Featured Health Care

Haslam Rejects State-Run Exchange

Siding with Tea Party activists and GOP lawmakers, Gov. Bill Haslam said Monday that Tennessee would not run its own insurance exchange under the federal health care law.

But Haslam said he wasn’t bowing to political pressure.

“Believe me, the politics haven’t changed,” the Republican governor said after a speech at a Rotary Club of Nashville luncheon at the Wildhorse Saloon on Second Avenue. “I knew what the politics were of this decision seven or eight months ago. I can assure you: while we listen to everybody, in the end we made what we think is the right decision.”

Haslam said that as late as Friday he would have considered moving forward with a state-run exchange if federal officials “could soothe some of our fears.”

If Haslam had said yes to a state-run exchange, he would have been the only southern Republican governor so far to have done so.

But politics, Haslam said, “had zero to do with our decision.”

Until Haslam’s decision, a debate had been raging in Tennessee over whether state officials should support the federal health insurance exchanges outlined in President Obama’s healthcare overhaul or disavow state-level cooperation and let federal officials run the exchange.

The Tea Party held a rally last week urging Haslam to ‘Just Say No’ to Tennessee taking ownership of an exchange. Few if any GOP legislators have expressed any willingness to support a state-run exchange.

“As caucus chairman I helped get six new guys elected to the Senate, and the first bullet point on all their mail pieces was that they could not vote for or support Obamacare,” Sen. Bill Ketron, R-Murfreesboro, told TNReport last week. “So you can’t expect them to come back in January and vote for it.”

Sen. Ken Yager, R-Harriman, said he had little choice but to fight against a state-run exchange if he was interested in staying on the right side of popular opinion in his district.

“The overwhelming majority of my constituents is opposed to it,” said Yager.

The exchanges are supposed to be up and running by Jan. 1, 2014.

Haslam did say it’s possible that Tennessee might be able to take over its exchange at some point in the future.

“To work together with [the federal government] in this way we have to be convinced that they are literally ready to do it,” Haslam said. “In the last two or three weeks since the original deadline they gave us, they’ve issued us … 800-plus pages of rules — and those are just drafts. So just think about what that means: That was after the original deadline, they’ve given us 800 pages of something that was passed two years ago.

“I’m not being political. I honestly think they don’t have this planned out.”

Republicans legislative leaders applauded Haslam’s decision.

“It would be dereliction of our duty as public servants to take on as a partner a federal government that is clearly out of its depth,” Lt. Gov. Ron Ramsey, R-Blountville, posted on Facebook. “I’m proud to stand with Governor Haslam as we continue to find ways to minimize the impact of this insidious federal law on the citizens of Tennessee.”

And House Speaker Beth Harwell, R-Nashville, said in a statement: “As I have stated many times before, I am vehemently opposed to Obamacare and the mandates that come along with it. The decisions regarding health care are best left to each Tennessean and their doctor—not a massive bureaucracy that is sure to send this country further into debt.”

Democrats chided Haslam for foregoing the state-run exchange.

“I’m disappointed to see the Governor pandering to the far right of his party rather than doing what is best for the people of Tennessee,” House Democratic Leader Craig Fitzhugh said in a statement. “I would hate to know that I had a 70 percent approval rating statewide and couldn’t get my own party to support my initiatives.”

See the letter Gov. Bill Haslam wrote to Health and Human Services Kathleen Sebelius by clicking here.

Trent Seibert can be reached at, on Twitter at @trentseibert or at 615-669-9501.

Featured Health Care

GOP Leaders Still Undecided on Obamacare

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.