Gov. Bill Haslam of Tennessee describes it as "trying to thread a needle from 80 yards." Mr. Haslam is only the latest Republican tailor trying to figure out whether to expand the state's Medicaid rolls as prescribed by President Obama's Affordable Care Act. In his case, it involves trying -- so far unsuccessfully -- to balance some sharply conflicting concerns: struggling hospitals, local business groups, dwindling state resources and fierce conservative opposition to the new health care law. And it has left him hanging out there, with no resolution in sight (Lyman, 11/16).