The report says that federal money would result in additional production of goods and services valued at $17.6 billion and wages, salaries and benefits worth $7.9 billion. The study calculates there would be a nearly $30 return for every state dollar spent on expanding Medicaid.
But skeptics have cited the state's experience as a pioneer in expanding Medicaid to cover the uninsured back in the 1990s. Federal funding for that expansion was cut after the White House and governorship changed hands and ballooning expenses set off incendiary fights over taxes that reshaped the state's political landscape.
Haslam's predecessor, Democrat Phil Bredesen, in 2005 cut 170,000 adults from the TennCare rolls and reduce benefits to thousands more. It was an acknowledgment that the state had given up on expanding Medicaid and would revert toward the traditional approach of covering only poor women and children.
Haslam has said he has been pouring over the deals struck by other Republican governors who have decided to pursue Medicaid expansion, and said would want maximum flexibility for Tennessee under an expansion.
The governor vowed not to be swayed by political considerations, though his previous decisions not to pursue either a state-run health insurance exchange or a joint one with the federal government hewed closely to the ideological preferences of federal Republicans in the Legislature.
"You're elected to try to make the hard decisions on the big issues," Haslam said. "And there's no question that health care is as big an issue facing Tennessee and the country as there is."
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