Lee says people concerned over Medicaid block grant proposal are ‘misinformed’ or haven’t adequately studied it

Oct. 3--This story was updated at 3:48 p.m. on Thursday, Oct. 3, 2019, with more information.

NASHVILLE -- Tennessee Gov. Bill Lee says he believes critics' opposition to his Medicaid block grant proposal during two public meetings earlier this week stems from misinformation or failing to take sufficient time to understand what he's trying to achieve.

"I do think that a lot of the folks that are concerned about this have either been misinformed or not taken the time to really understand it," the Republican governor told reporters Thursday. "And there's legitimate concern about that."

Emphasizing "we want people to fully understand this," Lee said "that's why we've added a couple more cities, that's why there's an online portal for understanding."

Lee's comments came following two public hearings in Nashville and Knoxville on Tuesday and Wednesday on his Medicaid waiver request to the Trump administration. He is seeking federal permission to waive many rules regarding operations and expenditures in TennCare, the state's $12.1 billion Medicaid health insurance program for an estimated 1.4 million low-income children, their adult caretakers, seniors and the disabled.

The governor is also seeking to convert some $7.9 billion in federal funding into an annual lump sum known as a block grant. With the Trump administration pushing block grants as a way of saving money on Medicaid, Lee is hoping to wrest additional power to control costs as well as more funding from Uncle Sam through a proposed share of cost savings.

Lee and administration officials say TennCare, a managed care version of Medicaid created in 1994, already produces about $2 billion annually in savings for the federal government that a traditional Medicaid fee-for-service program would not.

The governor hopes to negotiate getting upwards of half that -- as much as $1 billion a year -- to use for TennCare and other health initiatives in Lee's drive to improve health services and outcomes in rural parts of the state.

But most attendees at two of the three required state public meetings, among them Democratic U.S. Rep. Jim Cooper of Nashville, widely panned the governor's waiver request. A few attendees were neutral.

The second public hearing was held Wednesday in Knoxville and a third public meeting is today in Jackson. Meanwhile, Lee's administration announced Wednesday officials have added a fourth public meeting in Chattanooga, scheduled for Oct. 16, while yet a fifth meeting will be held in Memphis. The public comment period ends Oct. 18.

"We're listening and hearing what is said," Lee said. "I think there is a real opportunity if people will look deep at this. It's a complicated block grant proposal. There's a lot to understand about it. Certainly anyone can understand it and if they take the time to do it, it's a great deal for the state of Tennessee. It's a great deal for the TennCare population."

During Tuesday's public hearing in Nashville, Congressman Cooper called the proposal "a radical, Trump-inspired plan, to treat Tennesseans like guinea pigs," WPLN reported. "This waiver request not only doesn't help," Cooper added. "It actually goes backwards."

Advocates for the poor have also attacked the plan. And some state provider organizations, including the Tennessee Hospital Association, say that although they find some provisions such as the proposed shared cost savings provision intriguing, other aspects are worrisome and they need to learn more.

Asked about providers' concerns, Lee said "we're engaging them as a part of the process. And every time we will get a concern like that we want to communicate why we believe that concern is not valid. That's the process over the public comment period."

Regarding the possibility that he may not be able to address all concerns and that some may file negative comments in the public record on the waiver proposal, Lee said "I suspect there'll always be people, always be some who are opposed to change."

But Lee said he also believes the comments and proposals others bring forward can "strengthen this for Tennessee's benefit. We're certainly are going to take those into account. This is certainly going to be a good deal for Tennessee or I'm not going to do it. I've been really clear about that from the beginning."

What that means, Lee said, is "it'll be a good deal for TennCare patients or recipients. It'll be a good deal for those who may become TennCare recipients as a result of this, this will be a win for our state. I'm going to make sure of that. We're going to take this comment period to strengthen the proposal."

Lee's fellow Republicans in the GOP-led Tennessee Legislature this year passed legislation directing the governor to seek the waiver.

But the Democratic chairman of a powerful U.S. House panel as well as some experts say the Trump administration has no legal authority to approve the waiver.

Contact Andy Sher at [email protected] or 615-255-0550. Follow on Twitter @AndySher1.

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