From the Chattanooga Times-Free Press:
“I can use any number of examples of bad things we could do more efficiently than the federal government. That doesn’t mean we should do them,” House Majority Leader Gerald McCormick, R-Chattanooga, said after a speech to the downtown Chamber of Commerce.
McCormick represents a conservative faction at odds with Republican Gov. Bill Haslam in a deadline-driven fight over health insurance markets required by the Affordable Care Act. Haslam has until Dec. 14 to authorize a state-run insurance exchange; if he does nothing before the deadline, the federal government will set it up.
“The feds created it. Let them run it,” McCormick said. “I don’t have an obligation to clean their mess for them.” While Alabama and Georgia have decided against setting up exchanges, Tennessee and nine other states are still split over state-versus-federal.
Haslam routinely criticizes “Obamacare,” but he’s pushing for a state-run exchange he believes will be less costly and more helpful than a federal program.
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.
By Erik Schelzig, Associated Press
FRANKLIN, Tenn. — Gov. Bill Haslam says Tennessee’s long experience in running an expanded Medicaid program is the reason it’s taking longer than most other states to decide how to comply with the new federal health care law requirements on insurance exchanges.
Tennessee is one of 10 states yet to make a decision on whether it will run its own health insurance marketplace, let the federal government handle it or choose hybrid of the two. The deadline to decide is Dec. 14.
“We have an advantage in that we have a TennCare system, because we’ve been doing this for a while, so we have some of the very best in the business working for us there,” the Republican governor told reporters after a speech to the Farm Bureau on Monday.
“I think we’ve gotten into this in more detail. I think we understand the ramifications both ways better than some others do,” he said. “I’m not saying they’ve made a mistake in making their decisions. But it’s important for us to make the best decision.
TennCare was plagued by out-of-control costs until former Democratic Gov. Phil Bredesen in 2005 decided to make deep cuts to both enrollment and benefits.
The governor has said he leans toward having more state control, but has criticized the federal government for not being able to divulge details about how much flexibility would be granted to the state. But he has also acknowledged that a state exchange would be a tough sell among fellow Republicans in the Legislature, many of whom ran for office on a platform of opposing President Barack Obama’s signature health care plan.
But Haslam said he won’t be swayed by a planned tea party rally outside the Capitol on Wednesday to urge him to reject a state exchange.
“Obviously in government we want to listen to everybody,” he said after the Farm Bureau speech. “But I could probably go in this room and say, do you think we should run a state-run exchange, and I could probably get a whole bunch of people who say, yes.
“So you take all the information you can,” he said. “But at the end of the day it’s our job to make the very best decision we can for the state.”
Excerpt from an Andrea Zelinski story on Gov. Bill Haslam mulling whether a Tennessee Health Care Exchange is to be or not to be: Thousands of Tennesseans are weighing in on the issue. Gov. Bill Haslam’s staff said they have received some 4,000 emails and 2,000 phone calls about insurance exchanges.
While the staff didn’t break down the email messages to pros and cons, almost all of the phone calls were urging the governor to say “no Obamacare in Tennessee” — a decision that is out of the state’s hands — or ditch the exchange and let the federal government handle it.
Of the rest, about 75 said they were in favor of a state exchange. Another 32 spoke out against the state running it, but changed their stance after the choices were explained, according to the governor’s constituent services staff.
Almost 30 called wanting the state to secede, and eight urged nullification of Obamacare. Six called for a civil war.
….Haslam has until Dec. 14 to decide who will run the exchange. For months he has repeatedly said the state can run the program better than the federal government could, but he has shied away from committing to that route. He blamed the holdup on a lack of information from Washington, D.C., on details of how exactly the state-run exchanges and federal exchanges would work.
For example, the state would have at least some power to choose which health insurance carriers could sell on the exchange, but it’s unclear which details will be up to state officials to determine and which will be prescribed by the feds.
The same goes if the state opts to let the federal government run the exchange for Tennessee. State officials say they have no clue whether that means the state would be totally hands-off or would still have a role to play. In addition, the state could decide to partner with the federal government to run the program.
The feds handed the state $9.1 million in grants to help it do the homework to figure out whether to pursue an insurance exchange. So far, state officials say they’ve spent less than $1.5 million of it, mostly on salaries and benefits for staff researching insurance exchanges, although they say they still don’t have enough details to put forth solid recommendations.
By Erik Schelzig, Associated Press
NASHVILLE, Tenn. — Republican Gov. Bill Haslam said Monday that a lack of information from the White House is delaying a decision about whether the state should run its own health insurance exchange under the new federal health care law.
Haslam told reporters that President Barack Obama’s administration has refused to address a series of questions about the health insurance marketplaces raised by Republican governors, including whether states would be able to create wellness-based incentives to encourage healthy behavior.
“I think that’s a key to healthcare in the country, people taking more responsibility,” he said.
Other unresolved questions include whether family members participating in different plans will be covered by the same provider; how the state will be able to avoid being double-charged when seniors transition to Medicare; and if the state will be able to access information stored in the federal database.
“You literally have us saying we want to come sit down and talk about this to ask some of our questions, and get answers,” Haslam said. “And their response coming back has been ‘there’s no need in doing that.’ And I don’t find that an appropriate response.”
U.S. Rep. Scott DesJarlais says that implementation of the 2010 federal health care reform still can be blocked and has urged Gov. Bill Haslam to not create a state health insurance market, according to The Tennessean. Originally, Haslam faced a deadline today to notify the federal Department of Health and Human Services about whether Tennessee will create its own health insurance exchange or let the federal government create one for the state. But HHS announced Thursday evening that the deadline had been extended to Dec. 14.
Under Democratic President Barack Obama’s federal health care law, the exchanges are intended to be a kind of clearinghouse through which insurance companies will compete for customers beginning in 2014.
Most observers interpret the law as allowing the federal government to create exchanges in states that decide not to create their own.
But DesJarlais, in an argument first raised earlier this year, contends there can be no health care exchanges, and thus no final implementation of the controversial health care law, if states refuse to create their own.
In a letter to Haslam dated Thursday, DesJarlais said his position has been bolstered by a recent Congressional Research Service report.
IRS officials, however, contend the clear intent of the law is to allow federally created exchanges in states where governors don’t act. Many Southern governors have opposed setting up exchanges.
“In short, states that refuse to create and implement their own state health-insurance exchanges could potentially have the ability to block the law altogether,” DesJarlais wrote.
Because of President Barack Obama’s re-election and a changed makeup of Congress, he added, this may be one of the last options for stopping the law, at least until it can get further judicial review.
NASHVILLE, Tenn. (AP) — Gov. Bill Haslam says he’s taking advantage of an extended deadline the federal government has given states regarding health insurance exchanges.
States had until Friday to inform the U.S. Department of Health and Human Services if they plan to set up their own health insurance markets. But the deadline has been extended to Dec. 14.
Haslam has yet to reach a decision, but the Republican governor says he’s hopeful that in the coming weeks he will receive answers from Washington to questions he has about the exchanges, mainly the amount of flexibility Tennessee would have if it set up its own.
Republican Senate Speaker Ron Ramsey of Blountville told reporters earlier this week that he expects the governor to keep his options open on the state-run exchange
— Note: Here’s a statement issued by the governor: “The deadline for states to respond to the federal government about health insurance exchanges has been extended,” Haslam said.
“We are hopeful in the coming weeks we will receive answers from Washington to the many questions we’ve asked in our effort to have a full picture of the future of exchanges in Tennessee.
“Let me be clear, I oppose the Affordable Care Act. I joined with other Republican governors earlier this year to fight the law. Unfortunately, the Supreme Court upheld a majority of it this summer, including the provision that states are required to either participate in a federal exchange or establish their own.
“I understand there is a lot of passion and uncertainty about the health care law, and I share that frustration. As governor, I believe it is my job to put emotions aside and to make the tough decisions on the serious issues that impact Tennesseans. That is what I’m working hard to do.”
News release from Senate Democratic Caucus:
NASHVILLE – Senate Democratic leaders on Tuesday urged Gov. Haslam to establish a Tennessee Insurance Exchange under the Affordable Care Act.
In a conference call with the governor Tuesday, administration officials told legislators that establishing a state-run exchange would be cheaper for Tennesseans and for insurance providers, and could give the state more control. With three days before the federal deadline, the administration still had not made a decision.
“The presidential election was decisive, and Obamacare is the law of the land,” Senate Democratic leader Jim Kyle said. “Government closest to the people governs best, and that should be a guiding principle as we implement the new health care law.”
The governor can say yes now to a state-run exchange and back out later if that’s what’s best for Tennessee. But if we say no now, the state could lose as much as $90 million in federal grants. Any state-run exchange would still be subject to approval by the General Assembly.
“We have come to count on Gov. Haslam for pragmatic leadership in an environment where the legislature is increasingly partisan,” Democratic caucus chairman Lowe Finney said. “It’s clear that if we run the exchange, it will be cheaper for taxpayers, and it will allow our state to retain more control.”
— Note: News release from House Democratic Caucus below.
Governor Bill Haslam says he’ll be taking all the time he can to make a decision on setting up a state-based health insurance exchange, observes WPLN. Republican governors around the country are split ahead of Friday’s deadline. A few folks like Rick Scott of Florida and Bobby Jindal of Louisiana say the exchanges were the idea of the federal government and it should be the one to run them. But several GOP governors reluctantly say states could do a better job. Haslam says he’s in the latter camp, though he’s still not made a final call.
“There’s going to be an exchange. Ultimately, our citizens through insurance companies are going to pay for the cost of running that exchange. And so, who do we think can run it cheaper, us or the federal government? I’ll bet on us every time. I really believe that. But we have to be convinced that the flexibility they’ll give us is worth taking the risk or running it ourselves.”Health Care, Bill Haslam,
The Affordable Care Act is estimated to cost Tennessee $1.4 billion through 2019. In budget hearings, TennCare officials told the governor most of the increase is unavoidable, regardless of his decision on running a health insurance exchange and – down the road – expanding the state’s Medicaid program.
Some other coverage: The Commercial Appeal, the Tennessean.
Tennessee Governor Bill Haslam says he’s leaning toward the state running its own insurance exchange program under the federal health care overhaul, according to WPLN. But he’s holding off on making a final decision, which is required by the end of next week. The Republican-led state legislature would have to sign off, and some lawmakers in the governor’s party are dubious.
“I think politically it will be difficult. In some other states, you had some governors who said they wanted to do it and a legislature that voted no. But I think the arguments haven’t been made yet.”
Haslam says a state exchange could create better tax situations for businesses that choose to use it to insure their employees. And Haslam says insurance companies who would offer plans on the exchange, tell him they’d prefer to work with states over the federal government.
…House Majority Leader Gerald McCormick argues a state-run exchange would be a hard sell among rank-and-file Republicans.
“The federal government is the one that set up this and quite frankly made this mess, and I think we’ll probably let them deal with it.”