Chattanooga area legislators said they've heard tell of a health plan in which it was proclaimed "we have to pass the bill so that you can find out what is in it," and they don't want any of that.
So, please pardon them, they said, if they're not ready to embrace, with a ring and a date, Tennessee Gov. Bill Haslam's Insure Tennessee plan.
The two-year pilot plan, announced just a month ago with few details, would offer two private market choices for health care for state residents who currently don't have access to health insurance or have limited options. It is expected to be revenue neutral for the state since the Tennessee Hospital Association has committed that its members would make up any money the federal government doesn't pay.
The legislators give the Republican governor props for insisting Washington, D.C., not handle expanding Medicaid in the state under the Affordable Care Act, for attempting to create something unique to Tennessee and for offering a plan that even attempts to address health care costs and promotes personal responsibility.
"We haven't seen the details," said state Sen. Todd Gardenhire during a meeting with Times Free Press editors and reporters last week. "I couldn't support it until I've read it."
"Is this a better way?" questioned state Rep. Mike Carter, R-Ooltewah. "We have no idea how this will work. I'm open-minded about the concept if it works."
"I trust the governor, yes," said Rep. Marc Gravitt, R-East Ridge. "The federal government," which would initially fund Insure Tennessee, "I don't know." The funding would be 100 percent, then 90 percent, "then who knows."
Even Rep. JoAnne Favors, D-Chattanooga, who said she was "a staunch supporter of [Medicaid] expansion," was reticent.
"I can't give it 100 percent support until I see [the specifics]," she said.
Sen. Bo Watson said the local legislators' feelings "reflect where most members [of the General Assembly] are" because "they are fairly deliberative."
What worries many of them, he said, are "the long-term ramifications. What does it look like in 20 to 25 years?"
Several things are already known, Watson said. The state must pass a balanced budget every year. The cost of health care continues to go up, takes up more and more of the state budget, and the Affordable Care Act does nothing to control the cost of health care.
As time goes on, with the federal government funding at best uncertain, the cost to the state could be unsustainable, he said.
It's "not an economic model that works," Watson said. "People are getting more stuff, but fewer people are working to pay for it."
In September, for instance, despite the meager economic recovery that had occurred since the advent of the Great Recession, America's labor force participation rate fell to a three-decade low of 62.7 percent. And the percentage of Americans receiving benefits (which, granted, includes Social Security), likely has increased to more than half of the population. It had reached 49.2 percent in 2011, well before sign-ups for the Affordable Care Act began.
And, of those receiving some type of federal benefit, 35.4 percent were receiving support from one or more federally funded welfare programs in the most recent measurement available.
Gov. Haslam is expected to call for a special session of the General Assembly beginning in early February to discuss Insure Tennessee, but Chattanooga area legislators weren't sure a week would be enough to hear all of the details, discuss them and come to a definitive vote.
Complicating that is the United States Supreme Court's scheduled hearing of a case challenging a part of the Affordable Care Act in late March. Since a ruling on that case, which deals with tax credits for people who purchase health insurance through the Affordable Care Act exchanges, would not come until June, a newly passed health care law in the state could become moot with the decision.
Even without seeing the details, though, the Coalition for a Healthy Tennessee -- which includes, among others, the Chattanooga Area Chamber of Commerce, the Tennessee Hospital Association, Blue Cross Blue Shield of Tennessee and Memorial Health Care -- is on board.
"Why would we not try something that's free?" said Blue Cross Chief Executive Officer Bill Gracey. "It seems like a no-brainer."
He said although the coalition doesn't know details of the plan, because it knows its structure, "I can't imagine a situation that would be problematic." Of what he knows, it's "like the doctor would have ordered it."
That's all understandable, but the legislators -- also understandably -- kept returning to the "devil in the details" of the plan. They all acknowledge the need for the care and applaud the effort but aren't ready to subject the state to something that hasn't been thoroughly vetted.
On that, then, they should proceed -- as an elderly family member once described her steps -- "slow but sure."