Gov. Bill Haslam announced Monday that Tennessee will not create a state-run health insurance exchange, but the Republican governor said he remains undecided about whether to expand Medicaid.
Haslam said in a speech to the Nashville Rotary Club that he was unsettled by the lack of guidelines from the federal government about the insurance marketplaces that are required under President Barack Obama's healthcare overhaul.
"This is a massive federal program to be implemented across millions of individuals, and the amount of information and data that we have about it — or the lack of that — is scary, quite frankly," he said.
Exchanges are new online markets where consumers will be able to buy individual private policies and apply for government subsidies to help pay their premiums. About 30 million people around the country expected to gain coverage under the law will get policies in the new exchanges, and the other half will be covered under Medicaid. About 982,000 people are uninsured in Tennessee.
"To me this is a business decision," Haslam said. "If you take the politics out of the decision, what you're left with is this: As the CEO of the state of Tennessee I'm being asked to make a significant business decision based on information that's only now dribbling out of Washington and that we appear to have little influence over."
The governor denied that political calculations influenced the decision, though he acknowledged that getting a state-run exchange approved by the Legislature would have been be a difficult prospect. His deliberations over the proposal had led to tea party supporters protesting outside the Capitol last week, deriding it as "Haslamcare."
"If it was a political decision we would have made it months ago — the politics of this were clear from the beginning," he said. "It was our responsibly to find out what really is the best answer for Tennessee."
Reaction to the decision nevertheless played out along partisan lines.
"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 Minority Leader Craig Fitzhugh, D-Ripley, said in a statement.
Meanwhile, a series of Republican lawmakers lauded the governor's choice.
"It is the right decision for Tennesseans and one of the few remaining ways to fight the government takeover of healthcare," said Sen. Jim Tracy, R-Shelbyville, who also urged the governor to reject Medicaid expansion.
House Speaker Beth Harwell, R-Nashville, agreed.
"The decisions regarding healthcare are best left to each Tennessean and their doctor— not a massive bureaucracy that is sure to send this country further into debt," she said.
Friday is the deadline for states to decision whether they will create a state-run exchange, let the federal government administer the program or create a joint marketplace. The governor said a decision on Medicaid expansion may not come until after the Legislature adjourns this spring.
"The expansion does not have that timeline, but to be fair to our healthcare providers, we're going to try to do that as quick as we can," Haslam said.