Monday, March 25, 2013

Haslam's Day of Reckoning Draws Nigh: Time to Decide ObamaCare Question

Posted By on Mon, Mar 25, 2013 at 7:09 AM

This week, Gov. Bill Haslam might make the most important decision of his political life. That’s whether to expand Medicaid under the Affordable Care Act: the issue vexing the governor since last summer when the Supreme Court upheld the law but made a key component—Medicaid expansion—optional with the states.

Suddenly, after the court's ruling, it wasn’t so easy anymore for Haslam to demagogue ObamaCare as the apocalypse. Now he's got skin in the game, to borrow a phrase from conservatives. Actions have consequences. In this case, Haslam either incites a riot in his party's base or he pisses off everybody else in the state.

Politics aside, the rational answer to the Medicaid expansion question is yes. The benefits are enormous, and the costs of saying no are high. But with Republicans in full froth, who’s listening to reason?

In the run-up to Haslam’s Day of Reckoning, health care advocates have gone into heavy lifting mode, unleashing study after study showing the importance of Medicaid expansion to Tennessee.

“We need to focus on how Medicaid expansion will impact Tennessee’s economy, the bottom lines of our employers, and the health of our workforce.” said Steven Andre, general manager of the Hutton Hotel and an organizer of business people for Medicaid expansion. “This isn’t about whether our legislators like ‘Obamacare’, it’s about dealing with the real impact this decision will have on our state’s economy.”

AARP released its own study showing expansion would bring new production of goods and services valued at $17.6 billion, and wages, salaries and benefits worth $7.9 billion.

The state’s major newspapers have editorialized in favor of Medicaid expansion, and eight of the state’s Chambers of Commerce have endorsed it.

In a Sunday editorial calling for expansion, the Jackson Sun referred to "near irrational opposition by a few state lawmakers." Actually, it's a lot more than a few but whatever. Here's the Sun's point:

Blind opposition to the nation’s health care reform law is irrational and self-defeating. Frankly, we don’t like the law, either. But we believe Haslam must do what makes sense and is best for all Tennesseans by expanding TennCare.

Given Haslam’s history as a risk-averse politician (a polite way to say he's weak-kneed), it seems entirely possible that he’ll punt this decision for another year rather than fight it out with his own party (a move Lt. Gov. Ron Ramsey suggested last week to reporters). Maybe it'll take the closing of a hospital or two to bring the GOP to its senses. If Haslam recommends expansion this week and then loses in the legislature, what would that accomplish? He'll only show up his party as a gang of radicals, way out of the mainstream even in fire-ant red Tennessee, and incapable of governing.

How about a blue-ribbon commission to study this matter for a while? It needs some serious analyzation.

Andrea Zelinski with more on the politics of the ObamaCare decision, Erik Schelzig on how the TennCare experience is influencing the debate, and The New York Times on Tennessee's health care lottery for the poor.

Sen. Brian Kelsey on his bill to forbid the state from expanding Medicaid:

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