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Medicaid expansion fails in TennCare Subcommittee after physician testimony urging action
Summary
Representative Salinas’s bill to expand Medicaid to draw federal funds and shore up rural hospitals was defeated in subcommittee (2–4). Dr. Katrina Green testified that expansion would reduce uncompensated care, stabilize rural hospitals and lower maternal and infant mortality; members debated budgetary and reimbursement concerns.
Representative Salinas introduced House Bill 1101 to permit the General Assembly to expand Medicaid under the Affordable Care Act, arguing the state is foregoing federal funds and that expansion would help struggling hospitals. "We are losing out on $1,400,000,000 every year that would go to take care of our people," the sponsor said, linking expansion to fewer hospital closures and potential economic benefits.
The subcommittee heard testimony from Dr. Katrina Green, a board-certified emergency physician at Nashville General Hospital, who described direct clinical consequences of the coverage gap: late-stage diagnoses, increased dialysis admissions, and higher uncompensated-care burdens on safety-net hospitals. "When a rural hospital closes the golden hour…the critical window I have to save a stroke or trauma patient disappears," Dr. Green said, and she urged members to vote yes on HB 1101.
Members pressed Dr. Green on details: she said she sees uninsured patients on every shift and described how safety-net hospitals lack specialty services, which increases referrals and downstream costs. Chairman Kumar responded that federal funding phases down over time and noted budgetary trade-offs, saying the state faced different budget dynamics than earlier eras. After debate, the subcommittee called the previous question and voted; the clerk recorded two ayes and four noes, and House Bill 1101 failed in subcommittee.
The transcript records the sponsor’s funding claim and the physician’s clinical testimony; committee members raised fiscal concerns and asked legal and budget questions during the exchange.
