Governor Says ‘Cover Tennessee’ Program to be Voluntary

March 27, 2006

Tenn. Gov. Phil Bredesen said he won’t force his “Cover Tennessee” plan to cover the state’s uninsured on small businesses or individuals.
If the one-in-10 state residents without health insurance are going to participate in the “Cover Tennessee” program, he said, they are going to have to be willing to pay their share voluntarily.

“I don’t believe in that kind of mandatory stuff,” Bredesen told The Associated Press late last week. “I think if you get the economics right, the thing stands on its own.”

That would be a departure from some other states’ programs that have tried to force employers pick up part of the tab.

“There’s a reason a lot of these companies are not offering health insurance, and that’s because they can’t afford it,” Bredesen said.
Under Bredesen’s plan, uninsured residents would share the cost of health insurance premiums with state, and businesses would have the option of paying a share. Bredesen said he has proposed that the federal government participate in the future.

The program also would stand in contrast to legislation under consideration in Massachusetts that would require all state residents to obtain health insurance, much the way the states require all car owners to have auto insurance.

Massachusetts Gov. Mitt Romney, a Republican, has said the “individual mandate” is key to bringing health care costs down for everyone. Bredesen disagrees.

“It’s kind of a bizarre situation,” Bredesen said. “You have the Democratic governor of Tennessee talking about market forces, and the Republican governor of Massachusetts talking about mandated coverage the world is turned upside down!”

Bredesen has declined to divulge the specifics of his “Cover Tennessee” proposal such as levels of deductibles, premiums or copays before Monday’s speech to a joint session of Tennessee’s General Assembly. But the key to maximum participation will be accessible pricing and a range of medical services that people feel they need, he said.

“To make a program like I’m talking about work, you’ve got to have large numbers of people. And to do that, you’ve got to keep it inexpensive and lean, so people can afford it,” he said.

Bredesen said he will consider his program a failure if it doesn’t far outpace the participation levels of the Healthy New York program as a percentage of population.

Healthy New York’s about 100,000 participants would be the equivalent of about 18,000 in Tennessee, Bredesen said. About 600,000 Tennesseans are uninsured.

Bredesen is also trying to avoid some of the problems experienced by Maine’s three-year-old Dirigo Health program.

“What they did in Maine is they started with a very constrained program, and then they got fancy and kept adding things to it …,” Bredesen said. “So what you get is a small program with a lot of very sick people in it and the costs get out of control.”

Maine’s Gov. John Baldacci, a Democrat who is seeking re-election, has acknowledged that the program he’s championed is a work in progress. But he said it’s insuring 15,000 people now and has brought about savings in Maine’s health care system.

Republican critics say Dirigo has become too dependent on public financing and that Dirigo needs major surgery.

Bredesen’s plan has yet to encounter vocal criticism in the state Legislature, though that might just be a matter of waiting for him to release the details of the proposal.

“It all sounds well and good as long as the numbers work,” said Senate Majority Leader Ron Ramsey, a Blountville Republican.

Escalating costs at TennCare, Tennessee’s expanded Medicaid program covering about 1.2 million residents, led Bredesen to cut 191,000 adults and reduce benefits for thousands of others last year.

“What we’re talking about (with Cover Tennessee) is not an entitlement program,” Bredesen said. “It’s one where you can control the number of people, it’s operated under state law instead of federal law, it’s not subject to these consent decrees and federal regulations like Medicaid is.”

But some critics have argued that the state is giving up federal matching funds by not investing heavily in TennCare.

“I’ve always considered that a crazy criticism,” said Bredesen. “Would I love to have $2 for every $1 of ours? Yes.

“But you know, it’s like someone comes up to somebody working in a restaurant and says: ‘I’m going to give you a $1 million house and you only have to put up $333,000.”‘ Bredesen said. “Well, that’s a great deal, but if you don’t have the $333,000, you can’t do it.”

Bredesen said he has taken pains to keep control of the Cover Tennessee program as it moves forward.

“I think you’ll see I’ve gone to great lengths that this is a program where you can keep your hand on the throttle…,” he said. “If it does start going out of control, fine, we have a very good way of putting on the brakes.”

Topics Massachusetts Tennessee Maine

Was this article valuable?

Here are more articles you may enjoy.