Top Tennessee state leaders are more undecided than ever about how to approach two major decisions tied to the federal health care overhaul.
Gov. Bill Haslam met with Lt. Gov. Ron Ramsey and House Speaker Beth Harwell in Ramsey’s legislative office Thursday morning to discuss the pros and cons of embracing key pillars of the health care law. The policy decision is also a political one, with GOP leaders contemplating how closely they should attach the deep red state to President Barack Obama’s healthcare reforms.
For months, the three leaders have hinted that if they must usher in the Patient Protection and Affordable Care Act passed in 2010, they would want to do it, as Ramsey puts it, “the Tennessee way.”
For example, they had said they like the idea of running a so-called health insurance “exchange,” a government-controlled “marketplace” for people and businesses to comparison shop for health care plans. If Tennessee decides against running the “exchange,” the federal government will manage it instead. The state has until Nov. 16 to decide.
“I don’t want to turn it over to the federal government and allow them to do it, and yet at the same time, I think this thing is doomed to disaster eventually, and do we want to put our fingerprints on it? So, it’s a catch-22 situation,” Ramsey told TNReport after the meeting.
Haslam, who has leaned toward running the exchange, said he, too, isn’t so sure.
“I think there are certain advantages to running something ourselves,” Haslam said. “We definitely have not made a decision on that.”
The other issue is whether to expand TennCare, an option that arose after the U.S. Supreme Court upheld Obamacare as constitutional but determined that states cannot be forced into expanding their Medicaid programs. The expansion would cost the state $1.5 billion over five years, according to a Commercial Appeal review of federal data.
“It’s a pretty complex decision,” Haslam said. “I think at this point in time, all we’re trying to do is to help (legislators) understand all the different ramifications of the decisions.”
A handful of southern states have already washed their hands of much of the Obamacare program, saying they’ll have nothing to do with assembling the exchanges and will refuse to expand their Medicaid rolls.
Top lawmakers have lately toned down their rhetoric of exercising state control in implementing Obamacare in favor of waiting out the general election to see if former Massachusetts Gov. Mitt Romney defeats President Obama and follows through on promises to repeal the health care law.
House Minority Leader Craig Fitzhugh said Haslam is meeting with top Democrats soon to review the state’s options. He said he already favors the idea of expanding TennCare and running the health care exchanges and called both options “foolhardy” to pass up.