Tennessee Gov. Bill Haslam speaks at Pellissippi State Community College on Jan. 9, 2015, in Knoxville.

NASHVILLE -- Tennessee lawmakers can expect fights over Republican Gov. Bill Haslam's Medicaid expansion proposal as well as state education standards, abortion and possibly a gas tax hike during their annual session that starts this week.

The new session begins at noon Tuesday, when the 99 House representatives and 33 senators serving in the 109th General Assembly will officially convene.

But with the exception of a planned "Women's March" on Tuesday by opponents of proposed new state abortion restrictions, don't go expecting a lot of legislative activity this week. Or even the rest of this month.

The real action will begin Feb. 2 with a special session in which Haslam will seek approval for his "market-driven" approach to Medicaid expansion.

It would affect some 200,000 adult Tennesseans and already has some Republicans in the GOP-dominated Legislature rebelling.

This week's gathering is devoted to organization. Newly elected members will take their oaths of office, elect the House and Senate speakers, attend lobby group receptions, undergo mandatory ethics training and possibly get their committee assignments by week's end.

And then on Saturday they'll depart for a two-week break. While they're gone, legal staff will begin processing the hundreds of bills members are expected to introduce, and offices will be set up for 16 freshman House representatives and five freshman senators elected in November.

Insure Tennessee on the table

Haslam calls his Insure Tennessee proposal, a two-year pilot project, his "market-driven" take on Medicaid expansion.

It would use federal Medicaid funds to extend health care coverage to lower-income singles or families earning less than 138 percent of the federal poverty level -- $16,105 for an individual and $32,913 for a family of four.

"It's obviously a controversial topic when you start talking about Medicaid," Haslam acknowledged to reporters last year. "There are people who have philosophical questions and financial questions."

But, Haslam added, "I honestly think this is the right approach for the state of Tennessee that won't cost Tennessee taxpayers any money, puts us on the right path toward having the right kind of health care system and provides health care coverage to people who need it."

The program would be 100 percent federally funded until the end of 2016 under the Affordable Care Act. Federal support would ebb over the next three years to 90 percent by 2020, with the state kicking in 10 percent.

Tennessee hospitals have pledged to pay that share by raising the amount of a voluntary assessment fee that already provides money for TennCare, the state's version of Medicaid.

Current state Senate Speaker Ron Ramsey and House Speaker Beth Harwell say the proposal looks good on the surface. It includes a voucher program allowing workers to buy into employers' health coverage. Others would go into a redesigned TennCare program with incentives for healthy behavior and modest premiums and co-pays.

Still, the governor acknowledges he will need minority Democrats' help in passing it.

Senate Speaker Pro Tem Bo Watson, R-Hixson, told Times Free Press editors and reporters last week that he remains undecided.

"The challenge is what does this look like in 20, 25 years?" said Watson, asking, among other things, whether the plan does enough to discourage abuse of services.

Rep. JoAnne Favors, D-Chattanooga, said she hopes to support it but added she's "anxious to see the specifics."

Feuding GOP 'supermajority'

Though the Medicaid proposal may be in the center ring, there'll be plenty of other acts.

Groups from across the state plan to rally against proposed abortion restrictions being introduced in the Legislature after voters in November amended the state constitution to eliminate abortion protections.

"Hundreds of people from across Tennessee will come together to send a loud and strong message to our lawmakers that we are watching and ready to take action against any laws that restrict our individual rights and threaten the health of Tennesseans," Healthy and Free Tennessee, one of the participating groups, said in a statement.

Haslam, Ramsey and Harwell, along with Tennessee Right to Life, which spearheaded support for the amendment, have said they hope to keep pro-life lawmakers focused on just three areas that were struck down in a 2000 Tennessee Supreme Court decision. Those are informed consent or mandatory counseling, waiting periods, and regulation of all abortion providers.

Going beyond those areas runs the risk of being sued in federal court, they warn.

Undeterred, some lawmakers already have introduced bills. Rep. Rick Womick, R-Rockvale, would require pregnant women seeking abortions to watch an ultrasound of the fetus or listen to the doctor or technician describe the fetus's development.

In December, Womick challenged Harwell for the powerful speaker's position. He lost resoundingly, but it was an example of the tensions in the 73-strong GOP supermajority between its tea party faction and establishment and other Republicans.

Ramsey, who is more closely aligned with GOP hardliners, faced no leadership challenge. Neither speaker is expected to be challenged on the floor Tuesday.

Fight over education standards

Another area of friction lies in education standards. Last year, House tea party Republicans and Democrats rebelled over Common Core standards supported by Haslam and his then-Education Commissioner Kevin Huffman and adopted by most states.

The unlikely coalition, acting for different reasons, forced a one-year delay in implementation of testing. GOP hardliners, who dislike President Barack Obama's embrace of Common Core, want something with a more distinctly Tennessee flavor.

Haslam has been reviewing the standards and looking for a solution. Huffman, meanwhile, announced he's leaving.

Gas tax increase?

Haslam and his transportation commissioner, John Schroer, are warning that Tennessee will have to do something soon to pump up funding for road and bridge maintenance and construction. With most projects funded from fuel taxes, less driving, more fuel efficiency and congressional gridlock are creating a funding crisis.

The last hike in gas and diesel taxes was nearly 26 years ago. The tax is currently 21.4 cents and 17.4 cents per gallon, respectively.

There's talk of raising the per-gallon tax, indexing taxes to fuel prices, raising vehicle registration fees and creating mileage charges.

Haslam says he doesn't want a short-term solution and he's not sure he will press for any action this year. But a powerful new group calling itself the Transportation Coalition of Tennessee announced Friday that it's jumping in to push the funding issue. It includes road builders, truckers, city and county governments and others.

The governor has said he also is determined to get through his second term without raising the state's 7 percent sales tax, which funds general government, and that he'll oppose a move by fellow Republicans to eliminate Tennessee's Hall income tax on dividend and interest income.

"It [sales tax reliance] definitely leaves you limited options," Haslam said during an interview last year. "It's one of the reasons I've been concerned when people have proposed cutting other taxes."

Contact staff writer Andy Sher at or 615-255-0550.