'Votes not there' for full expansion of TennCare

photo Senate Speaker Ron Ramsey, of Blountville, left, and fellow Republican Gov. Bill Haslam appear at a news conference following the adjournment of the 107th General Assembly in Nashville.

NASHVILLE - Senate Speaker Ron Ramsey said Thursday he "doesn't think the votes are there" in the chamber if fellow Republican Gov. Bill Haslam presses for a full expansion of Medicaid under the federal Affordable Care Act.

With lawmakers hoping to adjourn in less than a month, time is starting to run out, Ramsey said. But he noted it might get GOP support for a measure based on Arkansas' plan, which the governor has publicly said he is closely examining.

"I've told him if we're going to do it this year or whenever his decision might be that it needs to be done very quickly, obviously," Ramsey said of Haslam, who has been weighing pros and cons of expansion since last summer.

In Tennessee, the Medicaid program for the poor is operated as TennCare.

He said he had dinner with the governor Wednesday night and discussed "where I thought the Senate was and things of that nature. I don't think the votes are there right now for a complete expansion."

He said Haslam "is being very methodical and very thoughtful in trying to figure out if there's some middle ground on this."

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Arkansas' governor, Democrat Mike Bebee, announced last month the Obama administration had given him the nod to implement the federal law's anticipated expansion of Medicaid to more low-income people using the law's subsidized insurance exchanges that offer private insurance.

But Arkansas is operating its own exchange while Haslam, after months of exploration of doing that, instead opted to let the federal government run it. It's unclear if that could complicate Haslam's ability to do what Arkansas is doing.

"It isn't as simple as saying no or just saying yes," Ramsey said. "There are a lot of options out there that haven't been explored yet. This [expansion] may not happen this year. I don't know, I'm not making a prediction. There's no gun to our head. In fact, the Supreme Court says we don't have to do it."

Meanwhile, Ramsey said he expects a bill from Sen. Kelsey, R-Germantown, which bans the Medicaid expansion expected to affect 180,000 Tennesseans, to come up for a vote in committee next week.

"He says he's going to bring it up," Ramsey said. "I've held it off for about four weeks. I've told the governor that's about all we can do." He praised Kelsey's patience.

On yet another front, Ramsey said he expects Senate Republicans to expand Haslam's proposed education voucher bill to children of higher-income families than the governor's bill, which deals with the poorest children in the lowest-performing schools.

Haslam spokesman David Smith said "the governor spent a lot of time studying the issue, and a lot of thought and input has gone into his proposal. He believes his approach best fits into our state's overall education reform strategy."

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