Joined by several Republican legislators, about 300 tea party activists rallied at the state capitol Wednesday in hopes of prodding an undecided Gov. Bill Haslam into opposing the creation of a Tennessee Health Care Exchange.
Haslam, who faces a Dec. 14 deadline for notifying the federal government of the state’s intentions, said he is listening to all sides but remains uncertain. Initially, Haslam said he was initially inclined to opt for a state-run exchange, but his misgivings have grown.
If they state does not create an exchange, which would serve basically as a clearinghouse between citizens and insurance companies, the federal government would instead operate an exchange in Tennessee. Nationwide, 22 governors have decided against running their own exchange.
At the rally, there was some criticism of Haslam for his indecisiveness from both speakers and signs waved by participants sign-wavers. One sign said, “Fire Haslam.”
“If Bill Haslam cannot say no, then it’s time we get another governor,” said Carl Boyd Jr., who hosts a Nashville radio talk show and was one of several speakers.
Legislators attending the event, including Knoxville’s Sen. Stacey Campfield, said they believe a majority of the Republican-controlled General Assembly would reverse Haslam if he decides in favor of creating a state-operated health care exchange.
Senate Republican Caucus Chairman Bill Ketron, said that, as he understand the federal law, the governor’s initial decision would have to be ratified by the General Assembly and “very few” Republicans would support a state health care exchange.
“We have six new (Republican) senators who had (campaign) mail pieces where the first bullet point was a promise not to support Obamacare,” said Ketron. “I don’t see them changing their minds.”
Campfield said that support for a state health care exchange would be seen as “tacit approval” of Obamacare by federal officials while rejection would send a clear message of opposition.
“No. 1, it’s not constitutional. No. 2, it’s bad policy,” he said.
Ben Cunningham, a founder of the Nashville Tea Party and an organizer of the event, said Haslam is under “a lot of pressure” to accept a state exchange, especially from the state’s hospitals. Tennessee hospitals are more actively pushing for an expansion of eligibility for Medicaid, an option that states must accept or reject next year, but Cunningham said the two decisions are linked in some ways.
“We believe it’s best to let the federal government own this disaster,” Cunningham said
David Smith, spokesman for Haslam, said the governor’s office has received thousands of calls and emails on the subject – most opposed to an exchange. By a count on Wednesday, he said there had been 4,460 emails and about 2,000 phone calls.
Phone operators notes indicate 1,905 of calls were against a state exchange generally, 32 said they were opposed but changed to pro-exchange “after the choices were explained;” 87 supported a state exchange, eight wanted “nullification” of Obamacare, 31 called for secession from the United States and seven for a civil war, Smith said.
“It’s our best attempt at tracking, but it’s not exact. There are a lot of duplicates – these are not unique contacts. Some people call multiple people for multiple days,” Smith said in an email.
Haslam, speaking to Nashville radio talk show host Phil Valentine late Wednesday, characterized the choice as deciding between the “lesser of two evils.”
“My first reaction was anything we can do, we can do it better, cheaper, faster and with better customer service than they (federal officials) will,” Haslam said. “The issue on the other side is, I really don’t think they’re prepared for this whole thing… I think they’re making it up as they go along.”
“It’s hard to do something with somebody who’s making it up as they go along,” Haslam said.
“It might be better say (to the federal government), ‘You get all this figured out.. then we might be come out and play,” he said.
The governor said, for example, federal officials have not said whether they would allow a state to offer cost saving incentives for healthy behavior, such as not smoking or reducing weight. That raises a question of whether the state will have the flexibility it wants, he said.
On the other hand, he said the federal government, if it operates an exchange, will tack on a 3.5 percent fee as a service charge to insurance premiums. The state likely could run the exchange at a lower cost, saving Tennesseans money on their insurance.
The question, he said, may revolve around the possibility of more state more control and flexibility – and the degree of that flexibility – and the potential cost savings.
“Is that worth the inherent problems of being tied in with them on this when they’re not ready to run it?” he asked.