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Old 07-25-2009, 11:07 AM
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TNPetite.45 TNPetite.45 is offline
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Default Tenncare vs. Obamacare - A Lesson Already Learned

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from The Weekly Standard
post-dated August 3, 2009

Tried and Found Wanting



Tennesseeans are especially skeptical of Obamacare--with reason.
At the Biloxi, Mississippi, gathering of the National Governors Association in mid-July, Tennessee's Democratic governor, Phil Bredesen, told the New York Times he feared the Obama-backed health system overhaul would be the "mother of all unfunded mandates." He was speaking from experience. Bredesen was elected governor in 2002 to fix TennCare--the state's public option, launched in 1994 to replace Medicaid and cover the uninsured. Now, well into his second term as governor, he's still struggling to tame the monster.
Rather, it's the southern state of Tennessee that offers the most relevant experience. Its track record goes back to 1994, when TennCare was launched by Democratic governor Ned McWherter on the promise that it would save the state money, reduce costs, and increase coverage. Instead, in a decade, the program went from a budget of $2.5 billion to nearly
$8 billion, became mired in litigation, and was forced to make major cuts.

Congresswoman Marsha Blackburn was a Tennessee state senator back when many of the problems began to materialize in 1999. "There is not a credible example of having brought about a cost savings and insured everyone. We have seen that in TennCare," Blackburn told me. "I just find it unconscionable that they are not talking about the lessons that they learned from the TennCare experience, the lessons that are still being learned every day from the TennCare experience."
TennCare was conceived primarily as a budget measure, to address the rising cost of Medicaid, the federally funded, state-administered health care program for the poor. McWherter received a Medicaid waiver in November 1993 that allowed the state to leave Medicaid but use the same federal funds for its own managed care plan. The happy McWherter said after the waiver announcement, "For the first time we have the chance to provide affordable health coverage to every Tennessean without bankrupting our state." The plan pulled in the nearly 800,000 people then on Medicaid along with more than 300,000 deemed uninsured or uninsurable.
In the summer of 1999, a state audit showed Tennessee was spending $6 million to insure 14,000 dead people, that 16,500 enrollees lived outside the state, and that 20 percent were not eligible to be in the program. Republican governor Don Sundquist tried to impose an income tax on the state in 2002 to cover the cost of the program (which by this time had 1.4 million enrollees), but failed to get it through.

After Bredesen was elected, he commissioned a report by McKinsey & Company that estimated TennCare would consume more than 90 percent of the state's normal tax growth within five years. The biggest cost: Tennessee led the nation in prescription drugs per capita.
Taking a mend-it-don't-end-it approach, Bredesen proposed to limit prescriptions to five per person per month, while also limiting the number of doctor visits and days in the hospital. The legislature passed these measures. But it wasn't enough, and by November 2004, Bredesen said it was time to scrap TennCare. That was not well received by interest groups such as the Tennessee Justice Center that were already engaged in litigation with the state over the program.

The governor negotiated a way to keep a dramatically scaled down TennCare in place, with fewer benefits and fewer people on the rolls. And this January, a federal court lifted the court order from 1996 that prohibited Tennessee from reviewing eligibility of enrollees. Thus, the state is eliminating up to 150,000 enrollees. TennCare estimates it spends $1.2 billion a year on covering people who are not eligible.
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Old 07-26-2009, 12:16 PM
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I was kid when TennCare went into effect. I remember what a sham it was just hearing the common sense analyses from adults. I also remember how people from other states were coming across the border for free insurance in TN by way of TN taxpayers. Ned McWherther should have been strung up.

But hey, Obama knows best. His community organizing skills will prove to us how smart he really is. [Sticking finger down throat.]
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