Tennessee’s Republican governor will use Obamacare Medicaid money to expand coverage

One of the longest and starkest boundaries in health care for the last year has been the border of Kentucky and Tennessee, because the Bluegrass State expanded Medicaid under the federal health-reform law and the Volunteer State did not. That is about to change, because Republican Gov. Bill Haslam of Tennessee will use federal Medicaid money to expand health insurance in his state.

Kentucky, Arkansas and West Virginia expanded Medicaid; Tennessee and Virginia haven’t yet.

“Like most other Republican governors who want to take the health-care law’s generous federal funding, Haslam is now offering a plan that deviates from the Medicaid expansion envisioned under the Affordable Care Act,” writes Jason Milliman of The Washington Post. “Haslam, who made the announcement almost a month after his re-election, said the Obama administration has verbally approved the approach.”

The Tennessee plan includes a two-year waiver program with two tracks. “It will offer vouchers to people earning up to 138 percent of the federal poverty level—or about $16,100 for an individual—to help purchase employer coverage they would otherwise struggle to afford,” Milliman reports. “Other newly eligible individuals can sign up in health plans modeled after health reimbursement accounts, with people earning above the poverty level required to pay premiums and copays. Haslam’s administration didn’t immediately offer details about how those payments are structured.”

In November the Kaiser Family Foundation estimated that Tennessee has “about 142,000 low-income adults fall into what’s known as the coverage gap—people who earn too much to qualify for the existing Medicaid program but not enough to qualify for subsidies to purchase private coverage on the Obamacare health insurance marketplaces,” Millman writes.

“Nine Republican governors have expanded Medicaid so far, while Indiana Gov. Mike Pence is still negotiating with the feds on leveraging an existing state program to expand coverage,” Millman reports.