Stating he “shared frustration” over uncertainties about how Tennessee will implement portions of the Affordable Care Act, Gov. Bill Haslam announced Friday he would accept a federal deadline extension and continue to consider the possible creation of a state-run health insurance exchange.

The announcement came on the day originally slated by the Department of Health and Human Services for undecided states to make their intentions known.Late Thursday, department Secretary Kathleen Sebilius announced that the deadline for undecided states would be extended an additional month to Dec. 14.

Attending a National Republican Governors Conference in Las Vegas, Haslam said he hoped to gain a “full picture” in the coming weeks of what the implications would be for the state to create its own online clearinghouse for health insurance purchases, an item which has divided state Republicans. Haslam added that he continued to maintain his opposition to President Barack Obama’s signature policy but had been left to adhere to provisions marked by the law after it was upheld in a U.S. Supreme Court ruling this summer.

“I understand there is a lot of passion and uncertainty about the health care law, and I share that frustration,” Haslam said. “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.”


Thursday’s postponement of the federal deadline came after Virginia Gov. Bob McDonnell, chairman of the National Republican Governors Association, requested that the deadline be extended. Many GOP governors, including Haslam, had deferred making a decision on the exchange portion of the law, as presidential candidate Mitt Romney had committed to work toward the law’s repeal if he had been elected to a term in the White House last week.

This week, Haslam heard from state officials in budget hearings regarding the impact of the exchange program, along with other items of the new law.

During a budget hearing Tuesday, TennCare Chief Darin Gordon told Haslam that the cost of setting up a state-run exchange could range between $20 and $40 million a year and that the costs of accepting a federally controlled exchange and deciding later to switch to a state-run system could cost the state in excess of $90 million. If states opt to run their own exchanges, the federal government has agreed to fund the first three years of an exchange program.

Haslam also heard this week that implementing the health care law in Tennessee is expected to cost approximately $1.4 billion in the first five and a half years. Extending state Medicaid provisions under the law are expected to cost Tennessee nearly $200 million through 2019.

Shortly before Haslam announced his decision to wait, the Tennessee Democratic Party issued a statement urging him to make a decision. House Democratic Leader Craig Fitzhugh said the governor had had “ample time” to consider his decision on exchanges since being elected to office in 2010.

The governor has had ample time to decide whether or not he wants to establish a Tennessee plan for a health insurance exchange,” Fitzhugh said. “Now is not the time for more delays; now is the time to create an open process that brings all interested parties to the table, Democrats, Republicans, consumer advocates, insurance companies, small businesses and others, to start deciding what this Tennessee health insurance exchange will look like.”

Haslam will have to indicate his decision before Dec. 14.