NASHVILLE, Tenn. (AP) - After months of negotiations and political wrangling, Republican Gov. Bill Haslam's proposal to extend health coverage to 280,000 low-income Tennesseans comes down to a 451-word resolution.
The Republican-controlled Legislature convenes in a special session on Monday to decide whether to OK the governor's Insure Tennessee plan - or to or leave $2.8 billion in federal money on the table.
"Insure Tennessee is a unique, alternative approach that brings Tennessee taxpayer dollars back to this state to benefit Tennessee citizens," according to the resolution filed Saturday.
While many lawmakers have praised Haslam for negotiating a special deal that includes co-pays and vouchers to buy private insurance, many Republicans still have grave reservations dealing with the federal government and about agreeing to a plan based on President Barack Obama's health care law.
"If they would block grant this money, we would probably implement what the governor is trying to do," House Republican Caucus Chairman Glen Casada of Franklin said last week. "Legislators are just concerned about making a deal, the governor making a deal, and another government agency out of Washington overriding the deal we make. That has happened."
The resolution seeks to defuse that line of criticism, stating that lawmakers recognize that Obama's Affordable Care Act "is the wrong approach to responding to the challenges of our healthcare system," while stressing that the Insure Tennessee proposal would take a different approach than simply expanding enrollment.
"Insure Tennessee is also different from Medicaid expansion because it creates financial incentives for providers to furnish high quality care in an efficient and appropriate manner so as to reduce costs and improve health outcomes," according to the resolution.
Haslam's proposal would establish a two-year pilot plan that the state could cancel at any time if costs exceed expectations. State hospitals have agreed to cover the $74 million state share to draw down the $2.8 billion in federal money, and especially rural hospitals have called the plan key staving off closures or reduced services.
The governor over the last week met with more lawmakers and hospital administrators around the state to try to drum up support for Insure Tennessee, while independent conservative groups like the state chapter of Americans for Prosperity and the Beacon Center have run radio ads attacking potential Republican supporters of the measure.
While the Medicaid proposal has been the center of attention around the state Capitol, a Middle Tennessee State University Poll released Saturday indicates that 34 percent said they favored Haslam's Insure Tennessee proposal, while 7 percent said they opposed it. Fifty-nine percent said they weren't sure.
Of the 600 people polled, 33 percent said they had heard either a lot or some about the governor's proposal, while the remaining 66 percent had heard either a little or nothing at all.
Among the third of respondents with at least some information about Insure Tennessee, 49 percent said they approved, while 11 percent said they were against it. The poll conducted Jan 25-27 has a margin of error of plus or minus 4 percentage points.