Haslam Fence-Sitting on Exchanges Until Final Hours

Governor Bill Haslam and TennCare director Darin Gordon talk to reporters after budget hearings Tuesday. Photo credit Blake Farmer/WPLN

Tennessee 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. 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.”

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.

More than $900 million of that unavoidable cost will be needed just to cover those already poor enough for TennCare but who haven’t signed up – a phenomenon known as the “woodwork effect.”