The first Extraordinary Session of the 109th General Assembly adjourned last week after three days of legislative deliberations on Governor Bill Haslam’s Insure Tennessee proposal. The action to adjourn came after the Senate Health and Welfare Committee voted 7 to 4 against giving the Governor authorization to enter into a contract with the federal government to expand the number of Tennesseans eligible for Medicaid or healthcare benefits which are available under the Affordable Care Act, also known as Obamacare.
Senate Joint Resolution 7001 would have given the Governor authority to implement TennCare Demonstration Amendment #25, which is a waiver amendment request to provide services to “newly eligibles” between the ages of 19 and 64 with family incomes that do not exceed 138 percent of the federal poverty level. Legislative authorization on the Insure Tennessee proposal was required under a law passed by the General Assembly last year.
I served on the special Committee on Health and General Welfare and listened to more six hours of testimony, fully discussing the issue on both sides. In the end, I felt that the responsibility of the Health Committee was to look at the health implications of the bill. It was my understanding that the other two special committees in the Senate (the Commerce and Labor Committee and the Finance, Ways and Means Committee) would be looking at the other aspects of the bill.
While there were presentations and varying opinions on how the waiver was written; whether it could be changed in DC, whether we could get out in 2 years if it wasn’t working; whether there would be additional costs to the State; whether it would increase the national deficit; whether it was ObamaCare or not; and other points of disagreement…..I felt that the testimony was very clear that it would be a positive health benefit to the citizens of Tennessee that would be covered. As a result of this, I was one of the four Senators who voted for Insure Tennessee.
As a result of the losing vote in the Health Committee, the bill did not go any further and was not able to be voted on by all the members of the General Assembly. I know that there are members looking at other possible solutions. I will keep you informed.
Governor Haslam presents budget proposal focusing on education and jobs for Tennesseans
Education and jobs were the focus on Capitol Hill this week as Governor Bill Haslam unveiled his proposal to fund state government for the 2015-2016 fiscal year in his annual State of the State Address. The $33.3 billion balanced budget makes strategic investments in education and workforce development, while continuing a thoughtful approach to making government work more efficiently and effectively.
During the speech, Haslam said nearly 225,000 new private sector jobs have been created in Tennessee since 2011. Over the past several years, the General Assembly has made great strides in preparing students for the 21st century marketplace and in creating a business-friendly climate which draws new and better paying jobs to our state. These efforts include passage of a number of job creation initiatives such as tort reform, unemployment reform and workers’ compensation reform.
The governor also announced that out of the 65,000 high school seniors, 58,000 have signed up for Tennessee Promise, the scholarship program which provides last dollar tuition assistance to fill unmet financial needs so students may attend community college or a college of applied technology free of charge.Norris was sponsor of the legislation which established the scholarship program last year. Tennessee Promise is part of the state’s efforts to ensure a strong workforce by filling the skills gap to bring technologically advanced industries to the state. It is also part of the Drive to 55 initiative that aims to raise the percentage of Tennesseans with a certificate or degree beyond high school from 32 to 55 by the year 2025.
On K-12 education, Governor Haslam heralded the state’s recent academic achievement gains. He also noted that Tennessee “is one of the few states in the country to make significant investments” in funding education improvements. State spending on K-12 education over the past four years increased at a rate more than double the national average. The proposed budget includes nearly $44 million in new money to account for growth in the Basic Education Program, $100 million for increasing teacher salaries and $5 million to create the Educators’ Liability Trust fund to offer liability insurance to teachers at no cost.
Other highlights of the governor’s proposed budget include:
- $260 million for capital projects, including new science facilities at Jackson State Community College and the University of Tennessee, nearly $25 million for improvements to colleges of applied technology across the state and funding for a fine arts classroom building at East Tennessee State University
- $25 million to fully fund the Complete College Act formula
- $10 million for need-based scholarships for students
- $2.5 million for statewide outreach efforts geared toward adult students, technical assistance to local communities that are finding ways to support adult learners, and a one-stop portal for adults
- $2.5 million to support the success of the SAILS (Seamless Alignment and Integrated Learning Support) program which address remediation in high school
- $1.5 million to provide last dollar scholarships to adults with some post-secondary credit to attend community college
- $1 million to establish competitive grants to 2-year and 4-year institutions to develop initiatives specifically designed for veterans
- $48 million for state employee pay raises and compensation tied to performance and ongoing market adjustments
- $4.7 to fund group health insurance cost increases for state employees and $2.5 million to fund their 401 K match plan
- $41.3 million to complete the phase out of Tennessee’s inheritance tax which is set to expire in 2016
The budget reflects $300 million in revenue growth, $500 million in cost increases and $200 million in reductions. Unlike Washington, Tennessee requires a balanced budget so any increase in spending in excess of available revenues must be off-set with reductions.
Tennessee has the lowest debt per capita of any state and is among the lowest tax rates. Haslam said that the state will spend $13 million less this year on interest than the previous as a result of reducing the amount of debt. At the same time, the proposed budget would add $36.5 million to the state’s Rainy Day Fund to bring the total to $528 million, the highest level since 2008. The Rainy Day Fund acts as the state’s savings account in case of an emergency and helps ensure the state’s financial stability with credit rating agencies.
Senate Health and Welfare Committee Hears Update on Tennessee’s Health Status and the growing problem of Neonatal Abstinence Syndrome
Dr. Randy Wykoff, Dean of East Tennessee State University’s College of Public Health, spoke to the Senate Health and Welfare Committee (on which I serve) this week regarding the health of Tennessee citizens, saying unhealthy choices are a key factor in the state’s low health ranking. Tennessee ranks 45th in overall health according to the United Health Foundation.
Wykoff explained that, of the five primary causes leading to early death, healthcare accounts for only 10 percent of the cause, while unhealthy choices accounts for 40 percent, genetics for 30 percent, environmental exposure for 15 percent and special circumstances for 5 percent. He said tobacco and the obesity epidemic accounted for some of the highest death rates in the behavioral categories in Tennessee. Approximately 24.3 percent of Tennesseans smoke tobacco and 33.7 percent are considered obese. In addition, physical inactivity has increased by 17 percent over the past year in Tennessee from 28.6 percent to 33.6 percent of adults.
Wykoff also linked economic development and educational attainment to poor health among Tennesseans. He urged lawmakers to continue pushing for education attainment and economic development improvements, as there is a huge life expectancy gap that is growing based on income.
Among Tennessee’s strengths listed by the United Health Foundation was the ready availability of primary care physicians and improved immunization coverage among adolescents by 16 percent from 52.7 percent to 61.2 percent of those who are 13 to 17 years of age. The state was noted for its low incidence of pertussis, more commonly called whooping cough, a condition for which children receive a vaccine.
The Health and Welfare Committee also heard testimony from Lisa Tipton, Executive Director of Families Free, a faith-based, not-profit organization which addresses the growing problem of Neonatal Abstinence Syndrome (NAS) in Northeast Tennessee. NAS is a condition found in newborns as a result of the mother’s addiction to opiates. Infants with the condition suffer withdrawal from drugs, which occurs at birth, causing tremors, weight loss, stiff muscles, seizures, inconsolable crying, gastrointestinal disorders and poor nervous system irritability within one to five days after birth in 55 to 94 percent of cases.
Studies previously presented to the Health and Welfare Committee showed that of the 42 percent of mothers who give birth to addicted babies have been prescribed the pills, 32.6 percent are from illicit or diverted substances, 21.5 percent are a mix of prescribed and non-prescribed doses, with the remainder from unknown substances. The same report said NAS babies often require ongoing medical care costing an average of $62,324 during their first year of life and that the infants are 19.7 times more likely to end up in state custody.
“NAS is preventable, but requires action by the medical community to help deter the number of babies born addicted,” said Senator Becky Massey. “I have personally visited East Tennessee’s Children’s Hospital in Knox County which is at the forefront in the treatment of these infants. It is heartbreaking to see these babies and watch their struggles. We need to do whatever we can to help fight this problem.”
Other Items of Interest
Tennessee is national leader in adoptions – Department of Children’s Services Commissioner Jim Henry appeared before the Senate Judiciary Committee this week to deliver his annual report to review any policy changes to the department that affect children in state custody. Henry said Tennessee continues to be the national leader in timeliness to adoption. In 2014, the state finalized 1,136 adoptions.
Broadband Internet Services – The Senate Commerce and Labor Committee held a hearing on potential forthcoming legislation to authorize municipal electric systems to provide high speed Internet services outside their boundaries to communities that do not have commercial services and have requested them to provide it. Senator Janice Bowling proposed a similar bill last year and has announced she will sponsor legislation again this session. A 1999 Tennessee law prohibits cities that operate their own Internet networks from providing access outside the boundaries where they provide electrical service. Committee members also heard from the opponents of the legislation who argue that government intrusion squeezes out free enterprise which helps to provide competitive rates. Expect the debate to continue as this legislation comes before the committee for consideration in the coming months
Transportation Funding Report – State Comptroller Justin Wilson appeared before the Senate Transportation and Safety Committee this week to present a report produced by his office entitled Tennessee Transportation Funding: Challenges and Options. The report outlined challenges to the state’s highway system, including “insufficient revenues to maintain existing highways and to meet the state’s long-term transportation demands.” The report said, “user fee revenues have stagnated and are not expected to increase without changes.” Tennessee relies more heavily on highway user taxes than other states and does not use debt financing, tolls or general fund revenues for highways. At this point, members are hopeful to look at a long term solution instead of a quick fix. The Administration has said that they have no plans to do so this year.
Veterans – During his State of the State Address, Governor Bill Haslam announced that veterans enrolled on college campuses have increased by 200 percent. Last year, the General Assembly passed the Veterans Education Transition Support (VETS) Act. This new law encourages enrollment of veterans and removes barriers known to impede their success in attaining higher education credentials. The governor said that the state’s Veterans Education Task Force has been working to address the unique needs that service men and women have when they go back to school. The budget includes $1 million to set up competitive grants to 2-year and 4-year schools to develop initiatives specifically designed for veterans to be successful in earning a degree or certificate.
Prescription Drug Abuse – Doctor shopping for narcotic pain medication is down 42 percent from its peak in 2011, according Governor Bill Haslam who noted the improvement in prescription drug abuse in his State of the State Address. The General Assembly passed legislation in 2012 that requires doctors or their designees to check Tennessee’s Controlled Substance Monitoring Database as of April 1, 2013 before initially prescribing an opioid or benzodiazepine substance, or at every six months thereafter for the same episode of treatment.
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