While addressing members of the Nashville Downtown Rotary Club Monday afternoon, Gov. Bill Haslam announced his final decision on whether the state would set up and run its own health insurance exchange. He said no.
Andrea Zelinski of The City Paper was there:
The governor, who has faced months of mounting pressure from Republican lawmakers and phone calls from the public, said the federal government hasn’t given him enough confidence to buy into the idea of running the exchange. Haslam informed U.S. Department of Health and Human Services Secretary Kathleen Sebelius of his decision in a letter dated Dec. 10.
“There will be people who say, ‘Oh you are just making a political decision.’ he told Nashville Downtown Rotary Club members at the Wildhorse Saloon Monday. “If it was a political decision, we would have made this months ago.”
Read Zelinski's full report here. Below, Haslam's full statement on the decision and a collection of statements from Republican and Democratic legislators responding to the announcement.
Gov. Bill Haslam:
“Tennessee faces a decision this week about health insurance exchanges created by the Affordable Care Act.
“I’m not a fan of the law. The more I know, the more harmful I think it will be for small businesses and costly for state governments and the federal government. It does nothing to address the cost of health care in our country. It only expands a broken system. That’s why I’ve opposed it from the beginning and had hoped we would be successful in court and at the ballot box this year.
“Now we’re faced with the fact that the law remains, and it requires every state to participate in an insurance exchange. Our decision is whether the state or federal government should run it, and the deadline for that decision is Friday.
“I’ve said that I think Tennessee could run a state exchange cheaper and better, and my natural inclination is to keep the federal government out of our business as much as possible. What our administration has been working to understand is whether we’d have the flexibility for it to be a true state-based exchange, how the data exchange would work, and if it would work.
“Since the presidential election, we’ve received 800-plus pages of draft rules from the federal government, some of which actually limit state decisions about running an exchange more than we expected.
“The Obama administration has set an aggressive timeline to implement exchanges, while there is still a lot of uncertainty about how the process will actually work. What has concerned me more and more is that they seem to be making this up as they go.
“In weighing all of the information we currently have, I informed the federal government today that Tennessee will not run a state-based exchange. If conditions warrant in the future and it makes sense at a later date for Tennessee to run the exchange, we would consider that as an option at the appropriate time.
“This decision comes after months of consideration and analysis. It is a business decision based on what is best for Tennesseans with the information we have now that we’ve pressed hard to receive from Washington. If this were a political decision, it would’ve been easy, and I would’ve made it a long time ago.
“I believe my job is to get to the right answer. That’s what Tennesseans expect of me and elected me to do.”
Lt. Gov. Ron Ramsey:
I applaud Governor Haslam's refusal to partner with the federal government on health insurance exchanges. The Obama administration has ignored questions, instituted arbitrary deadlines and made rules and regulations that change from day to day.
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. 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.
Senate Republican Caucus Chairman Bill Ketron:
"I am very pleased that Governor Haslam made the decision to reject state-based insurance exchanges. The federal government continues to show they have no qualms in making up new rules as they move forward.
As a businessman, I would not enter into any agreement without knowing all of the requirements. The Governor’s letter to Secretary Sebelius reiterates this citing the more than 800 pages of draft rules that have been issued since the November election. He also talks about the significant risks involved with taking on an exchange while they are still devising the rules and the fact that states have still not received appropriate information. I absolutely believe Governor Haslam made the right decision."
Speaker Beth Harwell:
As I have stated many times before, I am vehemently opposed to Obamacare and the mandates that come along with it. 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.
The federal government has not been forthcoming with details and information on the specifics of how to comply with setting up a state exchange, leading Governor Haslam to conclude that is not the best route for Tennessee, and I agree. Tennessee is fortunate to have a governor who thoughtfully arrived at this decision, and I appreciate his work on this issue.
House Republican Caucus Chairman Glen Casada:
“With this decision, Governor Haslam proved—once again—he is continuously looking out for the best interests of Tennesseans. I applaud the Governor for taking a deliberate approach and gathering all available facts and perspectives about this complex issue.
“It is readily apparent the federal government is making up rules for ObamaCare as it goes along. To have tied Tennessee to that albatross would have undermined our state in a number of ways. Ultimately, the costs and constitutional concerns associated with government-run exchanges were just too burdensome.
“Democrats, who are on the outside looking in and have an insatiable appetite for government largesse, will try and paint this as a political decision by the Governor. That could not be further from the truth. The fact is, on this day, the Governor stood up for our Tennessee principles and all of us should appreciate his decision.”
House Democratic Caucus:
Governor Bill Haslam announced today that Tennessee would not be setting up a state-based health exchange as called for under the Affordable Care Act. His decision will result in the federal government taking over responsibility for creating a health insurance marketplace for Tennessee consumers and small businesses.
“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,” said Leader Craig Fitzhugh. “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.”
State-based exchanges have enjoyed bi-partisan support historically. Former Sen. Majority Leader Bill Frist (R-TN) wrote in an op-ed recently that it would be “best for Tennessee to develop its own exchange because exchanges are an innovative, market-driven strategy, which foster competition, choice, cost-savings and quality among insurers.”
“It is disappointing that our Governor found it too difficult to do what 23 other states have begun to do — implement their own health insurance exchange,” said Caucus Chairman Mike Turner. “In the end, if Governor Haslam was unable to convince his party to reject partisan politics and do the right thing, perhaps it was best for him to allow the federal government to begin setting up an exchange for him.”
While Governor Haslam’s decision to leave health care exchanges to the federal government takes this issue off the table, Democrats will continue to push for Tennessee to participate in the federally funded Medicaid expansion that would cover an additional 330,000 souls.
“While the Governor is able to fall back on the federal government to handle these health care exchanges, he won’t be able to shirk the responsibility for participating in the Medicaid expansion,” said Leader Fitzhugh. “If we don’t participate in the new Medicaid program, we’ll be leaving $10.5 billion in federal dollars on the table. Punting on this issue would hurt Tennessee businesses, working families, and rural hospitals.”