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MYTH # 6: REALITY The Governor has made a calculated decision to cut TennCare, despite the availability of funds that could preserve health coverage for patients while real reforms are implemented. In August 2005, as hundreds of thousands of Tennessee’s sickest citizens lost health coverage, the state was hoarding funds that could have been used to protect them:
The Governor has been so determined to force through his policies that he has blocked attempts by others to save the program or, at least, lessen the damage to its enrollees. In a confidential November 22, 2004 planning document, administration officials outlined a plan to implement the massive cuts. The document established as an objective, in dealing with the legislature, to “prevent alternative proposals (e.g., savings, revenue generation, enrollment)”.3 The administration effectively carried out that plan. The Governor killed several widely supported legislative proposals that would have raised tobacco and alcohol taxes to fund TennCare and maintain coverage, by denouncing the bills and any other efforts to provide more funding for what he said was a “broken system”.4 Advocates responded that the program needs reform, but that is no reason to reject funding that could enable innocent people to retain badly needed health coverage. On May 27, 2005, the last day of the legislative session, a bipartisan group of members of the state House of Representatives tried to amend the appropriation bill to provide funding for the medically eligible, also known as the “uninsurable”. This group of 67,000, many of whom paid premiums for their coverage, are the sickest of the those losing coverage.5 When it appeared that the amendment might have sufficient votes to be enacted, the Governor had the House adjourn overnight, so that he could personally lobby members to defeat it. Governor Bredesen and his senior staff worked late into the night bargaining with members of both parties until he was assured that there were enough votes to defeat the amendment. The House of Representatives reconvened the following morning for an extraordinary Saturday session and voted to defeat the amendment before adopting the budget and adjourning for the year.6 In negotiations with the Tennessee Justice Center in 2003, Governor Bredesen promised to seek the help of Senator Bill Frist, Tennessee’s senior U.S. Senator and Majority Leader of the Senate, in supporting a federal legislative amendment that would restore funds that were taken back by federal officials in 2002. In December 2004, after the Governor had announced the mass disenrollment of hundreds of thousands of TennCare beneficiaries, the Tennessee Justice Center urged the Governor to seek “bridge funding” to sustain the program until reforms could be implemented. T.J.C. noted specific examples of other states that had recently obtained such aid with the help of members of their congressional delegations.7 In testimony in federal court in July 2005, Governor Bredesen’s Finance Commissioner admitted that the Governor may never have asked Senator Frist to support the federal legislative amendment, as the Governor had promised to do in 2003. The Finance Commissioner also testified that the Governor had decided not to ask for federal help that would prevent the disenrollments.8 1 See Tennessee Department of Finance and Administration, Media Release: June Revenues (July 8, 2005), available at http://www.tennessee.gov/finance/newsrel/june_rev05.html. 2 The TennCare reserves are in addition to the state Rainy Day Fund of more than $400 million, which is at its highest level in state history. See Governor Phil Bredesen, State of the State Address, January 31, 2005, at p. 2, available at: http://www.dlc.org/ndol_ci.cfm?kaid=106&subid=122&contentid=253144. 3 Confidential Information Document, “Back to Medicaid Kick-off” (November 22, 2004) at p. 5. A copy of this and other internal documents disclosed through litigation are available at http://www.tenncare.org/ 4 Anita Wadhwani, “Bills try to soften TennCare’s cuts”, The Tennessean, January 15, 2005. 5 Tennessee Fiscal Review Committee staff analysis: Estimated TennCare Disenrollee Cost with Benefit Limit Reductions, April 27, 2005. 6 Joseph White, “Roustabouts, trapeze artists question safety net; Ringmaster persists”, Nashville Bureau Reporter (May 30, 2005). 8 Testimony of Dave Goetz, Commissioner of Finance and Administration in Grier v. Goetz, No. 79-3107 (M.D. Tenn.) July 11, 2005, Transcript at pp. 1804-1815.
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