Alabama Gov. Robert Bentley used part of his State of the State Address on Tuesday to offer a full-throated defense of his decision to reject Medicaid expansion, one of the key components of President Barack Obama’s health care law.
Under the Affordable Care Act, the federal government will pay 100 percent of the cost of expansion for the first three years and then 90 percent after that.
Speaking to a joint session of the Legislature in Montgomery, Bentley drew one of his loudest applause lines by recounting some of the famous promises of Obamacare. Supporters claimed people would be able to keep their doctors and health policies, and that premiums would not go up.
Bentley has come under fierce criticism from state pension fund chief David Bronner and others who contend that his refusal to accept increased federal funding for Medicaid will cost the state jobs.
Alabama Senate Minority Leader Craig Ford, D-Gadsden, argued in his official response that the state has one of the most efficient Medicaid systems in the country.
“But it is struggling to get by after significant cuts over the past three years,” he said.
Ford suggested raising the cigarette tax by $1 per pack, which he said would bring in $230 million a year and close a hole in the Medicaid budget.
He noted that Medicaid spending has increased nationally by more than 1,500 percent since 1980 and that the program consumes up to 35 percent of Alabama’s General Fund.
“And under Obamacare, Medicaid would grow even larger – bringing millions more people to a state of dependency on government, and saddling our state and our nation – the taxpayers – with the enormous expense,” said the governor, who added that an expansion would siphon millions of dollars from the education budget by 2016.
Bentley recited familiar criticisms of Obamacare, from the 18 taxes included in the law to the well-publicized cancelation of some 87,000 insurance policies in Alabama deemed substandard by the statute.
The governor claimed the Affordable Care Act threatens “one of the most trusted relationships – that of a doctor and their patient.” He drew on his personal experience as dermatologist prior to entering politics.
“As a practicing physician, I would never want anything to come between me and my patient – especially the federal government,” he said.
Bentley explained reforms already under way in the existing Medicaid program. It involves setting up regional care organizations that aim to use “community-based, managed care to improve the health” of recipients and save taxpayers money.