- Associated Press - Monday, January 20, 2014

MONTGOMERY, Ala. (AP) - NN:

Alabama’s Republican leaders have made it clear they won’t be expanding the Medicaid government insurance program any time soon.

But that doesn’t mean that there isn’t an election-year fight over a key provision of President Barack Obama’s health care overhaul.

When he addressed legislators last week, Republican Gov. Robert Bentley restated his opposition to expanding Medicaid. He said it’s too expensive and would breed dependency on government.

Democrats say the governor is being short-sighted.

They note that some parts of the law will cost hospitals money they get for treating the uninsured. It’s foolish, they say, to not expand Medicaid to make up the loss.

Hospital executives, meanwhile, have launched a campaign to convince local civic and business leaders that expansion is the right move.

WT:

Alabama’s Republican leaders have made it clear they won’t be expanding the Medicaid government insurance program any time soon. But that doesn’t mean that there isn’t an election-year fight over a key provision of President Barack Obama’s health care overhaul.

Republican Gov. Robert Bentley used his annual legislative address to frame his refusal of federal money for more Medicaid coverage as a principled stand against a profligate White House and an expanding welfare state.

“The money the federal government is spending with wild abandon is not ‘federal’ dollars; those are your dollars,” the governor told lawmakers and a statewide television audience last week. “If states do not stand firm and say ‘no more,’ there will be no one left to stop the out-of-control spending in Washington.”

Widening Medicaid insurance rolls, a joint federal-state insurance pool for low-income Americans, was an anchor of the law Obama signed in 2010. But the U.S. Supreme Court ruled that states could decide whether to participate. The feds have agreed to pay for all new coverage through 2016 for everyone with household income up to 138 percent of the federal poverty rate - $15,420 a year for an individual or $31,812 for a family of four. States eventually would have to pay 10 percent of coverage costs for the new Medicaid recipients.

Besides fiscal considerations, Bentley argued that adding an estimated 300,000 Alabamians to the program would speed “a downward spiral of dependence” in American society. He added an argument familiar to Alabama governors: states’ rights. “It’s OK to question the federal government. … The 10th amendment to our great constitution gives us that authority,” Bentley said.

Each line of opposition drew enthusiastic applause with the Old House Chamber filled by the Republicans who dominate every branch of state government. Yet Democrats, even as an overwhelming minority, pushed back, accusing Bentley of putting easy politics above good policy as he faces a re-election campaign.

Sen. Billy Beasley, D-Clayton, said he was “disappointed in the governor.” Beasley and his fellow Democrats contend that Medicaid expansion makes sense from an economic, health care and moral perspective. And, they add, it would be more irresponsible to deny the state’s health care system a new cash flow when separate provisions of the new law promise to cut hospital revenues.

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