A plan to provide health care to some low-income Tennesseans seems to be gathering support among lawmakers, voters, and business leaders, as the GOP Medicaid expansion alternative is designed as an economic stimulus for the state.

Gov. Bill Haslam (R) recently unveiled his long awaited alternative to expanding Medicaid through the Affordable Care Act. While there has been some debate about the cost and efficiency of the expansion effort, Haslam says the two-year pilot program has tentative approval of federal officials.

Tennessee is one of 22 states that have not expanded Medicaid under the ACA, and one of seven states in which state lawmakers are discussing expanding Medicaid in some form, according to the Kaiser Family Foundation.

The Tennessee legislature, controlled by Republicans who have long opposed expanding health-care access, passed a law last year that prohibits the governor from expanding Medicaid under the Affordable Care Act through executive action, unless it is authorized by joint resolution of the general assembly.

Haslam has promoted his plan as a Republican alternative to President Obama’s signature health-care reform law.

“I think it really does lay out a pathway. … I think it really does go a long way toward reforming the health care system,” Haslam said, according to the Memphis News. “I think a lot of Republicans are saying we want our chance to do health care the way we want to. I would say this is the first step that we would take.”

Lawmakers will debate the governor’s proposal during a special legislative session that has been called by Haslam, set to begin on February 2. Haslam will address a joint session of the general assembly that same evening.

Officially known as Insure Tennessee, the governor’s proposed plan would provide coverage to more than 200,000 uninsured Tennesseans earning less than 138 percent of the federal poverty level, or about $16,000 a year for an individual and $27,000 for a family of three.

Insure Tennessee is divided into two separate plans: the Volunteer Plan and the Health Incentives Plan. The Volunteer Plan would use federal Medicaid dollars to assist low-income residents, who are employed and qualify for Medicaid, to buy private coverage through their employer. Instead of having their health insurance premium deducted from their paycheck, the state will pick up the cost.

The Health Incentives Plan essentially privatizes the state’s Medicaid program. The plan would add co-payments and premiums for low-income residents who qualify. There would be payment exemptions for the lowest-income residents and caps on spending per enrollee.

Several studies and reports have documented the consequences of states that have chosen not to expand Medicaid. Under the ACA, the federal government covers the full cost of the expansion for the first three years, and 90 percent of the cost in subsequent years.

Haslam’s plan would create 15,000 jobs and bring $1.14 billion in new spending to the state, according to a University of Tennessee study. An estimated 200,000 of the 470,000 eligible Tennesseans would participate in Haslam’s proposed version of Medicaid expansion.

The study, conducted by UT’s Center for Business and Economic Research, was commissioned by the Coalition for a Healthy Tennessee, a non-profit organization that advocates for Medicaid expansion in the state.

The impact on the state’s budget and economy appear to be convincing some business leaders and lawmakers to support Haslam’s plan.

Bobby Arnold, president of West Tennessee Healthcare, and Kyle Spurgeon, president of the Jackson Chamber of Commerce, both expressed support for the governor’s plan during a meeting with the Jackson Sun’s editorial board.

Arnold told the Sun that the expansion is not about endorsing the ACA, but is about access to health care, which creates a healthier population and workforce. “You can get immersed real quickly, but the best place to start is, do we want a healthy community or not?” Arnold reportedly said.

Bill Gracey, president and CEO of BlueCross BlueShield of Tennessee, and Charlie Howorth, executive director of the Tennessee Business Roundtable, wrote a joint op-ed in support of Haslam’s plan for the Nashville Tennessean.

The “plan will improve the health of Tennessee, directly benefiting the health of our rural and urban community workforces and the economy,” Gracey and Howorth wrote.

The Shelby County Board of Commissioners, which includes some vocal Republican critics of the ACA, endorsed Haslam’s proposal for an alternative Medicaid expansion. By a vote of 12-0, the commissioners passed a resolution to support Insure Tennessee, according to reporting by the Memphis News.

Commissioner Terry Roland, who authored the resolution, said the decision was politically difficult, but without some form of Medicaid expansion, the economic impact on local hospitals would force county commissioners to consider raising property taxes.

The resolution stated that Haslam’s plan is laying “the foundation for reform by addressing the underlying quality and outcome deficiencies that contribute to growing health care costs and unaffordable insurance coverage.”

There remain Republican lawmakers in Tennessee virulently opposed to expanding Medicaid.

“We must learn from our past, reject Obamacare and protect Tennessee taxpayers from the same liberal policies that have previously failed our state,” Rep. Jeremy Durham (R-Franklin) wrote in an op-ed published by the Tennessean.

State Sen. Randy McNally (R-Oak Ridge), chair of the Senate Finance Committee, sent a letter to the state attorney general questioning the legality of Haslam’s plan, according to the Knoxville News Sentinel.

At least one Republican lawmaker appears to be evolving on the issue. Lt. Governor Ron Ramsey (R), who also serves as the speaker of the state senate, initially opposed Haslam’s plan. However, he recently modified his position on the issue.

“I think if the governor can truly revamp the way our Medicaid is run and TennCare is run, then I think he may be able to sell that to the legislature. But I don’t think the Obama administration is ever going to go along with this, I just don’t,” Ramsey told reporters, according to the Tennessean.