NASHVILLE (AP) - Reactions to the defeat of Republican Gov. Bill Haslam's Insure Tennessee to extend health coverage to 280,000 low-income residents:

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"We still have health care cost issues that haven't gone away, so I don't know what the next step looks like. But I think people elected us to answer problems and to come here to make a difference. And we've got to figure out a way to do that." - Gov. Bill Haslam.

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"Ultimately, the absence of a clear, written agreement between the federal government and the State of Tennessee made passage impossible. ... We could not in good conscience put our stamp of approval on a mere verbal agreement with the Obama administration." - Lt. Gov. Ron Ramsey, R-Blountville.

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"The failure of Lt. Gov. Ramsey and Speaker Harwell to exhibit leadership in the face of partisan politics means over a quarter of a million hard working Tennesseans will continue to go without critical hea lth care." - State Democratic Party Chairwoman Mary Mancini.

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"I anticipate the Governor will continue offering ideas for reform and the Legislature will continue working with him to make Tennessee a leading state for conservative innovation." -State Republican Party Chairman Chris Devaney.

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"When 280,000 Tennesseans are just hours away from getting insurance, Republicans get cold feet and walk away. This is an insult to Governor Haslam, a betrayal of our constituents and proves that Republicans are totally incapable of governing." - House Minority Leader Craig Fitzhugh, D-Ripley.

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"Tennesseans will die and hospitals will close as a result of our cruel state legislature. Rarely in state history have we seen such a devastating lack of leadership." - U.S. Rep. Jim Cooper, D-Tenn.

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"Ultimately, seven legislators made a decision that prevented the full General Assembly from having the opportunity to debate this extremely important issue. We are hopeful that members of the General Assembly will continue to consider ways for Tennessee to provide coverage to the hundreds of thousands of uninsured in our state." - Craig Becker, president and CEO of the Tennessee Hospital Association.

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"Foolish, foolish, foolish. Sad, sad, sad. Sick, sick, sick." - U.S. Rep. Steve Cohen, D-Tenn.