Tennessee Governor Bill Haslam made a decision that could affect healthcare for thousands of Tennesseans.
Haslam rejected the Obama administration's expanded Medicaid coverage plan for covering the uninsured, but he went one step further and proposed another option for health care coverage and Tennessee's Medicaid plan called TennCare.
Just like TennCare expansion, Haslam's plan would be funded by federal dollars, but it would use those federal dollars to buy private insurance for uninsured Tennesseans.
The key is getting the federal government to allow this which is why the reaction is cautiously optimistic.
Saundra Kelley is one of thousands in Tennessee she said has fallen through the cracks; unable to qualify for TennCare. She's been without health insurance for about 25 years.
"I had to do things on my own and that's not easy," said Kelley.
Kelley told us after the passage of President Obama's Affordable Care Act, she was hopeful TennCare would be expanded to all Tennesseans who needed it.
But Governor Bill Haslam said that wouldn't be the case, citing strict rules and regulations for Medicaid programs like TennCare as costly and inefficient.
"Instead of insuring more people through an inherently flawed system, we hope to purchase private insurance for as many as 175,000 more Tennesseans," Haslam told lawmakers on Wednesday in Nashville.
It's a twinge of hope for people like Kelley. But with a plan hinging on approval from the federal government, there's concern.
"I would prefer that he went with what has been offered through the government, I really do. I'd feel a lot more secure. I feel like this is taking us out on thin ice," Kelley said.
We found out, there's a similar feeling of uncertainty with local health care providers like Mountain States Health Alliance.
It's already looking at half-a-billion dollars in funding cuts to support federal health exchanges. So if Washington says no to Haslam's plan, there could be a costly issue.
"In that scenario, people don't get coverage. All the cuts that happen to help fund the coverage, we're left having to do things to result in less jobs in healthcare," said Marvin Eichorn, Cheif Financial Officer for Mountain States Health Alliance.
Eichorn said he's hopeful for the best, because, if approved, it means compensation.
"We're fine with it [Haslam's plan]. You get to the same place in the end of the day," said Eichorn.
It would also mean coverage for those who need it.
"We've all got to have healthcare. It is America after all," said Kelley.
More facts on Governor Haslam's plan:
It would allow co-pays for people who can afford to pay something.
Even if the federal government won't approve the plan, Haslam said he will not ask the General Assembly to accept any Medicaid expansion funds.