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Vulnerable Democrats Run Against GOP Medicaid Decisions in 2014

Douglas Graham/CQ Roll Call File Photo
Landrieu has voiced her displeasure that Louisiana has not accepted federal aid to expand Medicaid.

Republicans have made the president’s health care law their primary ammunition in congressional campaigns since 2010 — but embattled Senate Democrats believe they have found an opening to turn voter ire toward the GOP this cycle: Medicaid expansion.

In 20 states, Republican governors have so far rejected a key piece of the health care law — federal aid to expand Medicaid for some of their states’ poorest citizens. Three of those 20 states — Alaska, Louisiana and North Carolina — are home to some of this cycle’s most competitive Senate races, where three incumbents up in 2014 voted for the law.

In the states that accepted federal aid to expand the health care program, the expansion has proved to be one of the rare early successes in the glitch-riddled launch of the landmark overhaul. That has given vulnerable Democratic senators in Alaska, Louisiana and North Carolina an opening to run against their home-state GOP governors in 2014.

“Yes. I have talked about it,” Sen. Mary L. Landrieu, D-La., said Tuesday between votes. “I have been trying to lead a broad coalition of Democrats and Republicans, rich and poor, business interests and consumers alike, to explain to Governor [Bobby] Jindal that the decision he made was not right. It is not in Louisiana’s economic interest, leaving $16 billion on the table.

“Every newspaper in my state — virtually every newspaper in my state — has editorialized for the expansion of health care so middle-class, working people can get coverage,” Landrieu continued. “And you, know, the governor travels all over the world bringing companies that will spend hundreds of millions of dollar to our state, well, this is $16 billion he’s just said ‘no’ to.”

Republican governors in Alaska, Louisiana and North Carolina opted out of $1.4 billion, $15.7 billion and $39.6 billion in aid, respectively, according to a Kaiser Family Foundation report. Estimates suggest that 40,000 Alaskans, 240,000 Louisianans and 500,000 North Carolinians are not getting Medicaid coverage offered under the plan that GOP governors in those states rejected.

The federal government would have paid 100 percent for the first three years of the program, after which states would pay no more than 10 percent of the costs for the expansion. Governors who rejected federal aid have said the ultimate cost of expansion to the state still would be too high, and they received significant conservative accolades for saying so.

Landrieu’s example of local papers editorializing against GOP leadership’s decision to reject aid is not unique. The New Orleans Times-Picayune editorial board has supported expansion, but so has the Anchorage Daily News in Alaska and the Raleigh News & Observer in North Carolina.

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