While Gov. Haslam weighs the state-or-federal insurance option, GOP lawmakers aren't giving ground on ObamaCare

Merely the idea that Republican Gov. Bill Haslam would think about managing Tennessee's version of ObamaCare's health insurance exchange has caused much of his party to revolt.

Senate Judiciary Committee chair Mae Beavers (R-Mt. Juliet) is so upset she's siding with tea partiers signing petitions for states to secede (see the related story), and Christian Right leader David Fowler has issued the call to arms.

"When our liberty was threatened in the War of 1812, so many Tennesseans volunteered to fight that we earned our nickname, the Volunteer State," Fowler wrote in an online message to supporters. "Once again our liberty is threatened, this time by our own, out-of-control federal government. It's time for Tennesseans, through their state officials, to live up to our nickname. The battle starts now."

The insurance exchange — though essential to the Affordable Care Act's operation — is nothing more sinister than an online marketplace, a kind of Expedia.com for ObamaCare where consumers can shop for private insurance and learn whether they are eligible for federal subsidies or for Medicaid, the government program for the poor.

But Republican opposition is so intense that last week the governor felt compelled to issue a statement explaining himself in the probably futile hope of calming the protests.

"Let me be clear, I oppose the Affordable Care Act. I joined with other Republican governors earlier this year to fight the law," Haslam said. "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."

The governor has said he's leaning toward state control. Haslam contends the alternative — letting the federal government do it for Tennessee — could result in higher administrative costs and higher premiums for consumers. That argument is based on the belief, popular with state-level politicians, that states can do any job more efficiently than the federal government.

Most experts say it shouldn't matter much who's managing the exchanges. But they do need to run smoothly, and at a minimum, that will take some coordination between state and federal governments. If states are recalcitrant and uncooperative, for instance, that could throw up roadblocks for consumers who learn via the exchanges that they are eligible for Medicaid.

Friday had been the deadline for the nation's governors to decide. Health and Human Services Secretary Kathleen Sebelius, recognizing states weren't ready to declare their intentions, extended the deadline to Dec. 14.

At least 10 states already have chosen to let the federal government do it. Haslam is among a handful of governors who say they will take the extra time to think about it.

Republican governors around the country are surprised they have to deal with ObamaCare at all. They initially thought the Supreme Court would overturn the law. Then they expected Mitt Romney to win the White House and repeal it. In state budget hearings last week, Haslam all but admitted he needed to cram for his decision like an unprepared college student pulling an overnighter for an exam.

"I read more about exchanges over the weekend than I ever want to read about anything again," he said.

Democrats in the legislature have urged the governor to agree to state management and to tailor the exchange to match the needs of Tennessee's consumers with the state's insurance companies. House Democratic leader Craig Fitzhugh says Haslam "has had ample time to decide."

But even if Haslam does agree, he'll eventually need the approval of the GOP-dominated legislature, and there seem to be few, if any, Republicans who are for it.

The exchanges are supposed to be up and running by October to let consumers start shopping. Americans are required to have insurance under the law by January 2014.

State Senate Government Operations Committee chair Mike Bell (R-Riceville) says he's holding out hope that state resistance around the country could kill ObamaCare.

"The very weight of the responsibility for setting up that bureaucracy to run 20 or 30 state exchanges will be so heavy the federal government won't be able to do it," he told Tennessee Report. "I hold out hope — now, it's a faint hope, but I hold out hope — that there's something that still could stop this."

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