Tennessee’s GOP Governor Rejects Medicaid Expansion, Leaves Residents To ‘Health Care Lottery’

Gov. Bill Haslam (R-TN) announced on Wednesday that he will not pursue Obamacare’s optional expansion of the Medicaid program, which would extend health coverage to an additional 140,000 uninsured Tennesseans and bring in $1.4 billion in federal funding in the first year.

Eight of Haslam’s fellow Republican leaders have come out in support of this provision of the health care reform law, as partisan opposition to Obamacare’s state-level reforms is finally beginning to give way. But the Tennessee governor is standing firm in his opposition to extending public health insurance to additional low-income Americans. Instead, Haslam will seek to extend coverage to the expanded population by using federal funding to buy private insurance, an alternative to Medicaid expansion that’s enticing a growing number of Republican leaders. The Tennessee governor said he won’t push for expansion until the federal government approves that plan.

Haslam’s announcement comes on the heels of reports about the dire state of Tennessee’s Medicaid program, known as TennCare. Since there are a significant number of low-income Tennessee residents whose annual incomes put them above the cut-off for TennCare coverage, but whose expensive medical bills make them unable to afford to purchase private insurance on their own, the state holds a “health care lottery” twice a year to allow those residents to call in for a special application for TennCare. The phone lines are flooded, and many people are unable to get through. Many of those people would be eligible to gain public health insurance coverage under the Medicaid expansion, and would no longer have to desperately dial a state number in the hopes of winning an elusive lottery to access the care they need.

Despite the fact that Tennessee is a deeply Republican state with a GOP-led legislature, Obamacare’s Medicaid expansion has won some support from business and labor leaders. The state’s largest business organization, the Tennessee Chamber of Commerce & Industry, came out in support of Medicaid expansion earlier this week, explaining that ensuring health coverage for poorer Tennesseans will have a “substantial economic impact benefiting our overall economy.”