If true, why couldn't this have happened a year ago?

Live coverage...

(link...)

Vouchers, two year pilot, tentative verbal approval from HHS, drafting legislation, special session will be called next year.

Official presser....

Haslam Announces Insure Tennessee Plan

Five key areas of the governor’s plan include:

A fiscally sound and sustainable program;

Providing two new private market choices for Tennesseans;

Shifting the delivery model and payment of health care in Tennessee from fee-for-service to outcomes based;

Incentivizing Tennesseans to be more engaged and to take more personal responsibility in their health;

And preparing participants for eventual transition to commercial health coverage.

..

Insure Tennessee offers several options of coverage for individuals below 138 percent of poverty ($16,100 for an individual and $27,300 for a family of three). Tennesseans 21 to 64 years old will be offered a choice of the Healthy Incentives Plan or the Volunteer Plan.

The Volunteer Plan would provide a health insurance voucher to participants that would be used to participate in their employer’s health insurance plan. The voucher, valued at slightly less than the average TennCare per-enrollee cost, can be used to pay for premiums and other out-of-pocket expenses associated with participation in an individual’s employer sponsored private market plan.

Participants in the Healthy Incentives Plan may choose to receive coverage through a redesigned component of the TennCare program, which would introduce Healthy Incentives for Tennesseans (HIT) accounts, modeled after Health Reimbursement Accounts (HRAs), which can be used to pay for a portion of required member cost-sharing.

..

The voucher program provides a fixed contribution that can be applied to the costs of a person’s private market plan. All costs incurred in excess of the amount of the voucher are the responsibility of the participant. This structure empowers individuals to make a choice about which plan is better for their needs and to manage their health care expenses to avoid additional costs.

Newly eligible individuals who choose to participate in the TennCare program and whose incomes are above 100 percent of poverty will be required to pay premiums and copays for services. All enrollees, including those with incomes below poverty, will have modest pharmacy copays. TennCare members “earn” contributions into their HIT accounts by performing healthy behaviors. The account then can be used to cover copayment expenses.

..

The program will not create any new taxes for Tennesseans and will not add any state cost to the budget. The Tennessee Hospital Association has committed that the industry will cover any additional cost to the state. The program will automatically terminate in the event that either federal funding or support from the hospitals is modified in any way.

Haslam and Ramsey keep talking about "personal responsibility." What if you get hit by a bus? Get the flu? Are born with a genetic defect? Etc. etc.

(link...)

otherwise known as: Don't Get Sick

What it means is that after working 90 hours at minimum wage you're expected to put on your cute little running outfit and spend 1 1/2 hours a day briskly walking around the Lakeshore track , then go over to Fresh Market browse through the seasonal vegetables, pick up whatever looks good to go with your fresh wild salmon that day and go home and whip up a protein and low carb meal for your family, because, well, that's just how people live in the Governors world.

You are saying that Haslam has the power to override Federal laws requiring treatment for life threatening situations.

I'm sure there are valid criticisms, but I am disturbed by your assertions that an individual below $16,000 income deserves better health insurance than the rest of us.

What if you get hit by a bus? Get the flu? Are born with a genetic defect?

If you get hit by a bus the bus company will most likely pay. If you get the flu you use your voucher to visit the doctor or go to the health department, and hopefully remember to get your flu shot next year. If you have a serious genetic defect, you will no longer be limited by a lifetime cap.

It feels like you all are upset by the rhetoric of "personal responsibility". Don't you realize Ramsey needs to use this language to get it through the legislature. And what's so wrong about personal responsibility anyway?

I think outcome based means a flat fee for seeing a patient. It may not be a workable model but it ain't what you describe, Bob.

If we really wanted to impact nutritional based health changes we'd disallow food stamps for junk food. But we won't because of the agribiz & food processing lobby.

Ramsey: Governor Haslam has negotiated a deal which returns tax dollars back to Tennessee while using conservative principles to bring health insurance to more Tennesseans.

Cause there's nothing more conservative than taking $$ from the Feds.

"Shifting the delivery model and payment of health care in Tennessee from fee-for-service to outcomes based;"

Outcomes based is how the state will calculate payment to the providers. There will be someone collecting data from them showing that they are working to keep their patients healthier. It has been a while since I was actively involved in this area, but it has to do with a number of quality or outcome data points that must be met. For instance, a diabetic patient is tested for their A1C levels once a year. Or it could be as simple as weight loss or high B/P controlled. All insurance companies now do this kind of monitoring of primary care doctors.

This brings up another concern I have about this new program.

"Providing two new private market choices for Tennesseans;"

This plan is creating more work for an already broken TennCare office. I have not scoured the information released to find the targeted start date if it is approved by feds and the state legislature, but there will certainly need to be time for the TennCare office to figure out how to make all this happen. Add to this the new payment system in my first paragraph. Sounds like a few new people may be needed to make all this work.

Didn't we see that Haslam is asking for budget cuts for the TennCare office? Will some of the Medicaid expansion $$ go to new TennCare staff? How about the need for a new computer system?

Don't get me wrong, I am all for something for those that should be Medicaid eligible, but I just doubt the TennCare folks to be able to implement it.

Vouchers = universal GOP policy coverage