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(Memphis) Uncertainty over Medicaid expansion in Tennessee is a bad dose of medicine for the MED.

The MED says its funds to pay for the medical care of poor people are shrinking.

The hospital was going to use millions from the Affordable Care Act to make up for the loss, but then the state told the Obama administration to keep its money.

Governor Bill Haslam now wants the federal government to give Tennessee that money, but he wants to put it into the private market instead of the public Medicaid program.

With so many people on Medicaid in Shelby County, the commission is sending a message to Haslam asking him to get that plan approved ASAP.

Administrators at the MED call the situation dire because they don’t know how it’s going to cover the massive costs of caring for poor people in Memphis.

Dr. Reginald Coopwood says money from the Affordable Care Act would allow people on Medicaid to get preventative care like annual check-ups instead of only emergency treatment, which is more costly.

Coopwood says the state legislature needs to rethink its decision to turn that money down.

“I think it’s very important that this message be sent to the state in support of that effort,” said Coopwood.

The Shelby County Commission is sending that message with a vote to ask Governor Haslam to accept the funds.

“If we don’t do this not only are there going to be poor people in Tennessee who don’t get health insurance and we’re going to reduce health outcomes, but the med is going to get slighted,” said Commissioner Steve Mulroy.

We spoke with Haslam in Memphis Tuesday and he says he’s in a very delicate dance with both the federal government and the state legislature to introduce a plan they’ll both accept.

“I have to see if I can come up with something that the legislature will approve because they have to pass the budget and something HHS will approve and those two bodies have a completely different view of how healthcare should work,” said Haslam.

Haslam wants to take those federal funds but put them into a private marketplace instead of a public Medicaid fund because he says that will do a better job controlling high medical prices and quality.

That private market approach requires the patient to pay some sort of copay, but hospital officials are foggy on the details.

The county commissions resolution says it supports that plan of the governors to use the funds for the private market they just want to see some movement on it sooner rather than later.