The matter of pressing importance is a decision: Will Tennessee operate its own health insurance exchange under the Affordable Care Act or leave it to the federal government? Gov. Bill Haslam and a few other Republican governors seem to be balking.
The feds have extended the deadline until Dec. 14, but in the additional time given them so far, Haslam and the group of governors have seen fit to send a list of questions to the White House that could have been asked more than a year ago.
Under the exchanges, residents of a state will have a means of buying private coverage by choosing from a wide range of health-insurance plans. The idea became a part of the Affordable Care Act based on the success of individual exchanges in a handful of states, including Utah.
Health care companies, particularly in Nashville, a national hub for the health care industry, have been preparing since the bill became law in 2010. And 23 states plus the District of Columbia already have notified the federal government that they will run their own health exchanges, while 15 states say they will let the feds run their exchanges. That leaves 12, including Tennessee, that cannot seem to make up their mind.
As of Jan. 1, 2014, health insurance exchanges will be in operation nationwide. Unless Gov. Haslam and the General Assembly face reality soon, they will be ceding all authority to Washington.
Tennessee Republicans speak much of too much centralized federal control, but maybe, deep down, they are federalists.