Dear Governor Haslam:
We are back from a short break. This is the 126th letter.
Please tell me I am wrong.
I have listened to many people talk about what they think you will do and why. Most of them know much more than me. I don’t think anybody claims they know. These are some guesses, educated guesses, but guesses. I hope they are wrong. Please tell me they are wrong.
1. The early optimism that many people had when you first announced you were going to submit a Tennessee Plan has disappeared. One person told me he thought your announcement was two things: a way to deflect rising public sentiment for Tenn Care expansion and a trial balloon floated out to see what kind of reaction you would get from legislators. On the one hand you could slow down criticism by appearing to be moving forward thus muting the outrage of so many. On the other hand you would know what to tell the legislators you were not doing. It gave you plausible deniability on both sides.
2. You have been surprised by the passion of the criticism that people have had for the passive approach you have taken to this issue. Many people see it as an emergency. You seem to have seen it as something “you hope to get to.” From the beginning you seemed to lack any sense of urgency on this issue.
3. The attack on Tenn Care operations and Darrin Gordon seems to have taken you by surprise. You didn’t seem to realize that many people saw the decisions made about enrollment, the lack of taking responsibility for computer problems, and the refusal to do anything in a timely manner while blaming those asking for help as supreme arrogance on your part and on the part of Gordon. Your attack on the Tennessee Justice Center as suing the state for frivolous reasons and your intent on defending the state from following the law by giving millions of dollars to an out of state law firm, at time when you are getting ready to announce widespread budget cuts, to pursue this defense makes your sincerity suspect at best.
4. Way too many people I know believe you will submit an initial plan to the federal government sure to be rejected as a way to show first of all that you can’t be pushed around by advocates, secondly to show you are not supporting the ACA and thirdly to maintain your credibility with the Tea Party folks. You get to say you care, you have a vision about how to make things better, the federal government is keeping you from making it happen and you are doing all this remaining true to “Tennessee values.”
5. If something does happen it will happen only after the economic disaster of not expanding makes it impossible for anyone to talk their way out of expansion. Multiple hospital closures might get us there.
6. A deal would be struck to “take the money” and to mollify the Tea party folks the poor would be required to have “skin in the game” through some type of co pays or other mechanism. Tenn Care would be expanded with the clear message “the poor cause their own problems because of the life they lead.”
I with everything in my heart want you to expand Tenn Care. I hope what I have written above is wrong….just totally one hundred percent wrong. I wish, and I know this is foolishly naive, that we gave health care to all Tennesseans because it was the right, best and only humane thing to do. I guess I am afflicted with terminal foolishness.
Good luck in the coming term. I hope you leave a legacy any governor would be proud to leave.
Until the next letter,