Tennessee Governor Bill Haslam has proposed a Medicaid plan for his state that would provide vouchers to individuals with incomes up to 138 percent of the federal poverty line to help purchase employer-provided health coverage that they would be otherwise unable to afford.
Haslam becomes the latest Republican governor to offer a plan to expand health coverage eligibility without moving toward conventional Medicaid eligibility expansion as envisioned under the Affordable Care Act. As Jason Millman reported in Washington Post’s Wonkblog, GOP governors Matt Mead of Wyoming and Gary Herbert of Utah have also offered innovative Medicaid proposals since the midterm elections. As well, Governor Mike Pence of Indiana is negotiating with the Obama Administration for approval of expanded use of the state’s Healthy Indiana program, which authorizes health savings accounts for low-income citizens and an emphasis on preventive care, in place of conventional Medicaid expansion.
Currently, 27 states have expanded Medicaid eligibility under the Affordable Care Act and 23 have yet to do so. This has led, according to the Kaiser Family Foundation, to a coverage gap in which approximately four million Americans have income levels that do not allow them to qualify for Medicaid but are too low to be eligible for premium assistance in state health insurance exchanges.