Tag: Insure Tennessee

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Politics Politics Feature

Government on Ice

So the bad weather came. Not as bad as was advertised, frankly, and not as bad as hit many other points in the nation, including parts of Tennessee to the east of us. Still, it was enough to halt, here as elsewhere, the momentum of politics and government for a couple of days.

“Parts of Tennessee to the east of us,” I said. Okay, Nashville, for instance. Tuesday was wiped off the calendar in state government, and at press time there seemed a real possibility that the General Assembly could have a de facto shutdown all week, even should the schedule of events (committee meetings and floor sessions) be formally reinstated.

East Tennessee proper, which supplies a generous share of human fodder for the legislature, was hardest hit by the storm and seemed destined to remain weather-bound. Conditions there were the primary cause of a state of emergency declared Monday evening by the Tennessee Emergency Management Agency (TEMA). But power outages and road closures were abounding in Middle Tennessee counties like Davidson, Hickman, Humphreys, and Williamson, as well.

Some urgent things, of course, had already been put on ice by the General Assembly — the most notable of which was Governor Bill Haslam‘s Insure Tennessee proposal for Medicaid expansion. That happened week before last, with the proposal’s rejection by a 7-4 vote in an ad hoc Senate committee meeting in special session.

Not to mince words, the proposal, which would have poured into state coffers some $1.5 billion annually — much of it destined for Tennessee hospitals struggling with the costs of uncompensated medical care for the uninsured (estimated to number at least 280,000 in the state) — was defeated because it could be linked to the Affordable Care Act, aka “Obamacare.”

Other arguments — that the federal government would eventually welsh on its commitment to fund the lion’s share of long-term funding or that Tennessee would be stuck in a “Hotel California” commitment it could never check out of — were demolished over and over by the governor or the attorney general or legislative supporters (including Democrats and Republicans), but they kept resurfacing — as a smoke-screen, backers of Insure Tennessee maintained.

Parenthesis: Late in that first week, state Representative Steve McManus (R-Cordova) expressed disappointment that many press reports up Nashville way had wrongly credited a fellow Shelby Countian, state Senator Brian Kelsey (R-Germantown) with authoring the “Hotel California” trope. McManus is correct. As the Flyer reported on its website on January 9th, McManus, a sometime thespian, was indeed the originator of that metaphor.

Kelsey had merely borrowed the phrase — along with predictions of a special-session “bloodletting” by state Representative Curry Todd (R-Collierville) — for his own numerous attacks on the governor’s Medicaid proposal. The senator from Germantown can lay claim to one original argument of his own, however — that, as he said during the fateful hearing by the ad hoc Senate Health and Welfare Committee, Insure Tennessee amounted to nothing more than a “bailout” for the state’s foolishly miscalculating hospitals.

Democrats in the House and Senate, more a remnant than a real force, have introduced legislation to renew consideration of Insure Tennessee in the regular session, now begun, but there seems little hope of that coming to pass. In his post-mortem with the press after the failure of the special session, Haslam said that he’d like to try again, but hinted it might not be possible until the election of a new president.

That same theme was noted directly last week by House Speaker Beth Harwell (R-Nashville), who declined to support Insure Tennessee in the special session and was quoted by The Commercial Appeal‘s Rick Locker as saying, “It might be that two years from now, we wake up with a Republican president, look at going after it again and coming back with a block grant. … Do I think we want to spend a lot of time during the regular session? Nah, I don’t think that.”

People wonder what presidents’ legacies will be. Barack Obama‘s might be that he was the first president who saw every proposal even remotely connected with him — good, bad, or indifferent — relentlessly stonewalled by his political opposition, not only at the congressional level but at the level of state government, as well.

So we wait two years. Right. That’s roughly $3 billion worth of waiting, and God only knows how many of the 280,000 uninsured Tennesseans could have health emergencies in the meantime.

Obama-bashing may work for GOP members in the legislature, but not for those Republicans with responsibility for actual governing in the affected localities of Tennessee. In two overwhelming votes, one in advance of the special legislative session, another afterward, the Shelby County Commission has endorsed Republican member Terry Roland‘s resolution calling for passage of Insure Tennessee.

Concern for imminent strain on the medical and financial resources of Region One Health (aka The Med) was cited by members of both parties. Shelby County Mayor Mark Luttrell has been outspoken in his disappointment, forecasting in a series of appearances lately that the defeat of Insure Tennessee could lead to a 10 percent county property tax increase. On last week’s Behind the Headlines broadcast on WKNO-TV, Luttrell bit down hard on that bullet:

“The opposition framed it as being an extension of the president. Those Republicans that dared to kind of step out and support it in the General Assembly were vilified.”

It should be noted that not every measure introduced in the current legislative session has met with a cold shoulder. Nah. As one example, a bill (HB677/SB0783) introduced by state Representative James Van Huss (R-Jonesborough) and state Senator Mae Beavers (R-Mt. Juliet), seems on its way to being fast-tracked. This bill would establish the Barrett Model 82A1 50-caliber semi-automatic rifle, manufactured in Murfreesboro, as Tennessee’s “official state firearm.” First things first.

• Another political situation which may have experienced a brief freeze since last week was the rush of candidate declarations for various city offices.

The announcement last Monday by commission chairman Justin Ford that he would seek the office of Memphis mayor further filled out a candidate roster that is ultimately expected to include a generous number of candidates besides those already declared, who include Councilman Jim Strickland, former county commission chairman James Harvey, former University of Memphis basketballer Detric Golden, and, of course, incumbent Mayor A C Wharton.

Councilman Harold Collins is considered a good bet to enter the mayoral field, and another likely possibility is Memphis Police Association director Mike Williams. Expect others before the Election Commission allows petitions to be formally pulled on April 17th. The election itself won’t happen until October 29th.

Other relevant dates: Filing deadline, July 17th. Withdrawal deadline, July 24th. Start of early voting, October 14th. Voter registration deadline, October 5th.

One of those still mulling over a city race and inclined, she says, to give the matter a good bit of time before deciding, is Kemba Ford, the daughter of former state Senator John Ford and an increasing presence in local civil and political affairs. Ford, who has run previous races for the city council and the state legislature, may be a candidate for the council’s District 7 position, but she’s involved at the moment with cousin Joe Ford Jr., a resident of Los Angeles, in an archival multimedia research project on Memphis politics during the civil rights era, focusing on the Ford family’s involvement.

Kemba Ford herself was a longtime resident of L.A., where she pursued an acting career until her father’s arrest, conviction, and imprisonment as a result of the FBI’s Tennessee Waltz sting brought her back to Memphis to provide him with moral support. (Former Senator Ford, long since released, accompanied his daughter to the Tennessee Equality Project’s fund-raising Gumbo Contest at Bridges downtown weekend before last.)

The District 7 position was formerly occupied by Lee Harris, who vacated it after his election year to the state Senate, where he is now that body’s Democratic leader. The seat is currently held on an interim basis by Berlin Boyd, sure to be a candidate in October.

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Politics Politics Feature

Can “Insure Tennessee” Rise Again?

NASHVILLE — By means of what many supporters of Medicaid expansion in Tennessee see as a stacked deck, an ad hoc state Senate Health and Welfare Committee last week aborted Governor Bill Haslam‘s special session and seemingly killed his Insure Tennessee proposal last week with a 7-4 vote against it on Wednesday — not quite two days after the special session had kicked off with an optimistic address by Haslam.

That vote, from a committee whose normal membership had been altered by Lieutenant Governor Ron Ramsey, the Senate speaker, effectively halted what would have been a gauntlet run for the proposal through a series of other committees, and prevented the proposal — which was couched in the form of a joint resolution — from reaching the floor of either the House or the Senate for a floor vote.

In the immediate aftermath of the committee vote, supporters of Insure Tennessee pointed out that the regular nine-member Senate Health Committee, which will reconstitute for the regular session that began this week, contains five members presumed to have been for the Insure Tennessee proposal, including the Senate sponsor, Doug Overbey (R-Maryville).

Ramsey’s ad hoc version — reshuffled, according to the Senate speaker, so as to insure that all 33 members of the Senate were evenly apportioned on the three committees that could potentially hear the bill — contained from the start a preponderance of skeptics regarding Haslam’s proposed plan. 

That hurt the proposal’s prospects, and so did the reluctance to endorse the bill of key Republican leaders — Ramsey and Majority Leader Mark Norris (R-Collierville) in the Senate and Speaker Beth Harwell (R-Nashville) in the House.

Much of the resistance to the Haslam proposal was clearly based on the opponents’ ideological hostility to the Affordable Care Act, the health-care system designed by the Obama administration to expand insurance coverage — in partnership, essentially, with private insurors. A component of the act has been the provision of billions of dollars in annual grants to participating states to expand their Medicaid programs. In Tennessee, as Haslam and others pointed out, that would have meant outlays of $1.4 billion annually to TennCare, the state’s version of Medicaid.

Although there were numerous Republicans prepared to vote for the bill, particularly in the House, GOP ideologues denounced the measure as “Obamacare,” despite numerous nods to marketplace methods in the Haslam version and kept on repeating discredited assertions (e.g., that the federal government would ultimately default on funding, sticking Tennessee with the bill, or that the state would not be able to extricate itself from Insure Tennessee, even though Haslam devised it as a two-year pilot program with an automatic fail-safe cut-off mechanism should assumptions prove incorrect or circumstances turn even slightly adverse).

Opponents were aided by a show of force in the hearing rooms by red-shirted representatives of “Americans for Prosperity,” a shell organization funded by the billionaire Koch brothers, who also paid for ads accusing Republican supporters of Insure Tennessee-like state Representative Jimmy Eldridge (R-Jackson) — of having “betrayed” Tennessee.

Predictably, there was a firestorm of criticism in the aftermath of the bill’s rejection, from legislative Democrats and from some Republicans as well, from representatives of Chambers of Commerce and from the Tennessee Hospital Association, whose member institutions had guaranteed to pay whatever future expenses for Insure Tennessee that the federal funding did not directly cover.

The Shelby County Commission, which had voted 12-0 to encourage legislative support for Insure Tennessee three weeks ago, reacted to the proposal’s defeat with a 10-1-1 vote for a fresh resolution on Monday, sponsored by conservative Republican Terry Roland of Millington, urging that the Haslam proposal be reconsidered in the regular session now begun. The desperate financial needs of The Med (now known as Regional One Health) and the predicament of Tennessee’s uninsured population were cited by another GOP conservative, Mark Billingsley of Germantown.

Weighing in at some length also was Republican County Mayor Mark Luttrell, who said, among other things, “I think our citizens in Shelby County deserve more. There should have been a full hearing before the Tennessee General Assembly.”

And, amid calls in the General Assembly itself for renewed consideration of Insure Tennessee, Governor Haslam, whose initial statements following rejection of his proposal were fatalistic, included some determined, even upbeat-sounding statements in his “State of the State” address to a joint session Monday night.

From the governor’s speech: “Last week, the decision was made not to move forward with Insure Tennessee. However, that does not mean the issues around health care go away. Too many Tennesseans are still not getting health coverage they need in the right way, in the right place, at the right time. An emergency room is not the place where so many Tennesseans should be going for health-care services. It’s not the best health care for them, and it’s costing us a lot more in the long run.

“Health-care costs are still eating up too much of our state’s budget and impacting the federal deficit and nation’s debt. According to the Congressional Budget Office, if we maintained health-care costs at their current levels, which we know are inflated, for the next eight years — just kept them flat — we’d eliminate the nation’s deficit. To do that, we can’t keep doing what we have been doing.

“So, though the special session has ended, I hope we can find a way to work together to address those problems.”

• The Memphis mayoral race, just as many expected, and just as some — existing candidates included — were hoping, is filling up. The latest to declare a candidacy is Shelby County Commission Chairman Justin Ford, who had promised the media he would reveal his decision to them on February 9th. And, came Monday, February 9th, Ford did just that.

In a conversation with reporters during breaks in Monday’s commission meeting at the County Building, Ford said he’d been thinking about a mayoral race for four or five years (or about the time he was first elected to the commission in 2010), and, after paying brief homage to the Ford family’s commitment to public service, made special note that his father, former councilman, commissioner, and interim county mayor Joe Ford, was able to raise “half a million dollars” in a race against then Mayor Willie Herenton in 1999. “It won’t be [any] different this time,” avowed Ford, who said he would run on issues of economic development, health care, education, and public safety.

Asked about the fact that the mayoral field was fast multiplying, Ford said, “The more the merrier. When you look at any type of race, especially in this democracy, in the city of Memphis, we’re accustomed to change. The more people in the race the better. They bring different perspectives [for] the opportunity for people to make the decision whether or not they want some change.”

Victory, he said, could come to “whoever has a resounding message, goes door to door, and also raises the right amount of money.”

Ford said he was aware that both Mayor A C Wharton and Councilman Jim Strickland, a declared mayoral candidate, had already raised prodigious amounts of money. “I’ve seen their financial disclosures,” he said.

As an incumbent, Wharton had a head start, Ford acknowledged. “Incumbents are hard to beat, so at the end of the day, if you don’t have a focus and have a real plan, you might not be successful.” But, he noted, “We’re a long, long way from the finish line.” And a few months, for that matter, before petitions for the October election become available in April.

Other candidates already declared are Wharton, Strickland, former Commissioner James Harvey, and former U of M athlete Detric Golden. Considered likely to enter the race are Councilman Harold Collins, New Olivet Baptist Church Pastor and former School Board member Kenneth Whalum Jr., and Memphis Police Association President Mike Williams.

• An effort last Wednesday by county Commissioner Steve Basar to hold a review of the joint city/county EDGE (Economic Development and Growth Engine) board — billed as an “update” on the published Commission agenda for Basar’s economic development committee — was forestalled, with several members insisting on the presence of EDGE board members before having such a discussion. Basar agreed to defer the discussion until the presence of board members, who had not been invited to last week’s commission session, could be arranged, likely in March.

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Letter From The Editor Opinion

The Republican Rift

Anyone who’s been paying attention knows that Lieutenant Governor Ron Ramsey’s hand-picked Senate committee voted not to allow Governor Bill Haslam’s innovative Insure Tennessee proposal out of committee. Seven Republican legislators — including local lightweight champion Senator Brian Kelsey — each of whom gets per diems, paid travel expenses, and government health care for their part-time jobs — voted to keep sending Tennessee tax dollars to other states and to keep 280,000 Tennesseans from being able to purchase affordable health care.

Those seven people voted to turn down funds that would have helped keep county hospitals open all across the state. They voted to make people have to travel farther for care. They voted to make the rest of us pay for uninsured Tennesseans’ medical care. They voted to force more people to face medical-related bankruptcy. They voted to let thousands suffer and die from lack of medical care.

Why? Because most GOP legislators in Tennessee are owned by Americans for Prosperity (AFP), the Koch brothers’ group that is fighting the Affordable Care Act all over the country. If a Republican dares to not sign the AFP pledge to fight “Obamacare,” AFP runs ads in their communities linking them to President Obama. Oooh.

The legislators’ decision is another indication of the growing rift in the GOP between the socially conservative, “shrink government,” pro-gun ideologues and the business-friendly, common-sense-governing faction. The former group boasts our two local AFP toadies, Senators Mark Norris and Kelsey. The latter group includes Haslam, Shelby County Mayor Mark Luttrell, GOP members of the Shelby County Commission, and many others around the state.

Someone’s going to have to lead the fight for common sense in the GOP. Haslam is the obvious choice, but there’s not a lot of fire there. I never thought I’d write these words, but we need more Republicans like Commissioner Terry Roland, who isn’t intimidated by out-of-state interests and who gets that foolishly turning down federal money that’s already ours is going to mean a tax increase in Shelby County.

We need somebody like Montana Republican state Representative Frank Garner, a conservative who was open to hearing how “Obamacare” might or might not work in his state. AFP ran ads with his picture super-imposed over President Obama’s. They called a “town meeting” in Garner’s district to tell his constituents about his nefarious activities. They didn’t invite Garner, but he showed up anyway. From a rawstory.com account of the meeting:

“I promised the people here when I ran that I would listen to you and not out-of-town special interests,” Garner said to wild applause. “If every time they want me to sign a pledge card and I don’t do it, they are going to rent a room and have a meeting, then this is going to get real expensive — because I’m not signing the pledge card.”

Having the courage to do what’s right for your constituents. What a concept.

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Editorial Opinion

Leading From the Top

So far in 2015, we have  been sufficiently dosed with annual “State of …” speeches delivered by the heads of government of most direct importance to us — the governor of Tennessee and the mayors of Memphis and Shelby County.

And we have heard both preamble and follow-up speeches from all three officials. Though, as expected, all three, Governor Bill Haslam, Memphis Mayor A C Wharton, and Shelby County Mayor Mark Luttrell, found much to boast about, they all also, with varying degrees of frankness, touched upon some dire needs — for more money, more efficiency, more ingenuity, or whatever — to avoid a curtailment of vital governmental services, including provisions for public safety, that all citizens, regardless of ideology, insist on.

All three chief executives can, with some justification, state a claim that serious efforts have been made within their jurisdictions over the past several years to operate their governments in accordance with the dictates of economy and the needs of hard-pressed taxpayers. But, even amidst the boasting, all three conceded the degree of difficulty they’re operating under.

As Wharton acknowledged on Tuesday, the strain of keeping the city in the black has been considerable. Speaking of the wrenching changes he deemed necessary in the benefits package of city employees, Wharton said, “We’re all scarred, but our city is better off as a result.”

And Luttrell has confessed that the incentives offered to potential new businesses by the EDGE (Economic Development and Growth Engine) board supervised by himself and Wharton are under fire and very likely — like the board itself — in need of review.

Meanwhile, Haslam also has his problems. He is fresh from having offered a special session of the Tennessee General Assembly an unusual bargain — some $1.4 billion annually in federal funding (a measurable part of it derived from this state’s taxpayers in the first place) in order to facilitate health-care insurance for an estimated 200,000 Tennesseans who have not been able to afford such coverage. 

Temporarily, anyhow, this bonanza — based on a carefully structured plan with numerous free-market components — has been denied to these citizens, as well as to the state’s over-burdened hospitals, by an ad hoc state Senate committee. The committee was stacked in advance by Senate Speaker Ron Ramsey with opponents of the governor’s plan for Medicaid expansion, called Insure Tennessee, and denounced by them as synonymous with the imagined excesses of “Obamacare.” This, despite the fact that the Haslam’s plan has numerous distinguishing features and was designed to spare the state of Tennessee and its taxpayers any expense whatsoever.   

Perhaps the General Assembly, meeting now in regular session, will revive Insure Tennessee. We hope so. The Shelby County Commission, in two bipartisan votes, has urged just that in no uncertain terms. So have our two mayors. We hope, too, that the scars spoken of by Wharton will heal, and that his and Luttrell’s devices for attracting new jobs, and for developing the workforce to assume those jobs, can reach the right kind of equilibrium to satisfy all components of what is still a seriously divided community.

We agree that these leaders have all managed to get some roses to bloom. But the thorns are still there, too, and somehow have to be plucked.

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News News Feature

Haslam’s Next Move

Although I’ve never been there, I can imagine that somewhere inside Tennessee Governor Bill Haslam’s office is a picture. I envision it as a photo of a bright, ambitious, and idealistic Emory University college student proudly standing next to former iconic Tennessee U.S. Senator Howard Baker. It would have been taken when Haslam volunteered to work on Baker’s reelection campaign in the 1970s. I can further imagine Haslam worshipped the man whose colleagues dubbed him “The Great Conciliator” for his uncanny ability to politically maneuver diverse factions into seeking workable compromises for the benefit of the common man, because it was the right thing to do.

In a previous column, I, like many others, scoffed at Haslam’s 21-month attempt to work with the federal government to craft an expanded health insurance plan tailored for Tennessee. I criticized him for what I perceived as his foot-dragging to aid the 280,000 Tennesseans who fall through the cracks of Medicaid and are left unable to pay for simple medical care or are victimized by the ravages of a catastrophic illness. I will admit I should not have been so quick to judge his intentions or his determined strategy at devising a workable proposal.

But as we found out last week, even the best of intentions seems to carry no weight with the current Tennessee General Assembly. To have Haslam’s well-thought-out Insure Tennessee plan fail to even get out of a Senate committee is an abomination, especially for anyone still deluded enough to think our elected officials are chosen to do the will of the people.

The majority of Tennesseans favored taking the available $2.8 billion in federal dollars over two years to finance the program. Using the inclusive vision practiced by his political mentor, Baker, Haslam methodically garnered the support of the state’s medical associations, bankers, businessmen, and law firms. He had fact-based rebuttals for any questions about the validity of the plan, including the trump card of it being a “pilot” program that could be dropped after two years of enactment. But, once again, sinister forces within and outside Tennessee’s borders used their financial and political influence among state legislators to defeat the proposal, mainly by invoking the conservative rallying cry of Obamacare.

Haslam appears to have thrown in the towel on pushing any further efforts toward passing Insure Tennessee. He was quoted in The Commercial Appeal as saying, “At the end of the day, I’m really disappointed that 280,000 people who could have had health-care coverage, at least right now, it doesn’t look like we have a path to get them there. That’s the end result to me.” To which I say:

Governor, look at that picture of you and Baker and ask yourself: “Why does this have to be the end of your plan? If one path is closed off then try another.”

You admitted you hammered out the final approval to go forward from the U.S Department of Health and Human Services in December, and then announced it in the first week of January. You then went on a whirlwind tour of the state, with a stopover in Memphis. It seemed more like a victory lap, as if the heavy legislative lifting had already been done. Yet, you didn’t have vocal support from key legislators — House Speaker Beth Harwell, Senate Majority Leader Mark Norris — and only lip service from Lieutenant Governor Ron Ramsey.

A parade in Nashville of highly paid hospital administrators endorsing the plan doesn’t carry anywhere near the emotional impact of real people bringing their personal stories directly to the faces of legislators.

It’s time to cash in on your solid state-wide popularity. You didn’t give yourself enough lead time to drum up support. People like you. Use the bully pulpit of your office to energize your message; force legislators to listen. Then go summon that Baker voodoo for bringing opposing sides together and work out a compromise.

Governor, to breathe life back into this proposal, you’re going to have to roll up your sleeves and do something you’ve previously chosen to avoid: getting down in the trenches and fighting for the good of all Tennesseans. You can begin by convincing yourself that it’s the right thing to do. Look again at that picture of Baker, and maybe you’ll find the inspiration and courage to do it.

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Editorial Opinion

Haslam’s “Good Faith” Issue

As chronicled elsewhere, Governor Bill Haslam began this week of legislative special session in Nashville with the challenge of persuading reluctant members of his Republican Party to suspend their aversion

to what they call Obamacare and accept his home-grown version of Medicaid expansion called Insure Tennessee.

Prior discussions of the matter in the media have focused almost entirely on the mechanics of the plan or the political matters at stake or the financial incentives available to Tennessee (and its hard-pressed hospitals) should the General Assembly opt to give its statutorily necessary approval to the proposal. Those financial stakes are large indeed, amounting to somewhere between $1 billion and $2 billion annually. But the political obstacles are large, as well: GOP talking points against Obamacare (the vernacular name for the Affordable Care Act) are so well established that the governor’s arguments for Insure Tennessee had to be couched in terms that drew the broadest possible distinctions between his Tennessee variant and the federal act.

Accordingly, Haslam made much of marketplace methodologies embedded in Insure Tennessee — including an alternative plan-within-the-plan for vouchers to pay for private insurance, as well as requirements for co-pays and modest premiums for those new insurees opting for coverage under TennCare (Tennessee’s version of Medicaid). And the governor catered to home-state Republican sensitivities by adding an anecdote to his prepared speech involving his past entreaties to President Obama, along with those of other Republican governors, to allow Medicare funding to be dispensed to the states via block grants for the states to dispense as they wished.

But much of the governor’s speech was taken up, too, with appeals to the legislators’ hearts as well as to their heads. Opponents of Insure Tennessee have been shedding crocodile tears at the plan’s provision for discontinuing Insure Tennessee after two years if either the federal government or the Tennessee Hospital Association default on promised funding. That would drop thousands of new insurees from coverage, the critics say. To this, Haslam offered the common-sense rebuttal that two years of coverage are significantly better than no health-care coverage at all.

And he offered his listeners a real-world anecdote about a Tennessean whose stroke, resulting from his inability to afford health insurance, had “landed him in the hospital, followed by rehabilitation” and taken him out of the workforce. “He was a hard-working Tennessean who wasn’t able to get the care he needed on the front end and that has real consequences for him and his family. Having a stroke wasn’t only devastating to him and his family, it could have been prevented, and not preventing it is costly to all of us.”

The governor then, having argued facts and savings and marketplace models, laid the matter to rest on the bedrock issues of values and good will: “I think this is also an issue about who we are. My faith doesn’t allow me to walk on the other side of the road and ignore a need that can be met — particularly in this case, when the need is Tennesseans who have life-threatening situations without access to health care.”

Indeed. It’s a matter of good faith and we agree with the Governor: That’s the nub of the issue.

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News News Feature

Thanks, Obama!

Last week, I joined the nine-million-plus Americans who have Obamacare.

My premiums are less than I paid with employer-sponsored health insurance, my deductible went from $2,800 to zero, and I can stick with the same primary care doctor.

Thanks, President Obama!

The opportunity to have affordable health insurance separate from a job allows me and many others to pursue more meaningful work. For the first time in my life, I can explore being not just an employee but an entrepreneur. (Or as Mitt Romney would say, a maker, not a taker.)

Nearly five years after the Affordable Care Act was signed into law and after months of dithering over whether to get on board, Governor Bill Haslam has come up with Insure Tennessee, his too-little-too-late version of Obamacare.

Of course, Haslam would never call it that. But without Obamacare, it’s unlikely that the nation’s richest politician (net worth: $2 billion) would have devised a health insurance plan for the working poor.

Thanks again, Obama!

On Monday, Haslam convened a special session of the state legislature to consider Insure Tennessee. The two-year pilot of Insure Tennessee wouldn’t start until 2016. That means the state would forfeit even more than the $2.4 billion it’s passed up so far by refusing to accept federal dollars for Medicaid expansion, which was a key part of the Affordable Care Act.

Insure Tennessee is aimed at those who earn less than 138 percent of the federal poverty level, or $16,242 for an individual. Haslam’s administration estimates that 200,000 Tennesseans would be eligible for Insure Tennessee.

Even if I stood to benefit, I wouldn’t be impressed.

Said Haslam when he announced his plan: “This plan leverages federal dollars to provide health-care coverage to more Tennesseans, to give people a choice in their coverage, and to address the cost of health care, better health outcomes, and personal responsibility.”

See that last part about personal responsibility? If you thought Haslam was motivated by any Christian obligation to be his brother’s (or sister’s) keeper, those two words should disabuse you of that notion. This right-wing blather about personal responsibility is a smokescreen, part of a nasty narrative that falsely insists those who accept government assistance or subsidies in any way are reckless ne’er do wells.

The Robert Wood Johnson Foundation estimates that expanding Medicaid would cost Tennessee $1.7 billion over 10 years, most of which would come after 2017, when the federal government’s contribution drops to 95 percent, then 94 percent in 2018, 93 percent in 2019, and 90 percent from 2020 on.

Under Insure Tennessee, state hospitals would cover that 10 percent gap. Not out of the goodness of their hearts, but because patients with insurance mean more money for hospitals.

But here’s something you should know. According to a New York Times analysis, Tennessee spends at least $1.58 billion each year on incentives for businesses. That’s right, Tennessee would spend far, far less on health care for the working poor than it does on tax incentives, sales tax refunds, and corporate income tax reductions to lure companies to the state. If corporations are indeed people, then Haslam is the most compassionate man on the planet.

But if people are people — including the 918 lives that would have been saved in 2014 with Medicaid expansion — then the refusal to embrace Obamacare is cruel, mean-spirited, and immoral.

It is unconscionable that, just now, Haslam’s administration will give to Tennesseans the care and attention it’s been giving to businesses for years.

But with a Republican governor and a Republican-controlled state house and senate, Insure Tennessee is the best we will get — and it’s far from certain that the legislature’s Tea Party contingent, which is virulently anti-Obama anything, will support it.

Open enrollment for Obamacare continues through February 15th. If you don’t enroll by February 15th, you probably won’t be able to get insurance through the federal exchange this year, unless you get married, have a child, lose a job, or experience some other qualifying life event.

Go to getcoveredtenn.org to schedule an appointment with an enrollment counselor who can walk you through the process.

And once you’re enrolled, you know who to thank.

Categories
Politics Politics Feature

Sentiment Divided on “Insure Tennessee”

NASHVILLE — Like his 11-minute re-inauguration speech delivered two weeks ago, Governor Bill Haslam’s 15-minute opening address Monday night to this week’s special session on Insure Tennessee, his Medicaid expansion plan, was brief and to the point and couched in accommodationist rhetoric.

The previous speech had no particular mission in mind other than to hint at a more assertive second term: “[W]e haven’t had nearly high enough expectations of ourselves. In many ways, we’ve settled and haven’t lived up to our full potential. So one thing I can guarantee you that we are not going to do in the next four years is coast to the finish line.” But Monday night’s address was designed to spell out a key resolve that could be crucial to the success or failure of that race to the finish line.

The good news, from the governor’s point of view, was the prolonged standing ovation he received upon entering the chamber Monday night — a sign of the general good will that the General Assembly, on both sides of the political aisle, continues to extend to Haslam.

The bad news, from Haslam’s point of view, was that, by general agreement, he still has — in the words of state Representative Glen Casada (R-Franklin), who has been a prominent opponent of  the governor’s plan — “his work cut out for him.” Said Casada about House prospects: “He needs 50 out of 99, and right now he doesn’t have it.”

That outlook was echoed by state Representative Craig Fitzhugh (D-Ripley), the Democrats’ House leader and a firm supporter of Insure Tennessee. Fitzhugh said, “He answered the questions. The main questions my friends on the Republican side have had. … The Republican caucus needs to show they have a concern for ‘the least of these’.'” The plan had “no downside,” said Fitzhugh, but, “I think he’s got a lot of work to do.”

State Senator Brian Kelsey (R-Germantown), chairman of the Senate Judiciary Committee and a foe, not just of the governor’s plan but of Medicaid expansion in general, said he thought opposition to Insure Tennessee was “mounting, the more we hear about it.”

Referencing a point Haslam had extemporized into his prepared remarks, to the effect that Republican governors had persistently expressed a wish to President Obama that Medicaid funding be presented to the states in the form of block grants, and that Insure Tennessee came close to that goal, Kelsey said, “My takeaway is this: The governor and I agree that we’d love to have a block grant in Tennessee, but that’s not what the president is offering.”

There were, however, signs that a bipartisan support coalition of Insure Tennessee from Republicans and Democrats (a distinct minority in the legislature that Haslam, however, had made a point of courting) might be possible.

In the immediate aftermath of the governor’s speech, state Rep. Antonio Parkinson, a Memphis Democrat, and state Rep. Mark White, a Republican who represents East Memphis and the suburbs, agreed that Haslam had made enough distinctions between Insure Tennessee and the Affordable Care Act (Obamacare) to coax reluctant GOP members to support the plan.

White himself had been one of those GOP members who’d been biding his time but now expressed support.”I think that was important for him to distance himself from the president,” White said. “He also gave a personal side. It’s not all politics. … The more you weigh it on our measuring scale, it weighs out that we need to do something.”

Two Democrats differed on the role of their party in the debate over Insure Tennessee. State Senator Lee Harris, the former city council member who was elected by Senate Democrats (5 members out of 33) to be minority leader, said, “It’s not about the Democrats. It’s not newsworthy what the Democrats are doing. That’s irrelevant. It’s about the Republicans. They have control of both chambers. If you’ve got control, you’ve got responsibility.”

State Representative G.A. Hardaway, another Memphis Democrat, begged to differ. Of the 26 Democrats in the 99-member House of Representatives, Hardaway said, “We hold the key in the House.”

• In his Monday night address opening the week of special session, the governor — Haslam being Haslam, a man of soft persuasion rather than faustian and bombast — artfully pitched an appeal that was simultaneously above partisan politics and designed to address what have been the main sticking points among GOP legislators.

The governor dutifully paid lip service to Republican talking points, loosing his own shots at what he consistently called Obamacare but taking pains to distinguish his own plan from the superstructure of the Affordable Care Act.

Haslam gave an explanation for why, in 2013, he had rejected the opportunity to expand Medicaid (TennCare in Tennessee) — an expansion that would have allowed the state to avail itself of about $1.5 billion annually, money which the state’s hospitals, charged with caring for indigent patients, contended they desperately needed.

He hadn’t accepted expansion then, the governor said, because “expanding a broken program doesn’t make sense. … But I also didn’t think that flat-out saying no to accepting federal dollars that Tennesseans are paying for — that are going to other states, and that could cover more Tennesseans who truly need our help — I didn’t think that made much sense either.”

Accordingly, he said, he decided to provide his own example of how a governmental health-care plan should work, spending the time since that decision in 2013 to devise what he told the assembled legislators is a two-year pilot program that has incorporated free-market principles, both through an optional voucher component for use with private insurance plans and through requiring co-pays and modest premiums — “skin in the game” — of those new insurees who chose to go through TennCare.

Haslam pointed out that Insure Tennessee would add no new costs to the state budget, since the Tennessee Hospital Association (THA) had guaranteed to pay any additional costs incurred once the federal government, after two years, dropped its own subsidy from 100 to 90 percent.

If either the federal government or the THA proved unable to follow through as promised, or if the state in two years’ time decided Insure Tennessee wasn’t a good fit, the state had been assured by court decisions and the state attorney general’s advice that it could discontinue the plan.

(Pointedly, the governor, in giving the address, dropped this line from his prepared remarks: “I understand the concern, but I think it’s worthy of mention that the United States of America has never missed a scheduled Medicaid payment.”)

As for the professed concern of Insure Tennessee skeptics regarding the pain of having to discontinue coverage for new insurees after two years, Haslam said, “If you gave your loved one an option: You can have health coverage now to address your very real need and with that the possibility that you might lose it in the future, or you could never have it, which would you choose? If you think about your loved one, I bet the answer is simple.”

Ultimately, said Haslam, the state simply had an obligation to the unfortunate and the indigent, one based in commonly held spiritual precepts. “My faith doesn’t allow me to walk on the other side of the road and ignore a need that can be met — particularly in this case, when the need is Tennesseans who have life-threatening situations without access to health care.”

• Back in Memphis, pent-up controversy was also moving toward some overdue discussion. On Wednesday’s committee agenda of the Shelby County Commission is a call for open discussion of the future of the Economic Development Growth Engine (EDGE), which guides industrial and business expansion and awards economic incentives toward that end.

Republican member Steve Basar, chair of the commission’s economic development committee and the commission’s ex officio member of the 11-member EDGE board, placed the discussion item. Basar said he heard “rumblings” of discontent about EDGE on the commission, including possible calls for the board’s abolition, and, as an EDGE supporter, wanted to address it.

Much of the discontent was an adverse reaction to the EDGE board’s recent decisions on PILOTs (payment-in-lieu-of-taxes), but Basar said only minor modifications were needed.

Categories
Cover Feature News

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.

Categories
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.