2 More Reasons to Leave Insure Tennessee in the Dust


July 8, 2015 2:38PM

As we learn more about the players who advocated for Gov. Haslam’s Medicaid expansion plan, Insure Tennessee—particularly, the hospitals who offered to front the state’s share of the costs—we have more reasons to thank legislators who twice voted to reject this flawed proposal.

And just yesterday, two new and explosive reports were released that should put to rest any assertions that patients didn’t dodge a bullet (or many) with the downfall of Insure Tennessee:

#1. TennCare officials announced they are terminating their $31 million contract with a call center that botched their responsibilities that included the processing of new Medicaid applications and trouble-shooting patient questions, amongst other administrative tasks. As TennCare’s spokesman admitted, “the call center failed to adequately perform its duties.” Really? At the same time these problems were occurring, the administration proposed we dump another 400,000 Tennesseans onto the program? This further supports our assertions that expansion might mean “coverage,” but doesn’t equate to “care.”

#2. The Government Accountability Office (GAO) just released a scathing new report on the federal 340B drug program, which mandates that pharmaceutical companies provide drugs at a discount to low-income patients through participating hospitals. In turn, these hospitals are expected to extend the discount to the qualified patients or provide greater charity care. Beacon has sounded the alarm in the past about how 340B hospitals in Tennessee have been abusing the program, noting that over 67% of our participating hospitals provide less charity care than the national average.

The latest findings by the GAO expose another layer of abuse that’s particularly relevant for Tennesseans: 340B hospitals are also over-prescribing high-cost medications, presumably so they can pocket higher profit margins when they fail to pass along the discount to patients. As the report notes, “… there is a financial incentive at hospitals participating in the 340B program to prescribe more drugs or more expensive drugs to Medicare beneficiaries.” In fact, GAO found these hospitals were billing twice as much per patient as hospitals not participating in 340B, regardless of health status. As a state that struggles with prescription drug abuse, we should be appalled. And this just scratches the surface of what the GAO uncovered.

Couple these findings with the facts we already know: state Medicaid expansions have largely been unaffordable, unsustainable, and unsuccessful at addressing the dilemmas of the uninsured. It’s time that we focus on meaningful healthcare reforms that put patients back in the drivers’ seat.