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NASHVILLE -- Several Republican state lawmakers plan to renew their push next year for a multistate "health care compact" that, if approved by Congress, could lead to Tennessee taking over most federal health programs, including Medicare, operating in the Volunteer State.
Citing this week's U.S. Supreme Court decision upholding the federal health care law, the lawmakers said the time is ripe for the bill, which failed on the last day of this year's legislative session.
"I hope we can pass the Health Care Compact next year in Tennessee, and I look forward to working with Rep. [Linda] Elam, Rep. [Mark] Pody and other conservative lawmakers who hope to lower health care costs and raise quality in an efficient and constitutional manner," Sen. Mae Beavers, R-Mount Juliet, said in a news release.
Republicans began pushing the bill in 2010 as a way to get out of President Barack Obama's Affordable Care Act. It would require permission from Congress to do. Proponents said a state-based solution was preferable to a federal system that was already unwieldy.
The bill would authorize Tennessee to join a health care compact for states interested in crafting their own health care policies, which would supersede federal law.
Each state would receive a federal block grant covering programs such as Medicaid, the jointly funded state and federal health program for the poor. Tennessee's Medicaid program is called TennCare.
Legislative Democrats for the past three years have attacked the measure as a partisan attack against Obama and called it unworkable, pointing out that it would also impact Medicare, the federal health program for seniors.
The bill envisions the state receiving the $11 billion the federal government currently spends on Medicare beneficiaries in Tennessee as a block grant. The grant would be inflation-adjusted.
Rep. JoAnne Favors, D-Chattanooga, opposed the legislation and said Friday she continues to do so.
"We don't need to take care of Medicare. We can't take care of Medicaid," she said.
Favors recalled how the state in the 1990s expanded its Medicaid program, renamed it TennCare and quickly ran into trouble when insurance companies began dumping chronically ill people and those with pre-existing needs into TennCare.
That eventually led then-Gov. Phil Bredesen to cut some 170,000 people out of the program, Favors said.
"We shouldn't even look at the health compact," said Favors, a retired nurse and health care administrator. "Whoever came up with that, I question their sanity."
Senate Majority Leader Mark Norris, R-Collierville, raised the compact issue this week as he attacked the Supreme Court decision, which upheld an individual mandate requiring Americans to obtain private or employer-based insurance or, if eligible, a government-sponsored program.
"Perhaps next year our efforts to enact the Health Care Compact will finally succeed," Norris said.
The court ruled as unconstitutional a provision requiring states to participate in a major expansion of Medicaid programs like TennCare. But it allowed the expansion to proceed, giving states the choice of whether to participate.
Republican Gov. Bill Haslam, who is still sorting through the implications of Thursday's Supreme Court decision, wasn't so sure creating the compact is the right idea. He has supported federal block grants for Medicaid.
"I don't know that we have both the means or the ambition to take over all federal health care in the state," Haslam said Friday. "I think there would be some cost concerns."
Gordon Bonnyman with the Tennessee Justice Center, which advocates for the poor on health care among other issues, predicted the compact will never pass.
He said all it would take is one solid ad by Democrats, "saying, 'Yo, Medicare beneficiaries, do you want to be enrolled in TennCare and have TennCare govern your health care?' You can imagine the reaction. That's what that compact would be."
The legislative financial analysis of the bill was "very clear" that the measure would give Tennessee control over Medicare, Bonnyman said. Republicans should be wary about upsetting Medicare beneficiaries, who include the middle class and the wealthy, he said.
"It [bill] is the only thing that could restore a pulse to the Tennessee Democratic Party -- and not only restore its pulse but get it up on its feet prancing around," he quipped.