Tennessee Lieutenant Governor Ron Ramsey (R-Blountville) told Knoxville News Sentinel legislative correspondent Tom Humphrey today that he doesn’t think the General Assembly will take significant action on legislation to prevent federal Medicaid expansion in Tennessee in 2013. However Ramsey has been adamant that he is opposed to forced Medicaid expansion, which has the potential to create a State budget crisis similar to the one that sparked the last serious debate over a State income tax in 2002. That situation proved to be the political death of former Governor Don Sundquist, and was directly related to the cost of TennCare, the State’s formerly-expanded Medicaid program brought into being by the late Governor Ned McWherter (D-Dresden). The justifiable fear of many legislators is that expanded Medicaid will lead to a budget crisis where legislators will be unable to balance the State budget because of health care costs, and a balanced budget is required by the State Constitution.
The great problem is that the federal Affordable Care Act could make it very hard for rural clinics and hospitals, of which there are a great many in Tennessee, to remain open without Medicaid expansion, and the federal government may put pressure on Tennessee to expand Medicaid in the form of sanctions in other areas.