Nearly 10 months after announcing "A Third Way" or "Tennessee Plan" that would allow the state to accept Medicaid expansion money to provide health insurance for hundreds of thousands of Tennesseans, Governor Bill Haslam said he sent a letter Monday to Health and Human Services (HHS) Secretary Kathleen Sebelius outlining what he would like to do with what could amount to more than a billion dollars.
He said the formal letter would say, "Here's our understanding of the issues, here's our understanding of where the discussions have been going back and forth."
Secretary Sebelius is in charge of the federal agency Medicare/Medicaid Services (CMS) which would ultimately need to approve the governor's plan.
"They have had a lot on their plate, so we haven't had a lot of discussions," the governor said alluding to HHS responsibility for problems with the Obamacare Web site for purchasing medical coverage.
The governor made his remarks at the very end of a speech to an overflow crowd at Nashville's Downtown Rotary Club.
"We thought it was important because things feel like they have stalled out in the discussions about what needs to happen to move this forward," the governor told reporters in a question-and-answer session that was dominated with questions about the Obamacare Medicaid expansion funds.
"I hope the outcome [from the letter] is for HHS to say okay, let's sit down and have serious conversations with you about how we do move forward," added the governor. "Our point is, let's put it on paper so we can be real clear where we think we stand and where the unsolved issues are."
Haslam said HHS continues to say "we would love to do something with you," but what Tennessee has proposed varies from the present rules for the Medicaid expansion money.
"We think there is a lot more flexibility under the law than what they have shown," added Mr. Haslam.
The governor has long maintained he simply would not expand the state's Medicaid program TennCare, but wants to essentially use the money to help those without medical coverage to be able to purchase health insurance.
The idea has not been a popular one fellow Republican lawmakers who say they fear the state eventually being on the hook for costs that would be paid in full for two years by the federal government and 90-percent thereafter.
One key area of difference is some cost-sharing by individuals who would benefit from the being able to purchase insurance with the Medicaid expansion money.
This would likely come with some sort of medical savings account says Mr. Haslam.
"Have the user incentivized," said the governor after the speech
Another area of dispute is technically referred to as the "medically fragile."
At question is how those people are classified and the benefits they would receive to align with Obamacare provisions.