Tennessee House members on Friday approved a first-in-the-nation Medicaid block grant plan, following their Senate counterparts, who passed the resolution on Thursday.
The Republican-led legislature hurried the legislation to passage during an opening week typically reserved for organizational steps, an attempt to get the plan in place before Democrat Joe Biden is inaugurated as president next week.
Lawmakers passed legislation in 2019 directing Gov. Bill Lee to negotiate a Medicaid block grant with the Centers for Medicare and Medicaid Services. The outgoing Trump administration approved a deal and announced it earlier this month. Proponents of the measure say it will allow the state to reap the benefits of efficient TennCare management in the form of shared savings. Opponents say there’s no guarantee there will be any shared savings and there’s no guarantee that they would be reinvested in TennCare anyway.
One of the sponsors, House Majority Leader William Lamberth (R-Portland), said approving the resolution prior to Biden’s inauguration would make it more difficult for the new administration to renege on the deal. TennCare Director Stephen Smith said the administration has not approached the Biden transition team about the plan, and Biden transition representatives did not respond to a request for comment.
New House Finance Chair Patsy Hazlewood admitted that the speed with which the legislature was considering the plan was “rather extraordinary.” Still, the legislation easily passed several committee hearings and floor votes in the House and Senate, largely on party lines.
“This broad power shift from federal to state policymakers will have significant effects on TennCare spending, enrollees and providers,” said Laura Berlind, executive director of nonpartisan public policy research group The Sycamore Institute. “The ultimate impact could be positive, negative or mixed depending on what changes state officials decide to make. It remains to be seen how durable this agreement will be. The incoming Biden administration may seek to roll things back, and even if they don’t, litigation in federal and state courts is almost certain.”