Let's face it. Tennesseans don't like Obamacare.
They heard the promises; they saw them broken. They couldn't keep their insurance plan. They couldn't keep their doctor. Their insurance premiums did rise. Boy, did they.
Anything that smacked of the president's health plan, they didn't want. So when Gov. Bill Haslam's plan to access federal Medicaid dollars was announced in December, despite the hard work that was done to make it Tennessee specific, to allow some workers to join their workplace plans, to require from others the personal responsibility people say insurees should have, they weren't buying.
It took 21 months for the governor and his administration to put the Insure Tennessee plan together. It took less than three days for the General Assembly -- in a specially called session -- to tear it apart when a 7-4 vote went against the plan in the Senate's special Health and Welfare Committee Wednesday.
With the federal government, there are no guarantees and a lot of broken promises, but Haslam had tried to cross the t's and dot the i's ahead of what was supposed to be a weeklong special session.
No Tennessee taxpayer money would have been used for the pilot program. The state could have quit the program after two years if it proved to be unworkable. If the plan was continued, hospitals would have made up any difference when federal dollars decreased after the first two years.
In the end, some legislators said, they couldn't trust the feds. They couldn't trust that federal officials would let them out of the deal, if necessary, after two years. They couldn't trust that federal coverage requirements wouldn't become more and more onerous. They couldn't trust the federal Medicaid dollars to flow like the government said they would.
State Sen. Todd Gardenhire, one of three area "no" votes of the seven, was not one of those.
"I don't know if it was any one thing," he said.
Gardenhire, who said he did his own homework on the plan complete with spreadsheets, said the growth of Medicaid was "out of whack." While the state population grew 20 percent in the last roughly 45 years, Medicaid spending in the state grew 200 percent, he said. Going forward, even with Insure Tennessee, that seemed unsustainable.
He also said Haslam, "one of the most honest people I've ever seen," couldn't answer definitively on the state's exit strategy if Insure Tennessee didn't work and couldn't tell him what would happen if the matrix around which the plan was built failed. In addition, he said the governor needed more than a verbal commitment from the federal government on parts of the plan.
"I wanted specifics," Gardenhire said. "It kept adding up and adding up. But my mind was not made up until Monday."
The state senator's suspicion, and that of the other six members who voted against the plan, was well placed, but we believe the long-researched, carefully crafted plan was worth at least a two-year shot.
Certainly, the 280,000 Tennesseans who could have been covered by the plan must have thought so. But, instead, they'll soldier on, unable to afford a high-cost plan on their own, unable to be covered by the president's Affordable Care Act (flawed as it is) and hoping not to get sick.
They are only one concern. Another is hospital emergency rooms, which will continue to be overcrowded as the wasteful go-to place of first-line care for those without insurance. Still another is the hospitals themselves, which must now absorb some of the costs of that care without compensation. Some rural hospitals, unable to afford such absorption, could close.
It may be that all is not lost, though. Gardenhire believes it's a possibility Haslam might be willing to sit down with legislators, hear what they liked about the plan and what they didn't and submit a new plan to the Obama administration.
"[The administration needs] you more than you need them," he said James Blumstein, a Vanderbilt professor and adviser for former Democratic Gov. Phil Bredesen, told them Monday.
Some legislators said the bill might have passed had it emerged from committees, and it certainly would have had a more complete airing, but that matters little now. Now, the specific bill can't be brought up again in the 109th General Assembly, a Knoxville House member said.
But Senate and House members surely owe the uninsured Tennesseans and the governor, who was doing what the legislature asked him to do in creating and massaging a plan with Obama administration officials, due diligence to see what can be done when the regular legislative session starts Monday.
Ultimately, a plan that would affect 280,000 Tennesseans came down to a vote of seven members of one committee, which also included Sen. Mike Bell, R-Riceville, and Sen. Janice Bowling, R-Tullahoma.
Many constituents of those seven senators don't like what came down the pike as Obamacare and may have told them so. But it's disappointing the plan didn't get wider discussion before a final decision was made.