Gov. Haslam has been in negotiations with the feds over a waiver that would allow the state to design its own program in a two year pilot that would have to be reauthorized While this probably won't be as effective or efficient as regular Medicaid, it would still be a huge positive step.
There have been some interesting allies in this that may prove instructive for advocates in other conservative states. The Nashville Chamber of Commerce reportedly says that the expansion is a top priority. That's not necessarily as strange as it sounds. The Montana Budget and Policy Center has compiled a list of several state and regional chambers that support expansion.
That's largely because it's a good deal and not doing it is not just spiteful and mean but expensive. Last month, the NY Times an advocate for expansion in Tennessee who said that
some of the nation’s largest for-profit hospital chains, including Hospital Corporation of America and Community Health Systems, have headquarters in Tennessee and have watched the amount they spend on uncompensated care drop this year in states that expanded Medicaid while it has risen in states like Tennessee. “When they run the numbers, it’s dramatic,” she said.I hope it happens and keeps on happening.