Dwayne Thompson musing during block grant hearing
NASHVILLE — Two Memphis Democrats, state Reps. Dwayne Thompson and Larry Miller, did their best on Wednesday to put the brakes on a proposal, emanating from the Republican leadership of the General Assembly, insisting that federal Medicaid funding to Tennessee be in the form of block grants.
But, like it or not, and there is no indication that Gov. Bill Lee is opposed to the concept, HB1280, which requires that the governor request the state’s Medicaid funding via block grants, advanced a step closer to him on Wednesday in newly strengthened form.
The bill was amended in the TennCare Subcommittee on Wednesday by voice vote and is on its way to the full House Insurance Committee with an amendment from the bill’s sponsor, Rep. Timothy Hill ( R-Blountville), requiring legislative approval of any block-grant arrangement reached with the federal government. Meanwhile, SB1428, the Senate version sponsored by Senator Paul Bailey (R-Sparta), is pending before the Senate Commerce and Labor Committee.
In the TennCare Subcommittee, Reps. Thompson and Miller objected to the amendment and then to the bill as amended. Thompson had asked sponsor Hill how many other states received their Medicaid funding via block grants and when Hill professed not to know, Thompson supplied the answer: “I understand that it’s zero.” He then asked why Hill was proposing that the state pursue the “experiment” of block grants.
Hill alluded to the state’s volunteer tradition. “It’s the Tennessee way,” he answered. “Why not?”
Rep. Jason Zachary (R-Knoxville) responded similarly. “Let’s be the first. Let’s be the precedent,” he said.
Subcommittee Chairman Rep. Matthew Hill (R-Jonesborough) then indulged himself in what he himself branded as a “joke” by saying, “Chairman Hill, this is a great bill!” He went on to express enthusiasm that Tennessee, “known for innovation,” could by passing the bill, escape the “fetters of federal intervention” and maintain control of Medicaid spending at the state level.
In a brief question-and-answer session with reporters afterward, Hill exulted that his measure had passed its “first hurdle” and was presumably on its way to full passage. He acknowledged that there was some opposition to the bill, to be expected “whenever you’re proposing something that’s cutting edge.”
Asked whether there was polling to suggest popular support for his bill, Hill said he hadn’t conducted any. But he expressed confidence that the bill has “broad support...certainly with this supermajority” and would pick up more support “as we go along.”
He said he had “sat down” with TennCare officials but could not say what their opinion on the measure was. He acknowledged that the terms of the bill could alter the way TennCare operates but did not elaborate.