Like 24 other states, almost all of them with statehouses controlled by Republicans, Tennessee declined to expand Medicaid in the initial rollout of Obamacare last year, leaving tens of thousands of people uninsured. Since then two of those states have changed course and embraced Medicaid expansion, and another three states have expressed an interest in doing so. Tennessee now joins the latter group.
Tennessee and HHS have had some informal negotiations, including meetings between Haslam and then-HHS Secretary Kathleen Sebelius, over the last few years. Haslam said on Thursday that he recently spoke by phone with Sebelius's successor, Sylvia Mathews Burwell, and that he hoped to set up a meeting with Burwell soon, according to The Tennessean.
Haslam has floated a "private option" plan, using Medicaid dollars to pay for private coverage, as has been done in Arkansas and Iowa. Other pieces of the Tennessee plan could include co-payments and incentives for healthy behavior, based on the governor's past public comments.
Such a modified Medicaid expansion would require approval from HHS. The agency has already shown willingness to accept alternative plans and approved Thursday a proposal from Pennsylvania with some similar features.