormous advantages already from the ACA. These include the reduction of insurance premiums for participating Tennesseans, the elimination of out-of-pocket expenses for a variety of testing and screening procedures, the prohibition of “pre-existing illness” restrictions, and the elimination of the infamous “donut hole,” whereby Medicare prescription benefits disappeared at a certain level.

That and more constitute the high side. But what the two White House reports also make clear is that, by declining to follow through on Haslam’s proposed “Insure Tennessee” program, the General Assembly has doomed the state to an annual loss of $1.77 million in ACA Medicaid funding for health care, and to the relegation of 180,000 uninsured Tennesseans to the kind of emergency-room care that has proved ruinously expensive to the state’s over-burdened hospitals. 

The White House issued no grades as such for Tennessee state government’s performance in providing health-care opportunities on its own or in taking advantage of those provided by the federal government, but it seems clear that, at best, the state has earned an Incomplete and, at worst, another “F.”

Failing grades in education and health care? Those are unacceptable report cards.

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Editorial Opinion

Koch Fight

As the Flyer reported back in February, members of the Tennessee General Assembly who had expressed either support for or open-mindedness toward Governor Bill Haslam’s “Insure Tennessee” proposal for Medicaid

expansion were being targeted in their home districts by savage attack ads sponsored by a group calling itself Americans for Prosperity (AFP). During the special session called by Haslam, AFP members, clad in red T-shirts, roamed the hallways of Legislative Plaza with placards attacking the governor’s proposal and crowded into hearing rooms, taking up all but a few available seats.

All legislators felt the heat from this sea of red in Nashville and from the paid inflammatory assaults on their reputations back home, but it was Republicans, members of the governor’s own party, who were subject to the most pressure.

During the special session, Jimmie Eldridge and Ed Jackson, two legislators from Jackson, site of Jackson-Madison County General Hospital, were firm and unrelenting backers of “Insure Tennessee,” which they saw as beneficial to their hospital and to their area at large. Ads appeared in the Jackson area accusing them of “betrayal,” and coupling their likenesses with that of President Obama, thereby exploiting latent political tensions and doubtless racial ones as well.

There is little doubt that the attack ads were paid for out of the same AFP pot that in recent years has intervened with prodigious outpourings of money and resources in general elections and in GOP primary races pitting Tea Party types against Republican regulars, especially relative moderates. That same AFP pot of gold has unstintingly financed efforts, nationally and in every conceivable locality, to discredit climate change, net neutrality, right-to-vote campaigns, teachers’ unions, and workers’ rights in general, to enumerate but a partial sampling of the AFP enemies’ list.

And who is AFP? It is a mask, little more than a synonym for right-wing industrialists David and Charles Koch, the financiers of this and several other propaganda organizations generically (and accurately) referred to as “Astro-Turf” (meaning artificially simulated facsimiles of genuine grass-roots groups).

In Tennessee as elsewhere, the Kochs have pitted their immense fortunes against indigenous local movements that have the slightest look of progressivism or relevance to ordinary Americans. They are enabled to do so by the shameful 2010 Citizens United decision of the U.S. Supreme Court, which effectively nullified the already insufficient safeguards of the McCain-Feingold campaign-finance reform.

The interests of the Kochs of AFP are not indigenous and civic-minded; they are self-serving and predatory. Combatting their deleterious effects on the Democratic process is not easy, but it can be done — as it was in Tennessee last year, when three state Supreme Court Justices survived an organized attempt to oust them that was largely financed by the Kochs.

Defeating the judicial purge required a coordinated and systematic — and expensive — effort on the part of numerous professional and civic groups across the state. And with new statewide elections coming up next year, it will need to be repeated.

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Politics Politics Beat Blog

Despite Competing Partisan Claims, the 2015 Legislative Session Was Neither a Grand Success nor a Total Flop

CREDIT: JB

JB

GOP Leaders: (l to r) House Majority Leader Gerald McCormick, House speaker Beth Harwell, Governor Bill Haslam, Senator Speaker/Lt. Gov. Ron Ramsey, Senate Majority Leader Mark Norris

NASHVILLE — Two sets of post-mortems on the 2015 session of the Tennessee General Assembly were held Thursday morning in the state capital — one by Governor Bill Haslam and the Republican leadership, another by the leadership of the Democratic legislative minority.

Haslam, flanked by House and Senate Speakers Beth Harwell and Ron Ramsey and by House and Senate majority leaders Gerald McCormick and Mark Norris, all sitting at a table in the old Supreme Court Chamber in the Capitol, opened up this way:

“The primary constitutional obligation of the General Assembly and the Governor is to present a budget that balances. This actually was an extraordinary year; not only did we do that, but if you think about it, the hardest time to govern is when you actually have extra money.” An A grade, all things considered.

Half an hour later, over in the Conference Room 31 of Legislative Plaza, it was the turn of House minority leader Craig Fitzhugh, standing primus inter pares among some 18 of his party members from both chambers (the total number of Democrats in both is 30, out of a total of 132).

Said Fitzhugh, by way of starting up: “We legislated quickly, and we passed a budget. That’s about it.” Inasmuch as the veteran Leader from Ripley was among the many in both parties and both chambers who had felt rushed by the session’s hyped-up pace and among the few who could not bring themselves to vote for the budget, that was a failing grade.

In fact, both Haslam and Fitzhugh were exaggerating.

The Governor actually made the claim that “all of what you would call Governor’s bills were passed,” when his most important initiative of all, his Insure Tennessee Medicaid-expansion plan, was blocked in both the special session that began the legislative year and in the regular session.

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Democratic Leaders: with House Minority Leader Craig Fitzhugh at podium; Others include House Caucus Leader Mike Stewart and Senate Minority Leader Lee Harris.

And, while Fitzhugh made a point of naming the failures of Insure Tennessee and of a late tax-relief bill to benefit veterans as reasons for his displeasure, it was also true that several measures opposed by Democrats were blocked as well, and by a bipartisan coalition. Among those were a bill to allow de-annexation of rebellious communities from cities and, for the third or fourth year in a row, a bill allowing for a modest school-voucher start-up.

True, a GOP-backed bill to strike down local options on banning guns in parks passed both chambers, but Haslam has made clear his disagreement with the bill and said on Wednesday that he would decide within a week — maybe as soon as Friday — whether to veto it.

UPDATE: To the surprise of most (and the acute dismay of many) the Governor signed the latest guns-in-parks bill on Friday, abolishing thereby the freedom-of-action of cities and other local jurisdictions regarding firearms in their park areas.

There was actual bipartisan concord on several matters — including virtual unanimity in passage of a home-grown educational standards bill to replace Common Core that was so similar in nature to the much-abused original as to be its fraternal twin.

And even the late failure in the House (on Wednesday) of a bill to permit in-state tuition for undocumented immigrants was not due to partisan disagreement — though a GOP right-winger, Rep. Matthew Hill (R-Jonesborough) may have sullied it for some Republicans by comparing it to President Obama’s immigration directives. The real problem may have been the absence of two Democratic supporters from the vote, both for work-related reasons.

House Democratic caucus leader Mike Stewart (D-Nashville) did what he could Thursday to deflect possible recriminations against the two, Bo Mitchell and Darren Jernigan, both from Davidson County, by saying, “This is a citizen legislature. Absences are going to happen.” The fact remains that the bill fell one vote short of the 50 needed for passage.

Stewart was less forgiving in the case of Insure Tennessee’s failure, clearly brought about by the failure of the Governor’s own Republican Party (with some exceptions) to support it. An “extraordinary failure,” the Democratic caucus leader called it, and, indeed, even as Haslam vowed at the GOP availability to continue supporting it as “the right thing to do,” Lt. Governor/Senate Speaker Ron Ramsey, sitting to the Governor’s immediate left, opted out loud for the alternative of a two-year scenario involving election of a Republican president in 2016 and conversion of Medicaid funds into pure block grants.

The Democrats, for their part, vowed to renew their support for Insure Tennessee. Fitzhugh announced that the combined party caucuses would be sending Haslam a letter before the week ended beseeching him to call another special session to deal with the measure. It’s fair to say that’s pretty unlikely, and the fact that next year is an election year decreases the likelihood of action in the 2016 session as well, especially given the scenario spelled out by Ramsey.

The Governor had expressed pride in getting safely through two “contentious” matters in the session just concluded. One was the Common Core matter, and that could be stacked up with other education-related successes of the Haslam agenda, including the roughly $170 million in “new money” appropriated for K-12 education and backing for higher education initiatives as well, including Drive for 55 and Tennessee Promise, both aimed at raising the level of adult post-secondary education.

Haslam was on thinner ice in expressing satisfaction in how the legislature had skirted (to his mind) major controversy in limiting anti-abortion legislation to the imposition of a 48-hour waiting period. The Democrats made whoopee on that matter, regarding which Planned Parenthood and various organized women’s groups remain outraged. “Their mission is to change the way women live. They are taking their rights away,” Rep. Sherry Jones (D-Nashville) maintained.

Still, a fair assessment of the just-concluded session from a neutral observer might be: Could have been worse; surely could have been better. Some of the outright wack stuff, like the attempt to make the Bible an official state book, was beaten down by bipartisan action, and there was intermittent harmony on other issues as well.

One such was the hectic pace of the legislature’s increasingly abbreviated sessions — an innovation that, quite obviously, has been driven by Ramsey, who has set mid-April adjournment deadlines for a body that in recent years had continued its deliberations well into summer.

At the Republican leadership availability in the old Supreme Court chamber, Ramsey had expressed pride in what he called cost-conscious “efficiency” gained from the sped-up pace and claimed, “We didn’t even feel rushed.” But, after a brief pause, in which he must have noticed either slight murmurs or rolled eyes out there among his auditors, he added, “OK, we were rushed.”

Earlier Thursday morning, a bipartisan group of legislators having breakfast at the Red Roof Inn, a modestly priced alternative to the state capital’s more expensive hostelries, sat together, grumbling about what they saw as a much too frantic pace, which one or two of them attributed to Ramsey’s need to get about his auctioneering and real estate businesses as early as possible in the spring.

In any case, these legislators agreed that key bills were being overlooked in the undue haste and some, like the in-state tuition bill which they all happened to support, had fallen victim to it. If there is a true bipartisan consensus developing on any one matter, this matter would seem to be it.

In any case, here it is, still April, and the General Assembly is over and out.

Categories
Politics Politics Feature

On the Health-Care Front

Against all odds, backers of a renewed effort to secure legislative approval for Governor Bill Haslam‘s Insure Tennessee proposal hoped to steer the Medicaid-expansion measure through committees in both the state Senate and state House this week.

And, even if the proposal is stopped short of the goal, as it was in an aborted February special session, 9th District Congressman Steve Cohen and other members of the state’s congressional delegation have managed to obtain some measure of fiscal relief for the state’s beleaguered hospitals.

Cohen announced this week the passage of the Medicare Access and CHIP Reauthorization Act, which, the congressman said in a press release, will “guarantee disproportionate share hospital (DSH) allotments totaling more than $530 million over the next 10 years to help the state’s hospitals and community health centers recoup expenses incurred caring for those who cannot afford to pay.”

As Cohen, who took the lead in securing the new funding, noted, Tennessee is the only state in the nation that, until passage of the act, was not in a position to receive annual DSH allotments automatically.

The reason for that has been that, when the administration of Governor Ned McWherter negotiated a waiver with the federal government to convert Tennessee’s Medicaid operation into what became TennCare, the DSH allotments were not included within the waiver. The oversight, based on an apparent overestimation of TennCare’s ability to cover all exigencies, may have kept the state from receiving as much as $450 million in DSH funding annually.

Attempts in recent years to remedy that situation have been blocked by a general atmosphere of fiscal austerity in Washington, and even the new arrangement, which secures a guaranteed amount of new federal DSH funding amounting to $53 million annually, provides but a drop in the bucket compared to the $1.4 billion that would be made available to the state’s hospitals for indigent health care through Insure Tennessee via the Affordable Care Act.

Haslam’s proposal was voted down 7-4 by a specially constituted state Senate Health and Welfare committee in the special session, but, Lazarus-like, it got up and moving again last week as Senate Joint Resolution 93, passing hurdles in the Senate Health and Welfare subcommittee and the regular Senate Health Committee.

SJR 93, co-sponsored by Senators Jeff Yarbro (D-Nashville), Doug Overbey (R-Maryville), and Richard Briggs (R-Knoxville), was on the schedule to be considered this week by the Senate Commerce and Labor Committee. Meanwhile, over in the House, Rep. Larry Miller (D-Memphis) had put the House version of the measure, HJR 90 on notice in the Insurance and Banking Subcommittee. Opinion of lawmakers consulted by the Flyer is divided on the extent to which consideration of Insure Tennessee on the floor of either the Senate or the House will be determined by what happens in committee.

Some proponents of the proposal are wondering out loud if a bill passed last year requiring legislative approval of Medicaid expansion actually applies prohibitively to an executive action by the governor.

· In separate conventions held over the weekend, the Shelby County Democratic Party (SCDP) and the Shelby County Republican Party each elected a new chairperson. In both cases – a woman.

The Democrats went first, convening on Saturday at First Baptist Church on Broad, selecting first a 29-member executive committee, which in turn elected longtime party activist Randa Spears on the second ballot from a field of four aspirants.

Spears thereby became the first white female to head the local Democratic Party in its history.

Her ascension to party leadership, after 32 years in the gruntosphere, made perfect sense. It was a reward for faithful service — including a recent stint as campaign manager for Deidre Malone, the Democratic nominee in last year’s county mayor race. It was a nod to the longstanding prominence of women in party affairs (as in local social and civic life, generally). And it was a clear signal to Shelby County’s white population that the SCDP was not, as it has sometimes seemed in recent years, a monolithically black organization.

Asked about that last fact in the aftermath of her second-ballot win over runner-up Del Gill, Spears was discreet, diffident, and diplomatic: “I don’t know that that is important. I think it’s important that someone with my focus and experience and enthusiasm is chairman. And I think I’ve worked with almost everybody in this room, except for the new folks, on one campaign or another. So I look at this as all one group.”

Malone, who, in an exchange of roles this year, had been Spears’ campaign manager, addressed the point more freely: “I do think it’s important to have elected a white chair — and especially a white female. It makes a statement.”

Just as it might to elect a female mayor at some point, she was prodded? “Yes,” she nodded, in gratitude for the implied tribute to her pathfinding 2010 and 2014 mayoral campaigns.

For the fact is, American politics is all about constituent groups (or blocs, if you choose). The more different ones your party can address satisfactorily, the more broadly based — and successful — your party is likely to be.

All four candidates on Saturday’s ballot had something to say for themselves. Runner-up Del Gill could boast his four decades of party work, newcomer Jackie Jackson was a fresh breath, just a little too new to most committee members to win; and pre-convention favorite Reginald Milton, a well-respected county commissioner, was conspicuous in his efforts to unite disparate party factions.

Politics is also all about trade-offs, and Spears’ victory owed much (as did Milton’s defeat) to longtime party broker Sidney Chism, who, for whatever reason, tipped his support, and that of his still significant network, to her.

Gill, all things considered, was not that far behind Spears, at 11 to her 16 on the second ballot. And, Gill being Gill, it was unlikely that he was prepared to fall in line behind Spears. Encouraged by his original first-ballot-leading total of 11, he put up something of a fuss at meeting’s end about a procedural issue regarding the validity of the new committee’s voice vote to continue the party’s bylaws in lieu of a full review of them.

The newly elected Spears politely but firmly disallowed the complaint and moved on to complete the day’s business. She did say later that she was willing to avail herself of the “wealth of experience” of Gill and whomever else. But it remained to be seen whether she can impose an effective measure of unity on a committee composed in large part of members potentially sympathetic to Gill’s dissident outlook.

A day later, on Sunday at the Bartlett Municipal Community Center, a throng of several hundred Republicans (including 400-odd delegates as such) witnessed what amounted to a re-assertion of the local GOP establishment’s control of the Shelby County Republican organization.

Though there was no dearth of competition — either for the party chairmanship, won by Mary Wagner over Arnold Weiner, or for the numerous other offices up for grabs — the Tea Party rebellion that flared up at the 2013 Republican conclave and in attempted power grabs at several local Republican clubs has been contained. There was no Tea Party slate as such, with adherents of that somewhat diversified, quasi-libertarian point of view to be found on both contending slates, Wagner’s and Weiner’s.

There was a message to be had, though, in the fact that the slate headed by Wagner, a relative newcomer to party politics whose last position was that of Young Republicans president, all but swept the slate led by Weiner, a longtime party veteran who had been, most recently, a party vice chair and immediate past president of the East Shelby Republican Club. And that “all but” is required mainly because Curt Cowan, the Wagner slate’s candidate for Primary Board position Number 5, was prevailed upon to drop out in favor of George Flinn, the wealthy radiologist/broadcast executive and sometime political candidate who still maintains a high profile in the local Republican Party.

The other 35 contested positions — for chairman, at-large steering committee members, district representatives, and primary board members — were won by the Wagner slate. The message, quite simply, is that there is a Republican mainstream, and it is back in full command.

Categories
Editorial Opinion

Commission Kudos

In Washington there appears to be no hope for anything like bipartisan cooperation — not even to mention nonpartisan thinking. Everything in our nation’s capital is akin to trench warfare, with the two sides — the now dominant

Congressional Republicans and the demoralized Democrats of the House and Senate glaring at each other across a no-man’s land of stalled or vindictive legislation.

It is much the same with the Tennessee General Assembly in Nashville, where the most obviously beneficial possibilities — think Governor Haslam’s proposed Insure Tennessee vehicle for overdue Medicaid expansion — are doomed to inevitable oblivion once the GOP super-majority there finds a way to link them to the name of President Obama.

American history — if a nation this conflicted can actually survive — will surely reflect at some future point on the ignominy of a time when an entire national party devoted itself not to the art of governing but to a grim determination not to govern. (The periodic attempt of Republicans in Congress to shut down the government is not the anomaly it is often presented as by a credulous media; preventing government would seem to be not a stratagem but an end in itself for the anarchist ideologues who control the party’s right wing.)

Luckily, though, there is one governmental unit that still seems to be functioning across party lines with the goal in mind of securing the greatest good for the greatest number. It’s the Shelby County Commission, whose seven Democrats and six Republicans have demonstrated twice in this calendar year that they not only can achieve unity of purpose, but do so in such a way as to shame the bodies that theoretically represent the larger enclaves of state and nation.

Casting partisanship aside back in February, the members of the commission, among whose responsibilities it is to maintain the effectiveness of Regional One Health (aka The Med) voted 12-0 for a resolution urging the General Assembly to approve the Haslam plan, which would have brought $1.4 billion a year into Tennessee for the rescue of its financially challenged hospitals.

Although some Republicans in Nashville were ready to concur, a band of GOP ideologues on a single Senate committee prevented the plan from even getting to the floor. All hail gridlock!

More recently, the commission put itself on record this past Monday with the same degree of unanimity in opposition to voucher legislation which has already cleared the state Senate and is ready for processing by the House. The Republicans and Democrats of the County Commission pointed out the obvious: Any money channeled into private schools will be at the expense of the state’s — and the county’s — public school systems.

The Shelby County Commission seems to have gotten the knack of seeing beyond abstract partisanship so as to do some real governing on behalf of their community. It’s an elementary habit of mind but one that seems unhappily lost to the denizens of state and local government.