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Members of the Senate debate legislation during a session Thursday, May 2, 2019, in Nashville, Tenn. (AP Photo/Mark Humphrey)

Updated at 9:07 p.m. on Thursday, May 2, 2019, with information about the passing of the bill.

some text Members of the House wait for the Senate to finish business so they can continue their session Thursday, May 2, 2019, in Nashville, Tenn. (AP Photo/Mark Humphrey)

NASHVILLE — Tennessee lawmakers wrapped up their annual session Thursday night after approving a controversial bill directing Republican Gov. Bill Lee's administration to negotiate a new Medicaid waiver to restructure federal financial support for TennCare, the state's health care program for the poor.

It was one of the last bills passed by lawmakers before the GOP-led 111th General Assembly adjourned for the year.

The Medicaid bill plan seeks to turn current federal funding for TennCare into an annual lump sum known as a block grant that has far fewer federal strings attached dictating how it is to be spent.

Republicans here say they can run a more efficient version of TennCare, a $12.1 billion program covering 1.3 million low income pregnant women, mothers and their children, as well as some disabled and elderly Tennesseans.

Democrats and advocates for the poor, however, are shuddering over the potential impact.

A dozen national patients' groups, including the the American Cancer Society, American Heart Association and American Lung Association, are urging Lee and lawmakers to reject the bill, warning it "will jeopardize Medicaid enrollees' access to care."

Earlier in the day, the Senate and House were still at odds over the bill when a joint conference committee deadlocked.

But Republicans resurrected the effort late Thursday afternoon. House Democrats briefly staged a walkout after Republican House Speaker Glen Casada excluded them from participation in the second meeting.

Earlier in the day, Rep. Timothy Hill, R-Blountville, the bill's House sponsor, said Senate language for the proposed conference committee report sought to put too many preconditions on Lee's administration.

"We want to be able to have high quality discussions with the feds, if at all possible," Hill said. "However, I have concerns that we're tying the hands of the [Lee] administration."

Rep. Robin Smith, R-Hixson, and Rep. Yusuf Hakeem, D-Chattanooga, served on the earlier conference committee with Smith, with both voting no. Hakeem said he opposed turning federal support of TennCare into a block grant.

Sens. Bo Watson, R-Hixson, and Mike Bell, R-Riceville, who both served on the earlier panel, voted for it.

Hill was particularly put out by Bailey's language that says the Lee administration "must" seek a block grant that is indexed for population growth, inflation and other factors in determining the base amount of money.

That was resolved by the second conference committee when "must" was changed to "shall." The House later passed the bill on a 63-19 vote, but not before Minority Leader Karen Camper, D-Memphis, again chided Casada for not putting Democrats on the second conference panel.

Senators approved it on a 26-6 vote, sending it on to Lee.

Currently, federal spending for states' jointly funded Medicaid programs matches whatever a state spends, based on a variety of factors. Proponents say the entitlement nature of the funding protects people during recessions, when unemployment is high, and also in cases of natural disasters such as epidemic.

For TennCare, the federal government now pays 65.87 percent or $7.5 billion of the Tennessee program's total $12.1 billion cost.

Republicans also passed Rep. Smith's "Right to Shop Act," which directs Tennessee-based insurance companies to provide their customers with price information on various providers' prices so they can make better decisions.

It too got hung up in a conference committee, but a second panel straightened out remaining issues and the measure passed.

Contact Andy Sher at asher@timesfreepress.com or 615-255-0550. Follow him on Twitter @AndySher1.

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