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Justin Owen warns that healthcare “reform” could cost Tennesseans more than $1 billion resulting from the proposed Medicaid/TennCare expansion. This article originally appeared in the Chattanoogan. by Justin Owen Healthcare reform is front and center on the national political landscape, and when the dust finally settles, state leaders could be left holding the bag. A bag full of debt and empty promises. This past year, Tennessee faced a $1 billion budget shortfall thanks to economic woes. Under the current healthcare proposal in Congress, that shortfall will grow even larger. Part of congressional healthcare “reform” is the largest ever expansion of Medicaid, known in Tennessee as TennCare. This expansion will cost the state, which is responsible for a portion of TennCare funding, an immense amount of money for two reasons. First, TennCare will be available to more people through increased income limits on those eligible. Second, health insurance mandates will enlarge the TennCare rolls. Under the reform package, TennCare will be available to every individual earning less than $14,404 a year. Many individuals over the federal poverty limit are now ineligible to obtain TennCare coverage, but this expansion will open up the program to far more people. Further, there are potentially thousands of Tennesseans that are currently eligible for TennCare but choose not to enroll. When they are forced to obtain insurance—whether through a private plan or the government—they will most certainly opt for the free government plan. Governor Bredesen, who has rightfully referred to the Medicaid/TennCare expansion as “the mother of all unfunded mandates,” anticipates that the state could be slapped with more than $1 billion in costs over the next five years. By far the largest single state program, TennCare already eats up 26 percent of the state budget, and the expansion will certainly require it to devour more. As it reaches the level of unsustainability, Bredesen and lawmakers will be forced into a tough spot: raise taxes or make cuts in other areas, such as education, transportation and more state employee layoffs. Neither of these is politically favorable or fiscally wise. Governors across the nation, led by Bredesen, are taking an admirable stand against the federal government’s attempt to saddle the states with unwelcomed debt. Let’s hope Congress heeds their warnings. Otherwise, start stashing some money aside for the inevitable tax increase that will follow. Consider it Tennessee’s billion-dollar doctor bill, courtesy of Washington. Justin Owen is the director of legal policy at the Tennessee Center for Policy Research