Speaking at a forum centered on health care, the majority of Tennessee's top-tier gubernatorial candidates stressed the need to tackle the ongoing opioid crisis and the importance of getting the state's residents to live healthier lifestyles.
The Friday forum, sponsored by the nonprofit Healthy Tennessee and Lipscomb University, featured six of the seven top-tier candidates in the race, with U.S. Rep. Diane Black, R-Gallatin, the only person to not make an appearance.
Each candidate fielded a host of questions from Manny Sethi, a Nashville-based surgeon and co-founder of Healthy Tennessee, and Lipscomb University President L. Randolph Lowary.
The two top-tier Democrats in the race — former Nashville Mayor Karl Dean and House Minority Leader Craig Fitzhugh — stressed the need for the state to expand Medicaid under the Affordable Care Act.
Dean called the state legislature's decision to reject Gov. Bill Haslam's 2015 health care proposal the worst decision the body had made in years.
"I think the non-vote on Medicaid expansion was sort of the high point of partisanship and ideologue politics," Dean said. "I don't think that's what works."
Both Fitzhugh and Dean cited the closure of rural hospitals in Tennessee, calling the issue a pressing topic to address.
"It is my opinion, shared by many of my colleagues in the legislature, that expansion of Medicaid would have prevented that," Fitzhugh said.
Dean, who has tried to paint himself as politically moderate during his campaign by praising Haslam and former Gov. Phil Bredesen, a Democrat, said he would support alternative ways to improve access to health care. Such examples, he said, include establishing public-private partnerships and working with nonprofit groups.
Several answers from the candidates underlined the differences between the two parties.
At one point, Fitzhugh said while government should not be responsible for doing everything "if we help those who need a little help, then every one of us is going to do better."
By contrast, former Sen. Mae Beavers, at one point, said, "I don't think government is always the answer to problems."
Despite their differences, the candidates from both parties said getting Tennesseans to live healthier lives will help reign in costs.
"Medical costs are increasing greater than the rate of inflation," said House Speaker Beth Harwell, R-Nashville, reiterating a common line from Haslam. "You cannot sustain that."
Although the four top-tier Republicans disagreed with the call for Medicaid expansion, the GOP candidates' answers to a question about the state's biggest challenges revealed differences.
Knoxville entrepreneur Randy Boyd said one of his top priorities is to reign in the cost of health care.
Beavers said the biggest challenge the state and federal government is facing is the need to repeal the Affordable Care Act. Beavers was the lone candidate to make such a statement, which was later followed by a call for a "top to bottom" review of TennCare, the state's Medicaid program.
Williamson County businessman Bill Lee said wants to address a "fundamental flaw" in the the health care system, which he said left payers, providers and patients with a host of unknowns, including cost.
Harwell said the health care market is facing instability in part due to the implementation of the Affordable Care Act and the uncertainty of its future under President Donald Trump's administration.
Throughout their remarks, both Lee and Boyd touted their business experience, saying at their respective companies they've implemented programs encouraging employees to be healthier.
"As governor, I'd want to make sure that we're encouraging our employers to create more wellness programs," Boyd said.
Candidates on the opioid crisis
In terms of opioids, each candidate acknowledged how widespread the issue has become in Tennessee.
During his answer on how to tackle the crisis, Lee said he lost a family member to an overdose.
"It cuts across all demographics and all people all across the state," Lee said. "It's a tragic epidemic."
He said he would like to see the government engaged with faith-based organizations and nonprofits to combat opioids and address the state's health care needs.
Similarly, Beavers called for more grants to faith-based charities, while rejecting the notion that the epidemic can be halted through the use of drugs like suboxone and methadone — opioid addiction treatment drugs.
Speaking about the overall crisis, Harwell said, "We didn't get into it overnight and we're not going to get out overnight."
Harwell said as part of the effort to address opioids she and Haslam will outline new legislation in the coming days. The announcement, which will also include Lt. Gov. Randy McNally and Chief Justice Jeff Bivens, is scheduled for Monday at 2 p.m.
At a separate event Friday morning, Haslam declined to share much about the forthcoming legislation, simply calling it a "comprehensive plan."