Tenncare Director Tries to Thread Needle on Medicaid Expansion During Visit to Meharry health policy center

TennCare Director Darin Gordon gave medical students insight this week on a difficult task — finding a way for Tennessee to benefit from federal tax dollars already being collected from state residents.

He talked about trying to come up with a “Tennessee Plan” that will satisfy the federal government for Medicaid expansion and simultaneously get past state legislators who don’t want anything to do with Obamacare. Gov. Bill Haslam gave him the task in March 2013, Gordon said during a Wednesday speech at The Robert Wood Johnson Foundation Center for Health Policy at Meharry Medical College.

“I told the governor, ‘I can tell you exactly what the federal government is going to do, and I can tell you exactly what the legislature is going to do,’ ” Gordon said. “Those things can’t be further apart. He said, ‘I have a task for you. I want you to thread the needle. Go right in the middle. Find something that has a chance that addresses both sides of concerns.’ That has not been easy.”

He said the discussions were ongoing, including dialogue this week. But he noted that an expansion would be a hard sell in Tennessee given the state’s experience in the mid-1990s, when it opened up TennCare under “the most ambitious expansion of health insurance the country had ever seen” — a program the state could not financially support and had to scale back.

But that was before the Affordable Care Act provided states more money to expand coverage. States have the option of extending Medicaid coverage to people who have not qualified in the past — primarily non-disabled adults.

Tennessee began losing out on $6.1 million a day on Jan. 1, when the federal government began picking up all the costs for covering people who newly qualify for Medicaid under expanded guidelines — an offer that goes away at the end of 2016. At that time, it begins phasing down to a permanent 90 percent matching rate in 2020.

Accepting the federal offer would provide health insurance to an estimated 161,560 Tennesseans, who account for 24 percent of the uninsured adults in this state, according to Kaiser Health News.

Contact Tom Wilemon at 615-726-5961 and on Twitter @TomWilemon.