At the end of August, Pennsylvania became the 27th state, along with the District of Columbia, to expand Medicaid coverage to low-income individuals who fall in the gap between current Medicaid enrollment requirements and the subsidies available through the federal insurance marketplace.

Might Tennessee become the 28th? Although too soon to jump to that conclusion, Gov. Bill Haslam is again talking about the possibility and looking at options that will appease both the Centers for Medicare & Medicaid Services and the Republican-led Tennessee Legislature ... a task he once called "trying to thread a needle from 80 yards."

With new HHS Secretary Sylvia Mathews Burwell in place and more perspective on alternative plans approved or disapproved by CMS, Haslam is ready to resume negotiations on the Tennessee Plan. Perhaps the new insights make it feel like he's trying to thread that needle from a mere 40 yards away.

For more on this story, please access coverage in our sister publication the Nashville Post here.

For more information on the Pennsylvania plan, click here for an analysis from The Advisory Board Company.