MONTGOMERY, Ala. — During a speech and subsequent press conference on Thursday, Gov. Robert Bentley for the first time signaled publicly that he would be open to expanding Medicaid.
It was a drastic departure from statements the governor made throughout his re-election campaign, and perhaps even more notably, during his 2014 State of the State Address.
“Ladies and gentlemen, nothing is free,” he said. “The money the federal government is spending with wild abandon is not federal dollars – those are your dollars, your hard-earned tax dollars. There is no difference between federal money and your money. Our great nation is 17.2 trillion dollars in debt and it increases by 2-billion dollars every single day. That is why I cannot expand Medicaid in Alabama. We will not bring hundreds of thousands into a system that is broken and buckling.”
Those strong statements put to rest lingering doubts for some conservatives who believed the governor was leaving himself wiggle room to expand Medicaid after getting re-elected.
But his Democratic opponent, Parker Griffith, insisted that Bentley had been “quietly promising” to expand the program.
“Either Governor Bentley has been lying about his strict opposition to Medicaid expansion or he is allowing his political associates and government insiders to lie to health care professionals all across Alabama,” Griffith said in May of this year. “It can’t be a coincidence that I have had numerous people tell me that they have been assured that Governor Bentley will expand Medicaid after the election.”
On Thursday, seven months removed from Griffith’s allegations and just over a month removed from securing re-election, the governor told reporters that he would be open to considering a Medicaid expansion similar to Arkansas and Pennsylvania.
Both of those states requested waivers from the Obama Administration to implement Medicaid expansion under slightly different rules.
“It would have to be in the private sector and there would have to be some requirements on it,” Bentley said.
Arkansas created a “private option” that was widely panned by conservative groups as “Medicaid expansion by another name.” And by requirements, Bentley specifically mentioned a “work requirement,” which were initially included in Pennsylvania’s waiver request, but were later dropped — or at least drastically modified — when the Obama Administration balked. Pennsylvania’s yearlong negotiation with the Obama Administration may be the best example of the difficulties Republican governors have in expanding Medicaid — no matter what they propose, President Obama has to sign off.
In the handful of states that have implemented a “private option” Medicaid expansion, the federal government provides the state government with money to pay private insurers to cover uninsured individuals. This is likely what Gov. Bentley was referring to on Thursday when he referred to it as a “block grant” for Medicaid. The federal government typically covers 100 percent for the first year, then scales back in the years to come, leaving more of the burden on the state. But as Gov. Bentley pointed out in his State of the State address, whether it’s state or federal dollars, it all comes from taxpayers.
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— Cliff Sims (@Cliff_Sims) December 3, 2014
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