Beth Harwell creates health care task force; critics call it a 'joke'
Amid calls for Republican leadership to do more to provide health care to the working poor, House Speaker Beth Harwell announced Tuesday the creation of a legislative task force that will look at ways to improve access to care.
The move was billed as an attempt to increase access to care for the working poor, but Democrats branded it a "pathetic" attempt to direct attention away from Gov. Bill Haslam's controversial health care plan.
Flanked by Haslam and Republican lawmakers at an afternoon news conference, Harwell said she reached out to experts at Vanderbilt University's School of Medicine last year after the failure of Insure Tennessee.
The "3-Star Healthy Project" is the result of those conversations: a task force that aims to offer proposals to federal health officials that could be implemented as pilot projects throughout the state. The announcement comes with suggestions for possible programs, but few specifics.
House Health Committee Chairman Cameron Sexton, R-Crossville, will lead the task force. GOP Reps. Matthew Hill, Steve McManus and Roger Kane make up the remainder of the group, tasked with coming up with more detailed initiatives.
The task force is supposed to find ways to make TennCare, the state's Medicaid program, more efficient and accessible. Harwell said the task force will consider pilot projects that could phase in "conservative ideas" for changes to the program.
With little time for discussion or details finalized, and having had no conversations with the federal government yet, the task force is doomed to fail, House and Senate Democrats argued. Senate Democratic Caucus Chairman Jeff Yarbro, D-Nashville, said there are no Democrats or senators on the task force, joking it appeared as though more thought went into the task force logo than its mission.
"What a sad political joke. What a political charade," said House Democratic Caucus Chairman Mike Stewart, D-Nashville.
"We came up here today to hear a health care announcement and we heard about potentially creating a task force that may think about doing pilot programs that has never spoken with the federal government. This is not a plan. This is a complete joke."
U.S. Rep. Jim Cooper, D-Nashville, later blasted the proposal on Twitter.
At least a few of the ideas listed in the news release — including asking those enrolled to take more responsibility for their own care — were a part of Insure Tennessee, the governor's plan to use federal funds to expand health insurance access to hundreds of thousands of low-income Tennesseans.
The task force is expected to complete its work in time to meet in June with Haslam and the U.S. Center for Medicare & Medicaid Services. Sexton acknowledged that's a quick turnaround, but pledged to have open meetings and to hear from all stakeholders.
Sexton said he didn't know where the money would come from or how much any programs would cost.
After the announcement, Harwell said there's a chance to leverage more federal dollars through the TennCare waiver approval process, which takes place in June. Noting she's not a member of the task force, Harwell said she expects at least some pilot programs could happen even if the federal government doesn't sign off on them.
The Tennessee Hospital Association will support a comprehensive plan, but THA CEO and President Craig Becker also wants to see more stakeholders, not just lawmakers, involved in the discussions between now and the end of June.
“Whatever we can do to get additional coverage, we’re going to be for. We like the governor’s plan, but we’re really for more coverage,” Becker said. “If it’s not comprehensive then it’s kind of hard to fathom how it’s going to really help. We’re certainly willing to talk to anyone about it.”
Harwell has faced increasing pressure to do something related to Insure Tennessee. Supporters of the measure — including Nashville philanthropist Martha Ingram — launched a billboard campaign in March aimed at pushing Harwell to take some action. Others protested outside her office, bringing in old shoes to symbolize walking in the footsteps of the uninsured.
Harwell: I can't unilaterally bring Insure Tennessee to vote
The speaker has repeatedly said she doesn't have the power to unilaterally bring Insure Tennessee to the full House for a vote — there is a procedure to bring a bill from committee that involves a full vote of the House — but she hinted at some alternative plan that could be released in April.
During the news conference, she said she's been working with Vanderbilt experts for more than a year on the idea for a task force. But that didn't appease some in the Old Supreme Court chambers at the Capitol. A young Insure Tennessee supporter, who has frequently led demonstrations at the statehouse, was escorted out of the news conference after shouting questions at Harwell and Haslam.
Haslam pushed back at the criticism, saying it's laudable that lawmakers want to come together to find answers. He argued the best answer is the policy that works for the state and receives a majority of support of lawmakers. Insure Tennessee never met that threshold.
Insure Tennessee is a two-tiered proposal that differentiated between people who have access to employer-sponsored insurance plans and those who don’t. The proposal had features requested by Republicans, including copays and the option to disenroll those who don't pay. Yet the plan failed to gain enough traction in 2015.
The Volunteer Plan under Insure Tennessee would give a voucher to people who can’t afford an employer-sponsored plan to offset the cost of the monthly premium. Employers would be required to cover at least half the cost of the insurance.
The Healthy Incentives Plan mixes aspects of commercial insurance plans with TennCare. It includes a monthly premium around $20 and a health savings feature that allows participants to accrue and spend credits toward health care costs.
Since the Senate defeated Insure Tennessee in 2015, a few Republican-led states, including Indiana and Louisiana, have either implemented an expansion or announced plans to do so.
Some of the ideas floated in the task force announcement are similar. A news release says the task force has "conservative ideas," including encouraging enrollees to "take more responsibility" for their health while using more health care services; creating health savings accounts to pay for copays; and providing workforce training.
Insure Tennessee included healthy incentives, and Republicans amended it to create copays. Insure Tennessee also had a mechanism to remove people from the rolls who didn't pay.
The governor's plan was "kind-hearted but not fiscally conservative," Kane said during the news conference. But the idea of a "circuit breaker," or enrollment thresholds, made the task force palatable for Kane.
"The question was asked, 'How many people can we put on this program before we run out of money?' when we were on Insure Tennessee. And the answer is we don't know. As a fiscal conservative, I just can't throw open the doors and say we'll take care of it when we take care of it," Kane said.
Michele Johnson of the Tennessee Justice Center helped lead the charge for Insure Tennessee. After the announcement, she said she was encouraged to see some action from Harwell. But the lack of specifics was worrisome.
"It's positive progress that they're engaging around governing. In terms of what they proposed, it doesn't sound there's a huge amount of detail," Johnson said.
"But the real test of leadership is not just standing there. The real test is are they going to propose something that's going to be approved, with the sense of urgency that's needed for the folks we're talking to all day every day, and for those rural hospitals."
Haslam defends Insure Tennessee, Harwell
Haslam announced his plan in December 2014 after months of negotiations with federal health officials. But the administration immediately faced the challenge of trying to distance the plan from the Affordable Care Act, especially unpopular with Tennessee Republican lawmakers. Attempts to bring back the bill in 2016 were stymied.
Polling from Vanderbilt University and other sources has consistently shown support for Insure Tennessee. Opponents argue those polls offer misleading information as to what the plan will accomplish. Vanderbilt polling and a recent poll from icitizen show less support when either questions included the terms "Medicaid expansion" and "Affordable Care Act" or referenced potential increases in taxpayer funding.
Reporter Joel Ebert contributed to this report.
Reach Dave Boucher at 615-259-8892 and on Twitter @Dave_Boucher1. Reach Holly Fletcher at 615-259-8287 and on Twitter @hollyfletcher.
MOBILE USERS: Click here for coverage of the news conference on the task force.
