- Associated Press - Tuesday, February 3, 2015

NASHVILLE, Tenn. (AP) - House Speaker Beth Harwell said Tuesday that she has offered to have her committee chairmen draw up alternate suggestions for Gov. Bill Haslam should his Insure Tennessee plan appear to be headed for defeat in the ongoing special legislative session.

Harwell told a conference organized by the National Federation of Independent Business and the Tennessee Grocers and Convenience Store Association that it’s not yet clear whether the governor’s proposal to extend health coverage to 280,000 low-income Tennesseans will gain enough votes to support.

Harwell said her colleagues are not yet convinced that the governor’s proposal to require co-pays, incentives for healthy lifestyles and revisions to the way medical procedures are reimbursed to hospitals will reverse the Medicaid drain on state finances.

“Whether you view that as enough to reduce costs is a real issue the General Assembly is struggling with right now, and there are plenty of people who don’t believe that would significantly reduce costs,” she said.

One problem facing lawmakers is that the governor’s measure faces an up-or-down vote without a chance for lawmakers to make adjustments to make them more comfortable with the deal Haslam negotiated with federal government.

“I have offered to the governor - and I think he’ll know better by (Wednesday) whether he wants this - to let our committee chairmen issue a report to say, ‘We’d like to see the following things and offer them back to you.’

“And then he can go back and renegotiate with the federal government,” she said.

Meanwhile, Senate Health Committee Chairman Rusty Crowe said the governor’s plan has five favorable votes - including his - and only needs one more to advance. The Johnson City Republican said his committee will likely put the proposal to a vote on Wednesday.

“I think the governor’s probably having discussions with the members as we go into tomorrow,” Crowe said.

House Republican leader Gerald McCormick of Chattanooga said earlier Tuesday that Haslam’s proposal would pass comfortably in a full floor vote, but faces an uphill battle in legislative committees.

“It’s important to note what this resolution does not do: It does not implement Obamacare in Tennessee,” McCormick said. “If the governor had wanted to do that, he could have done that in 2013 very quickly without any debate.”

Hospitals have pledged to cover the $74 million state share, meaning taxpayers wouldn’t be on the hook to pay for extra health insurance costs.

Craig Becker, president of the Tennessee Hospital Association, said the Medicaid expansion would help make up for $7.8 billion in cuts that state hospitals are facing over a decade following the passage of the federal health care law.

“It is absolutely a lifeline for hospitals, particularly our rural hospitals,” Becker said.

Opponents of the Insure Tennessee proposal object to adding to the federal debt by having the state draw down $2.8 billion in federal money under President Barack Obama’s health care law. Others say they don’t trust the federal government to keep promises to allow Tennessee to withdraw from the plan if it ends up being more expensive than expected.

Justin Owen, president and CEO of the conservative Beacon Center of Tennessee, said the federal government could reinterpret any agreement after the fact and refuse to allow the state to pull out of the plan.

“If you cannot answer yes to the question ‘Can you trust the federal government,’ then you should not vote to expand Medicaid in this state,” Owen told lawmakers.

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