Tea party pressures Tennessee Gov. Bill Haslam

photo Protesters participate in a tea party rally in Nashville on Wednesday to oppose Tennessee creating a state-run insurance exchange under the federal health care law. Republican Gov. Bill Haslam has said he wants to have a more complete understanding of the costs to the states of a state-run marketplace compared with one run by the federal government.

NASHVILLE - Tea party activists pressured Republican Gov. Bill Haslam on Wednesday to stand against creating a state-run health insurance exchange under the federal Affordable Care Act health reform law.

Some 300 activists, conservative talk radio hosts and several GOP legislators attended the rally outside the state Capitol.

Speakers and attendees attacked the health care law and some bluntly put Haslam on notice that he'll pay a political penalty if he proceeds. The insurance exchange is an online marketplace where low-income Tennesseans can find health coverage.

"If Gov. Bill Haslam cannot say no, then it's time to get another governor," Carl Boyd Jr., a Nashville radio host, told the cheering crowd.

Tennessee is one of only 10 states that hasn't decided whether to create a state-run exchange or cede it to the federal government. The decision deadline is Dec. 14. Georgia and Alabama have decided not to create exchanges.

Haslam has said that while he doesn't like "Obamacare," he is considering setting up a state exchange that he believes will cost less and provide better service than a federal program.

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He once told radio host Phil Valentine that he had hoped the U.S. Supreme Court would overturn the 2010 law or that Republican presidential nominee Mitt Romney would win. Neither of those things happened.

"It's a decision that's the lesser of two evils," Haslam said of a state-run exchange. "It's not a win-win. It's a lose-lose. We're working hard in Tennessee to come to the best possible answer, although there's not a good solution."

He said he's concerned whether a Tennessee-run exchange would have flexibility about coverage and eligibility.

For example, Haslam said, people who don't smoke and live healthy lifestyles should be eligible for lower premiums.

The governor also said he doesn't think the Obama administration is really "prepared for this whole thing" to take effect in 2014.

"The phrase 'they're making it up as they go' has never been more true," Haslam said. Earlier this week, he complained that his administration received some 300-plus pages of long-sought guidance just last week.

Chattanooga Tea Party leader Mark West attended the rally and urged Haslam to "say no to Obamacare and push the whole burden back on the feds."

"Our perspective is if Obamacare is such a great thing, let the feds implement it instead of forcing it on the states," he said.

The idea of a state-run exchange is "a joke" because the federal government really will be in control, West said

"We'd like him [Haslam] to stand up like approximately 20 other governors across the U.S. who've said no to Obamacare and a state-funded health care exchange," West said. "So far, though, it would appear that he's vacillating or leaning in the direction of implementing it."

Sentiment against the exchange runs high with at least some Republican legislators.

House Majority Leader Gerald McCormick, R-Chattanooga, has been highly skeptical about the feasibility of the health care overhaul generally. McCormick also believes that approval for a state exchange would face a tough time in the GOP-led Legislature.

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