Red States Begin To See The Light On Medicaid Expansion

Alex Zielinski

Alex Zielinski Health Reporter, ThinkProgress

Conservative leaders may be warming up to Obamacare’s optional Medicaid expansion — a program that has been traditionally gridlocked in GOP-led states — in an emerging trend that could have a serious influence on the program’s adoption in fellow red states. Recent state elections unveiled a majority of these changes.

At first, many voters in favor of Medicaid expansion feared the recent elections would worsen their chances. And with a new, staunchly anti-expansion governor elected in Kentucky and a unwavering Republican majority in the Virginia Senate, it’s clear why. But these potential road blocks to further state expansions may be countered with other unexpected victories in other states.

The biggest surprise came out of the Louisiana election, where Democrat John Bel Edwards won the governor’s race by a landslide this weekend. He’ll fill the seat of current Governor Bobby Jindal, who has rejected the “subpar” Medicaid expansion program from its start. Edwards is a true Southern Democrat — he’s openly against abortion and gun control — but stands firmly behind progressive health care and labor plans. He’s already pledged to sign an executive order authorizing Medicaid expansion on his first day in office. This would provide immediate coverage to an additional 225,000 uninsured residents.

Meanwhile, in Kentucky, Governor-elect Matt Bevin may be softening his opposition to this Obamacare provision. During his campaign, Bevin spoke firmly about his opposition to Medicaid expansion — which already exists in the conservative state. But now that the election’s over, he’s mentioned a scaled-back attack on the expansion program. Instead of cutting off the 400,000 people who benefit from the state’s Medicaid expansion, he may work with the feds to just adapt it to his liking. This will likely still shed some benefits of the current state program, but won’t affect its users as harshly as predicted.

Kentucky’s expected action — or inaction — may have inspired an unprecedented move toward expansion in a fellow red state, where no Democrat holds a political office: Alabama.

“I am concerned about the plight of the working poor … If doctors are not paid for seeing those patients, doctors will not go to rural Alabama because you can’t expect a doctor to go to rural Alabama and lose money,” Gov. Robert Bentley told the Associated Press a week after Bevin’s Kentucky victory.

Bentley, a former physician, said his administration is currently considering Medicaid expansion. If successful, Alabama could join Louisiana in influencing the usually Medicaid-resistant South to take a second look at the program. Around 300,000 people in Alabama, one of the nation’s poorest states, would be eligible for coverage under an expansion.

At the moment, more than 3 million poor uninsured adults in the country fall into the “coverage gap,” the income bracket that the optional Medicaid expansion covers — and 90 percent of that population lives in the South.

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This has been reposted from Think Progress.

Alex Zielinski is a health reporter at ThinkProgress. She was previously at Atlantic Media as an Editorial Fellow. Prior to her move to D.C. in 2015, Alex reported on city politics and social issues for the Portland Mercury and Street Roots in Portland. She graduated from the University of Oregon School of Journalism and Communication in 2011. Her work has been featured in Washington City Paper, Bitch magazine and other publications across the Pacific Northwest. Alex is originally from Arcata, California.

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