US Senate Committee on Health, Education, Labor, & Pensions

Alexander Asks Administration to Pay Close Attention to Tennessee Health Care Proposal

At Senate hearing, administration official calls proposals similar to Tennessee’s “very encouraging,” as states take “interesting approaches…to try to solve some of these problems”

Thursday, April 11, 2013Liz Wolgemuth 202-228-4729

Washington, D.C., April 11 – At a hearing today of the Senate Health, Education, Labor and Pensions Committee on the new health care law, U.S. Senator Lamar Alexander (R-Tenn.) encouraged the Obama administration to review and respond to Tennessee Governor Haslam’s request for flexibility in using the federal dollars provided to expand health care coverage to 175,000 Tennesseans under the new health care law.

In questions to administration official Gary Cohen, director for the Center for Consumer Information and Insurance Oversight at the Centers for Medicare and Medicaid Services, the regulator for the health insurance exchanges, Alexander said: “I know the administration has had discussions amid concern about people who may move in and out of the exchanges and Medicaid. These are two groups of people: people who make 138 percent of the federal poverty level, up to people making 150 percent of federal poverty, who you might call working poor, whose income might go down and they’d suddenly go into Medicaid. They might go back and forth. So, the idea would be, is there some way to stabilize and make it easier for people who go back and forth between Medicaid and exchanges?”

Alexander referred to the problem as “churn,” saying, “I think this is a good faith proposal by a governor who’s trying to come up with a way to provide health care for 175,000 Tennesseans who otherwise might have trouble getting it, and to do so in a way that, one, meets cost effectiveness, and also would meet the admirable goal of reducing the amount of ‘churning.”

Cohen told the senator, in response to questions about Arkansas’s similar proposal, “I think one of the things that’s been very encouraging throughout this process is that we do see very interesting approaches being taken by different states to try to solve some of these problems. We’ve tried throughout implementation of the Affordable Care Act to be as flexible as possible and to give states the ability to try different approaches, as long as, obviously, they’re consistent with the law.”

Cohen did not have a status report on Tennessee’s request, but Senator Alexander encouraged the administration to “get back” to Governor Haslam about his proposal.

Alexander said that a “stable and secure insurance policy” for lower-income individuals who may meet federal standards for Medicaid intermittently “might make their lives simpler, easier, and maybe even less expensive for the government.”

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