Study: GOP health care bill cuts subsidies in 4 TN cities; raises them in one

A WalletHub study has found that Chattanooga would face a bigger negative impact than all but four other cities in the nation under a Republican plan for repealing and replacing Obamacare – a loss of $5,786 in federal premium subsidies per household.

On the other hand, the study covering 457 U.S. cities found that the average subsidy available to households in Murfreesboro under the proposal would actually be $924 higher than under Obamacare for Murfreesboro residents.

The review includes six Tennessee cities. In addition to Chattanooga and Murfreesboro, they are (with average subsidy change in parenthesis): Knoxville (-$2,116); Memphis (-$1,826); Clarksville (-$222); Nashville (-$15).

The Times-Free Press has a story focused on the Chattanooga results HERE. The full report is HERE.

Trump budget ax would slash lots of fed spendng in TN

Dozens of programs that provide funding or services in Tennessee are targeted for elimination or drastic cuts under President Donald Trump’s proposed budget, reports Michael Collins.

The Great Smoky Mountains National Park, Oak Ridge National Laboratory and the Delta Regional Authority all would be impacted by Trump’s spending plan, released early Thursday and dubbed “America’s First” budget by the White House.

Other programs that reach into the state yet would get no funding under Trump’s budget include Community Development Block Grants, which provide resources to cities for a variety of activities such as affordable housing and anti-poverty initiatives; the Meals on Wheels food-delivery program for the elderly; the Minority Business Development Agency, which works to help minority-owned businesses grow and stay competitive; and heating assistance for low-income residents.

“The list of important programs cut or eliminated is huge,” said Rep. Steve Cohen, D-Memphis. “President Trump’s budget will thrust America into social and cultural deterioration, a new Dark Ages.”


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Roe doesn’t expect Congress to go along with Trump eliminating ARC

The Appalachian Regional Commission is one of 19 current federal agencies that would be defunded under President Trump’s proposed budget, but Republican Rep. Phil Roe of Tennessee’s 1st Congressional District says that’s probably not going to happen, reports the Johnson City Press.

The president’s proposal, subtitled “A Budget Blueprint to Make America Great Again,” provides increases to defense spending and law enforcement while eliminating the ARC’s $120 million appropriation, $3 billion for the Community Development Block Grant program — used by rural communities to provide housing, build infrastructure and stimulate job growth — and a slew of other domestic agencies and programs.

… In an emailed statement… Roe, R-Tenn., applauded the Trump budget proposal’s support for national defense and assured the safety of programs benefitting rural Appalachia.

… “In the weeks and months ahead, Congress will decide whether or not to adopt the president’s recommendations. Programs like the Appalachian Regional Commission, which does tremendous good for rural Appalachia, have bipartisan support in Congress and I don’t expect they will be eliminated. I look forward to working with my colleagues in Congress and the president to work toward getting our fiscal house in order and balancing our budget.”

Note: The Atlantic has a list of the 19 defunded agencies, including in its report this observation on eliminating the ARC: Its inclusion is notable, because it serves a region that largely supported Trump, and which he has promised to revive economically.

Haslam, other GOP govs, fret over lack of flexibility in health care bill

“Flexibility” has become a buzzword among 15 Republican governors raising concerns about U.S. House GOP’s health care bill, reports Politico, including Tennessee’s Bill Haslam on it list. No governors have publicly expressed strong support for the American Health Care Act.

Further from an AP report: The nonpartisan Congressional Budget Office estimates that GOP legislation would increase the ranks of the uninsured by 14 million people next year alone, and 24 million over a decade. Haslam says it’s not clear how many people would be affected in Tennessee, and that the legislation could still change in Congress.

The Republican governor said Tuesday that the main thing the state is looking for in the overhaul is more flexibility to deal with areas like increased enrollment during an economic downturn or escalating costs for medications. He says that flexibility was not included in the in the original version of the proposed overhaul.

Similar language was used by the director of TennCare in an appearance before the House Finance Committee on Tuesday, reports the Tennessean. She said the proposal is structured to reduce Medicaid funding without loosening up regulations for states to further tailor programs.

“We definitely have concerns at this point in time,” said Long, adding the agency would continue to be in touch with the state’s federal congressional delegation to monitor amendments.

TN hospitals oppose GOP’s Obamacare replacement plan

NASHVILLE, Tenn. (AP) — The Tennessee Hospital Association has come out against a new plan in Congress to repeal and replace the Obama health care law, saying the proposal poses “a dark forecast for the future of hospitals in Tennessee.”

THA, which represents 147 acute-care hospitals and health-care facilities across the state, said in a statement Friday that Obamacare has been a challenge. Obamacare is the informal name for the Affordable Care Act.

But the organization said it believes more will lose coverage under the new House GOP bill because it reduces the amount of federal aid people would get to help them pay for their insurance.

“Primarily, we believe a significant number of the roughly 230,000 Tennesseans currently covered could lose their coverage because of an inability to pay for insurance due to significantly reduced federal subsidies,” said THA president and CEO Craig Becker.

THA is affiliated with the American Hospital Association, which announced its opposition to the new proposal earlier this week.

In Tennessee, THA is concerned that the new plan would mean hospitals are going to have to provide free care for more uninsured people while getting even less money to treat Medicaid patients.

Note: The full AP story is HERE; the THA press release is HERE.

Politico: TN is ‘Exhibit A’ for Republicans pushing Obamacare repeal

Under the headline ‘Tennessee becomes Exhibit A in GOP’s Obamacare repeal push,’ Politico reviews the state’s health care system troubles, most recently highlighted by Humana’s move to cease operations in 16 counties where it is now the only provider and Blue Cross Blue Shield closing in much of the state while announcing “some of the sharpest premium spikes in the nation.”

Republicans warn that other states could look just as dire unless they get rid of Obamacare and replace it with a market-driven system.

“The Affordable Care Act is too expensive to afford,” Rep. Marsha Blackburn (R-Tenn.) said during a town hall meeting over the Presidents Day break in Fairview, about 30 miles southwest of Nashville. “Our goal is that health care is going to be more flexible, more usable and more affordable to everyone.”

But even here, despite all the turbulence, resistance is mounting to Congress scrapping the law without a credible replacement plan, because it could unleash even more chaos. Obamacare defenders believe their message is starting to resonate, especially with the state’s Republican senators, Lamar Alexander and Bob Corker.

…The challenge, then as now, is insurers have struggled to get enough healthy people into the coverage pool to offset the cost of caring for older, sicker individuals. Some in the desirable cohort have flouted the health law’s mandate that most people be covered and instead paid penalties, happy not to deal with rising premiums.

“What happened is the people who are healthy paid the penalty and moved on,” said state Rep. Cameron Sexton, a Republican who chairs the House Health Committee. “And then, the people who were really sick picked up the insurance because they needed it, and the risk to the insurance companies was far greater than they ever expected.”

…Michele Johnson, executive director of the Tennessee Justice Center, said the problems have been exacerbated by the state’s failure to expand Medicaid eligibility under the health law. Johnson pointed to neighboring Kentucky, which opted in and dramatically lowered its uninsured rate, as evidence that such a move would have helped stabilize the individual market and reduce premiums.

“We chose not to do it and then they’re like ‘This thing is dying.’” Johnson said. “That’s because you have your hand around its neck killing it.”

Note: Alexander has an op-ed piece declaring there’s an ‘Obamacare emergency’ in Tennessee. His bottom line (as it appears in Jackson Sun version):  It’s time to stop fighting like the Hatfields and the McCoys over Obamacare. Tennesseans expect the new Congress and administration to work together to quickly fix the Obamacare emergency in our state.

Blackburn holds broadband conference, bans media coverage

U.S. Rep. Marsha Blackburn met with “what appeared to be at least 100 area business and electrical coop executives at Columbia State Community College” – plus, reportedly, the chairman of the Federal Communications Commission – but barred media from attending, according to the Marshall County Tribune.

When your editor of the Marshall County Tribune attempted to gain access to the meeting, Blackburn’s Press Secretary Abby Lemons said, “This meeting is closed to press. This meeting is off the record.”

…Senate Majority Leader Mark Norris (R-Collierville) left Blackburn’s meeting to discuss with the Tribune Governor Haslam’s Rural Broadband initiative, announced recently.

The Tennessee Broadband Accessibility Act will provide $45 million over three years in grants and tax credits for service providers to assist in making broadband available to unserved homes and businesses. In addition, the law will permit the state’s private, nonprofit electrical cooperatives to provide retail broadband service and make grant funding available to the state’s local libraries to help residents improve digital literacy skills to maximize the benefits of broadband.

Many of the businesses represented at the meeting could be in competition for the same customers.

Tennessee taxpayers will pay for Internet service where it doesn’t exist now, and it might make all internet service faster.

“We need better access, not bigger government,” Sen. Norris said. “Broadband is critical to commerce and the quality of life for every Tennessean and is essential for our current and future education and economic initiatives.”

Haslam report from Washington: Things ‘pretty fluid’ on Obamacare, but he’s encouraged

After  a long weekend in Washington, including meeting with President Trump along with other governors, Gov. Bill Haslam says things are “pretty fluid” on repealing and replacing Obamacare in the nation’s capitol but he’s encouraged that the presidential administration, Congress and governors are working together on the matter.

Further from the Times-Free Press:

“What we’re trying to do is have everybody be on the same page with something that can actually pass and will work in the states,” Haslam said.

In play are several key aspects as Republicans seek to change the Affordable Care Act, also known as Obamacare, as well as the traditional Medicaid program for the poor, thereby saving billions for the federal government but potentially impacting millions of Americans.

One is ending the status of Medicaid as an open-ended entitlement Medicaid program with newcomers able to come in with the federal government picking up varying percentages of the tab with states covering a smaller percentage of costs.

…Haslam acknowledged difficulty in getting everyone on the same page.

“Obviously, to get something passed you’re going to have to do something that states that expanded and those who didn’t can live with,” said Haslam.

Haslam was appointed to the eight-person working group by Republican Governors Association Gov. Scott Walker of Wisconsin.

House Republicans’ plan includes a proposal to turn federal Medicaid financing from an open-ended entitlement to a block grant or a per capita allotment to states. Haslam said he favors the latter.

He also thinks states like Tennessee, which didn’t expand Medicaid, shouldn’t be harmed financially because they didn’t.

“No. 1, I don’t think that a state should be penalized who didn’t expand as we do that,” the governor said. “No. 2, I think it has to be something, I’m more in favor of a per cap-type grant rather than a block grant.”

A block grant provides a set amount of federal spending per year regardless of how many people enroll in a state’s Medicaid program. According to the nonpartisan Kaiser Family Foundation, the per capita grant differs in that the federal government would set a limit on how much to reimburse states per enrollee.

Duncan: Trump’s wrong in calling media enemy of the people

U.S. Rep. John J. Duncan Jr., who endorsed Donald Trump before almost all other Republicans in Congress and agrees with him on most issues, says the new is dead wrong on one issue, reports Michael Collins.

“I disagree with him completely on saying the press is the enemy of the people,” Duncan said. “I think it’s very important to the future of our country to have a free press and freedom of the press and to have a strong, active media. I think just about everybody in the United States – or most people in the United States – believes in freedom of the press.”

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Haslam helping congressmen seek GOP Obamacare repeal deal

Republican congressmen are hoping four Republican governors – including Tennessee’s Bill Haslam – will help them draft a deal for replacing Obamacare, according to CNN.

The governors are Haslam and Scott Walker of Wisconsin, who serve in states where Medicaid was not expanded under the Affordable Care Act, along with the chief executives of two states that did expand Medicaid, John Kasich of Ohio and Brian Sandova of Nevada.

The discussions are likely to continue at the National Governors Association meeting in Washington this week, and as Kasich privately meets later this week with Trump at the White House.

The thinking is that if these four can cut a deal, it will help resolve an issue that GOP leaders say is currently the biggest hurdle in putting together a plan to repeal President Barack Obama’s Affordable Care Act. But they have a monumental task: resolving concerns from conservatives who want to turn Medicaid into a block grant program and alleviate fears from politicians who hail from states that accepted federal dollars to expand coverage for low-income adults under Obamacare.

“We’re going to have to find a solution that accommodates those concerns,” House Speaker Paul Ryan said last week.

Republicans are hoping to unveil a plan in March that could be voted on within the next several weeks. They are under a time constraint because they are using fast-track budget rules that will allow them to avoid a filibuster in the Senate and pass a repeal bill on a party-line vote.

The party is still divided over key issues — including how far to take the repeal bill. Conservatives in the House Freedom Caucus want to pass a full-blown repeal bill that mirrors a plan that Congress approved in 2015 — and Obama vetoed — which would also repeal the Medicaid expansion.

Yet top Senate Republicans privately say that such an approach would not pass their chamber.


Former Knoxville News Sentinel capitol bureau chief Tom Humphrey writes about Tennessee politics, government, and legislative news.

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