In this March 27, 2013, file photo, Gov. Bill Haslam speaks to a joint session of the Legislature in Nashville, Tenn.
Mark Humphrey/AP

Another domino falls: Medicaid expansion advances in Tennessee

The more red-state governors embrace Medicaid expansion through the Affordable Care Act, the harder it is for the dead-enders to rationalize their obstinacy.
Take Tennessee, for example, where the Commercial Appeal in Memphis reports this morning on another step forward for the policy.
Gov. Bill Haslam plans to introduce his Insure Tennessee plan, an alternative to expanding the state’s Medicaid program, at a special session of the legislature in January.
Monday, the governor’s administration described a two-year pilot program that “rewards healthy behaviors, prepares members to transition to private coverage, promotes personal responsibility and incentivizes choosing preventative and routine care instead of unnecessary use of emergency rooms.”
Haslam, who recently took over as the chair of the Republican Governors Association, will reportedly call a special session of Tennessee’s legislature to consider the package he’s worked out with the Obama administration.
As is always the case in situations like these, the details make all the difference, and at this point, we don’t have enough information about Haslam’s model to critique it on the merits.
That said, in the larger context, those who continue to argue that states should reject Medicaid expansion out of partisan spite – regardless of the benefits for families, regardless of the needs of state hospitals, regardless of the effects on state finances – are facing headwinds that are only growing stronger.
Remember, Pennsylvania Republicans embraced the ACA’s Medicaid policy in September, and soon after, GOP leaders in Utah and Wyoming said they intend to do the same.
If Tennessee’s approach is adopted by state legislators, we’re looking at a landscape in which 30 states will be on board, which, as we discussed the other day, increases the pressure on the remaining holdouts.
States can only hurt themselves on purpose for so long before madness ends.