Waiting for a Cure 

Mark Luttrell tiptoes around the Medicaid issue

Taking stock of his governmental realm in a luncheon address to members of the Memphis Rotary Club on Tuesday, Shelby County Mayor Mark Luttrell listed several areas of public life that he was especially concerned with — most of them expected: education, public safety, and economic development prominent among them.

click to enlarge Mark Luttrell
  • Mark Luttrell

An additional one that he laid special emphasis on was public health — an issue which, as he acknowledged, he had little familiarity with in his previous roles as a prisons administrator and as Shelby County Sheriff. It had come to loom large in this thinking, though — notably the problem of the county's soaring rates of infant mortality, which have attained crisis proportions.

What, he was asked, would be the impact of a decision by the state — even at this late stage — to accept funds for Medicaid expansion under the Affordable Care Act? What has been the impact of the Haslam administration's inclination so far not to accept the funds? And what was his attitude toward it all?

As diplomatically as possible (given that Luttrell is a member in good standing of the state's reigning Republican Party), the mayor explained that the impact of not having the expansion funds has been serious, even critical, since a major portion of federal funding to The Med had been discontinued on the expectation that substitute funding to it and other hospitals administering indigent care would be administered through Medicaid expansion.

Luttrell took note of Haslam's frequent reiterations of his hopes that he will be able to obtain a waiver from the Obama administration that would allow the state to secure the add-on Medicaid funding to be administered through private insurance sources. The mayor said he had hopes that Tennessee might obtain such a waiver at some point.

The reality is not so hopeful. Arkansas is the major (and perhaps the only) other state to get such a waiver, and our neighboring state began floating a more or less complete version of its plan well over a year ago. As anyone knows who has paid close attention to the workings of Tennessee state government — and especially to the actions of the last two legislative sessions — Governor Haslam has owned up to not having a developed waiver plan and is in the position of asking that one be presented to him by the U.S. Department of Health and Human Services.

Moreover, while Haslam is thought to be sincere in his wish to find some contrivance that would allow the state to make use of Medicaid funding, the fact is that the GOP majority in the General Assembly is ill-disposed toward the idea and has basically tied the governor's hands with legislation in the session just ended. Any plan that the governor might come up with, or that he and HHS might agree on, must be approved by both chambers of the legislature.

So, like Luttrell, we Tennesseans can still hope for a cure; we just shouldn't count on one. 

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