Governor’s TennCare legislation politically savvy: experts

He could have made most of the cost- and benefit-cutting changes administratively, with the approval of federal officials. Instead, he presented two bills last week to lawmakers in hopes of cementing that authority in the law.

“It’s a way of co-opting the opposition,” said Bob Swanbrough, a political science professor at the University of Tennessee at Chattanooga.

He said that if legislators change the bills, they will “bear culpability of the problem continuing.”

Sen. David Fowler, R-Signal Mountain and a member of the TennCare Oversight Committee, called it “politically astute to get as many people (as possible) to share the responsibility if a measure may be controversial or unsuccessful.”

The move also strengthens the governor’s position with federal regulators, who must approve many of the changes, and with the courts, where enrollees are expected to challenge aspects of the overhaul.

Bredesen is hoping to save $2.5 billion over the next four years in TennCare, which will require $7.8 billion in state and federal funds next year.

The plan includes a limit on prescription drugs for many of the 1.3 million TennCare enrollees. It also places yearly caps on hospital stays, doctor visits and lab work, and sets a tiered co-payment system with charges ranging from $1 to $40. It will require the use of generics and over-the-counter drugs wherever possible.

Bredesen said he expects there to be few changes to his bills. So do several legislators.

“There may be some tweaking here and there and some discussion about things he can do differently, but there’s excitement about the change and the reforms we’ve been calling for so long,” said Rep. Diane Black, R-Gallatin.

TennCare advocates hope to convince lawmakers to look closely at the bill’s provisions. They’re sending letters to lawmakers Monday outlining fears that some people may be denied necessary medication or treatment.

“The lawmakers just assume it goes through the legislature as quickly as possible, and they have nothing to do with it,” said Tony Garr, executive director of the Tennessee Health Care Campaign.

“Every day that goes by, we learn a little more about what the impact would be, and every day that goes by we get a little more concerned. This plan, if implemented, would hurt people. And in some cases it could possibly kill people.”
———
Information from: Chattanooga Times Free Press, http://www.timesfreepress.com