May 30, 2005

On TennCare and Corrupt Legislators

Sate Sen. Jim Bryson, R-Franklin, has sent out an email discussing last week's arrest of four legislators on corruption charges and also detailing the effort) made by many Republicans in the state legislature to prevent Gov. Phil Bredesen from slashing 67,000 peopled deemed "uninsurable" from the TennCare rolls (and another 11,500 people who are mentally ill). It's an effort that failed because, as, Bryson notes, "the Governor fought this plan with all the tools at his disposal."

I'm republishing the entire email here in the extended-entry portion of this post.

Many people have asked me about the final days of the 2005 legislative session. This e-mail serves as my personal perspective on the events last Thursday, Friday and Saturday. My memories of these days will revolve around two significant events: legislators being arrested and the fight to retain the sick and needy on TennCare.

LEGISLATORS ARRESTEDOn Thursday morning, the FBI arrested 4 state legislators at the Capitol and hauled them off in handcuffs. All four of these legislators plus a former legislator were caught accepting money for sponsoring a bill in the legislature.

We were all stunned, shocked and deeply disappointed in our colleagues. Other than John Ford’s very public shenanigans, we did not know of the other four individuals’ involvement in anything of this type, nor did we suspect an ongoing FBI sting operation. We were as surprised as everyone else.

Between 8:30 and 9:00 I was called into a private office and told about the arrests of Sen. Ward Crutchfield, Sen. Kathryn Bowers and Rep. Chris Newton. At that time, the word was that the FBI was looking for John Ford and that more legislators may be involved. We soon discovered that the FBI had arrested John Ford as well as former Senator Roscoe Dixon and two “bagmen” (intermediaries who deliver the money, sometimes in paper bags).

The media began converging on the Capitol with reporters and television cameras in every hallway. Even perennial whistle-blower Barry Schmittou and perennial candidate John Jay Hooker showed up to pose for the cameras.

About 10:30 the Republican Caucus convened to discuss the situation and for prayer. At 11:00 we watched, along with the rest of the state, the press conference describing the sting operation and arrests.

That afternoon, we reconvened in legislative session. Outside the chamber, the media was swarming. Inside the chamber became a place of relative calm as the Senate resumed its business and we considered the bills before us. The mood was somber and businesslike. The occasional bickering over legislation virtually disappeared as Senators simply focused on the merits of individual bills.

When the Senate adjourned that evening, the media deadlines had passed and few reporters or cameras were in the halls. It was time to return to our offices to prepare for Friday since the budget would be first on the calendar Friday morning.

The events of Thursday will harm the credibility of the legislature for some time to come.

UNINSURABLE DISENROLLED
For the past three months or so, Sen. Diane Black had been leading a Republican Caucus team to investigate options related TennCare. The team met virtually every week and brought in numerous outside experts to share their ideas.

Besides serving on this Republican Caucus TennCare team, I also serve on the TennCare Oversight Committee and the TennCare budget sub-committee of the Senate Commerce Committee. I studied TennCare the entire session. In my opinion, the situation going into the legislative budget process was:

1. According to the TennCare budget office, the Governor’s budget was sufficient to provide more than enough savings to avert another TennCare crisis for two fiscal years (FY06 and FY07), after the next election.
2. The Governor expects a favorable court decision in early June that would eliminate many roadblocks to implementing TennCare reforms. These reforms would result in several hundred million dollars in savings.
3. The Governor was confident enough in attaining relief from the consent decrees that he had budgeted to spend $100 million in savings based on a favorable court decision.
4. Before getting the favorable decision and being able to implement cost-saving reforms, the Governor planned to disenroll 67,000 of the insurable and over 100,000 insured (those who do not have insurance but also do not have an uninsurable condition).

Given this information, Sen. Black and I devised a plan to continue the disenrollment of the uninsured but retain the 67,000 uninsurable on the TennCare rolls for one year at a reduced benefit level. This plan would give the Governor time to implement reforms and eliminate from the rolls anyone who did not qualify. We reasoned that reforms should be given a chance to work before disenrolling the sick from TennCare.

Our plan was based on financial information from the Governor’s own TennCare office and was contingent on the Governor obtaining relief from the courts regarding the Grier Consent Decree. The money was available to help these 67,000 as well as another 11,500 severely mentally ill who would also be disenrolled.

The Governor fought this plan with all the tools at his disposal. His lobbyists spread throughout the capitol to fight the plan. The Governor called us into his office asking us to drop the proposal. The Governor himself appeared at the Republican and Democratic Caucus meetings to fight the plan.

In the end, the Governor won. This summer, 67,000 uninsurable Tennesseans will be disenrolled from TennCare with very few options available to them. Some will be able to afford HIPAA policies with premiums generally over $800/month. These people were paying premiums to TennCare. Most of this population cannot afford such high premiums and will have no healthcare alternative. Virtually all have some type of chronic condition.

Why would the Governor fight a plan to help 67,000 Tennesseans who cannot obtain health insurance when the money was available and the "roadblock" consent decrees were eliminated?

The Governor has positioned the TennCare program to be stable at least through the election.

1. The TennCare budget is funded to avert a crisis for the next two years.
2. The consent decrees will be eliminated or greatly reduced to pave the way for the Governor to implement further cost-saving healthcare management reforms, saving about $300 million.
3. Benefit limits on enrollees will result in additional savings and provide incentive for people to self-disenroll.
4. The TennCare rolls will shrink by at least 200,000 people through disenrollment.

In 2006, watch for TennCare reforms to be implemented and for TennCare to be financially sound. I would also expect that the numbers will be so positive that TennCare will actually re-enroll some of the sickest individuals being disenrolled this year.

This week has not been a good week in our state. Our legislature has become even less credible to the people of Tennessee. Also, we will have at least 200,000 more people without access to insurance in Tennessee raising our uninsured population to almost 1 million people, or one of every 6 Tennesseans. I will begin working on insurance reform for the uninsured when the legislature reconvenes.

These difficulties shall pass and we will have better days. I am resolved today more than ever to legislate by principle not politics, to fight for right and not fold for gold, to stand strong in the face of adversity.

Thank you for your indulgence in reading this e-mail. My next e-mail will be a recap of the Legislative year. There were a lot of good things that I will have to report. Until then, I hope your summer gets off to a wonderful start.