Sen. Lamar Alexander, R-Tenn., has made the case for bipartisanship to "get results," citing several recently-passed bills he has sponsored.
But when it comes to implementing the Affordable Care Act or stabilizing its rocky rollout, Democrats are on their own, the senator told a group of Times Free Press reporters and editors.
Alexander was blunt when asked if Republicans would accept the ACA as the "law of the land," especially now that key parts are in effect:
"Not this law," he said. "If you want legislators and Americans to own a law, they need to have a role in forming it."
Alexander is among most GOP leaders who have plenty to criticize about the law's problem-riddled launch, but still push repeal over reform -- even though repeal is virtually impossible during the remainder of President Barack Obama's term.
The only reform Republicans have so far endorsed are several bills to allow people to keep canceled policies indefinitely, and in some cases, allow insurance companies to keep selling plans noncompliant with the ACA.
Alexander is a co-sponsor of one of those bills, despite his own concern that such a law -- or the president's recent decision to extend those policies for one year -- could have an unbalancing effect on the market, he said.
The senator said he's willing to see divergent insurance markets emerge, he said, so long as it takes health reform "in a different direction" as election season nears.
"Perhaps there will be a Republican majority in the Senate, and the president will realize he has made some mistakes," he said. "Perhaps we'll have a Republican president in a few years and we can make some bigger changes."
Tennessee health insurance plans considered dead under the Affordable Care Act may be revived for another year.
Tennessee Gov. Bill Haslam announced Tuesday that the state will allow insurance companies to extend health insurance policies canceled under the Affordable Care Act for one year.
The decision comes five days after President Barack Obama unexpectedly announced last week that health insurers could extend plans facing cancellation because they do not cover health benefits deemed essential under the new law.
The president has faced heavy criticism for the fact that millions of health insurance policies were canceled across the country despite his assurances that Americans could keep their plans if they liked them.
About 66,000 Tennesseans faced canceled policies from BlueCross BlueShield of Tennessee alone, but BlueCross says it plans to extend those policies now that the state has given the green light.
"Tennesseans should be able to keep the health care coverage that they were promised they could keep," Haslam said in a news release.
The state's Department of Commerce and Insurance Commissioner Julie Mix McPeak recommended the extensions after getting input from insurance carriers and Tennesseans with canceled policies.
Ultimately it will be up to insurance companies to decide whether it is "feasible" to extend already canceled policies or point consumers to new options, McPeak said.
BlueCross, the state's biggest insurance carrier, said last week it intended to extend the plans if the state agreed to the president's decision.
"We're committed to providing choice for our members and this allows us to do that for those members who would have been affected," spokesman Gary Tanner said Tuesday.
BlueCross is still working out specifics of implementing the extensions, Tanner said. It could take a few weeks before customers receive updates.
In Georgia, Insurance Commissioner Ralph Hudgens -- a vocal critic of Obamacare -- left the decision whether to extend the noncompliant policies in the hands of insurance companies.
Some insurance regulators and companies have expressed worry about the sudden change, saying it throws a massive wrench into the newly-created infrastructure for health insurance and could affect future premiums.
The president of insurance trade association America's Health Insurance Plans' Karen Ignagni issued a statement Thursday criticizing the president's sudden about-face.
"Changing the rules after health plans have already met the requirements of the law could destabilize the market and result in higher premiums for consumers," Ignagni said. "Premiums have already been set for next year based on an assumption of when consumers will be transitioning to the new marketplace."
Contact staff writer Kate Harrison at firstname.lastname@example.org or 423-757-6673.