NASHVILLE, Tenn. (AP) — Proponents of expanding Medicaid in Tennessee say the financial support from Washington is a deal too good to pass up — federal funding for 100 percent of the expansion costs for three years and at least a 90 percent match after that.
But Tennessee is approaching the carrot warily partly because of its experience as a pioneer in expanding Medicaid to cover the uninsured back in the 1990s. Federal funding for that expansion was cut after the White House and governorship changed hands.
The ballooning expenses for TennCare, Tennessee's expanded Medicaid program, strained state finances and set off incendiary fights over taxes that reshaped the state's political landscape.
That history is one reason Gov. Bill Haslam is among the last Republican governors to decide whether to expand Medicaid. He has said he will make his recommendation by the end of the month — though he acknowledges that it's far from certain that lawmakers will approve his choice.
"A lot of people say the governor should never propose something that he or she can't pass, but I haven't thought of that," Haslam told reporters at his most recent public appearance last week. "We haven't made the call, but if we decide to do it, obviously there's a lot of selling to do."
TennCare was authorized in 1994 by the Clinton administration after its national health care reform proposal died in Congress. The Tennessee plan was meant to be a new model for expanded Medicaid programs, where it was up to doctors to determine what care was necessary. The hope was that treating problems earlier would improve overall health and prevent costly trips to the emergency room.