“All we're asking from Washington is to allow us to use the funds to provide coverage on the healthcare exchange in the same way that other Tennesseans will access coverage, whether or not we expand,” Haslam said. “It's a very reasonable ask.”
Governors in several states, including Democrat Mike Beebe in Arkansas, are pushing similar plans.
But because federal officials have yet to allow that flexibility, Haslam said, he was not yet proposing to accept the expansion funding.
Another aspect of Haslam's proposal was to use the federal Medicaid funds to drive healthcare delivery changes in the state to reduce costs among Tennessee providers, especially hospitals, some of which will close without the additional federal Medicaid funds, he said.
Here are some recent developments in other states:
Missouri's Republican-led House rejected a Democratic gambit to expand Medicaid by adding more than $900 million in federal funds to the state budget, according to the Associated Press. The extra funding would allow the state's Medicaid program to cover 260,000 low-income adults.
Despite the Republican rejection, Democratic Gov. Jay Nixon continued a publicity campaign aimed at building public support for the Medicaid expansion.
A Missouri House committee is scheduled to vote next week on a Republican alternative that seeks a similar approach to the one that Tennessee's governor proposed. The Missouri Republicans would use the federal Medicaid money to adopt a private-sector insurance model for Missouri's Medicaid program.
Gov. Steve Bullock in Montana is another Democratic governor trying to press a Republican-led Legislature to raise Medicaid eligibility.
Bullock has been traveling the state for weeks talking about the Medicaid expansion to increase public pressure on Republican lawmakers, according to the AP.
The expansion in coverage for as many as 6,000 state residents received a hearing last week by the House Human Services Committee. Republican legislators said they were concerned that state costs for the program will eventually increase as federal money dries up.
The full House has advanced a Republican alternative to study the issue during the next two years instead of taking immediate action.
In Florida, a conservative interest group is making a publicity push against the Medicaid expansion, which last month won surprise support from Republican Gov. Rick Scott, a harsh critic of the healthcare law.
The Florida arm of the National Federation of Independent Business, which led a legal challenge that landed the reform law before the U.S. Supreme Court, launched a TV and online ad campaign to persuade residents to oppose adding more Floridians to the Medicaid rolls.
The campaign aims to shore up the position of Republican state lawmakers, many of whom disagree with Scott on the issue, to implement an “alternative” expansion, reports Health News Florida.
The business group's ad warns that the federal government's historic and growing debt has weakened the promise for ongoing federal funding to pay 90% of the costs of the new coverage. The ad points out that the state has to provide $3.5 billion over 10 years to match $51 billion in federal funds, according to estimates by the state's budget analysts.
