The governor of my state (Alabama) has once again announced that we will not be accepting the Medicaid expansion. This has been his stated position ever since Obamacare was passed so I guess it is no surprise. The position has evolved a little over the past 3 years. Initially, the position was that putting money into Medicaid was pouring money into a broken system. As a Medicaid provider in Alabama for over 20 years I could accept that and so supported the legislative efforts at improving the system. The legislature passed a comprehensive reform package this past session (comprehensive article found here). Then the Governor began getting pressure from business leaders in the state arguing for expansion. The most vocal has been David Bronner, the successful executive of the Alabama retirement fund. He listed 8 reasons that we should expand, mostly economic in nature. In other words, he pointed out that the “jobs governor” may cost us a lot of jobs.

The Governor has apparently decided to fight back and he lists his reasons why in the article:

  1. It is important to resist Obamacare to the death (even if it means the deaths of Alabamians)- (From the article) Gov. Robert Bentley maintains Alabama is doing the right thing by participating in neither.“I have a long-term goal for this. My long term goal is to resist the implementation of the Affordable Care Act and I believe we are going to succeed in that,” Bentley said. “If you don’t expand Medicaid – I don’t care what anyone says – you probably cannot implement the Affordable Care Act. If you don’t have a state-based exchange, it’s going to be difficult to implement the Affordable Care Act,” Bentley said.
  2. It is important for Alabama to stick it to the Chinese (even if it means the deaths of Alabamians) – (From the article) “May I say there is nothing free in America. The money that comes into this state is not free money. It’s money that the Chinese have loaned the United States because we are $17 trillion dollars in debt,” Bentley said.
  3. Alabamians admire a man of principle (even if it means the deaths of Alabamians)- (from the article) “Honestly, I do not look at it in that way,” Bentley said.“My stand has been the same today as it was 2009. I was against the passage of (the Affordable Care Act.) It was sickening the day that they had the one vote. If there had been one extra Republican vote in the Senate it would have never passed. And the country would be a lot better off,” Bentley said.

I hope he reconsiders. The Affordable Care Act is the law with which we can work to solve the health problems that rank us #48 in care of out poorest citizens.

Another option would be for the citizens of Alabama to get a clue. In the words of David Bronner from the same article:

“His big thing is economic development. Well, buddy, we can’t do anything in about six counties in the state because they don’t have a hospital. When we start closing the other ones, who in the world would bring their company to a county where the hospital is closing. No businessman in America with any brains would do that,” Bronner said.

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