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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.

“In our state, everyone from the Chamber of Commerce on down supports Medicaid expansion,” said Sen. Mark Begich, D-Alaska, who is seeking re-election. “It’s about 40,000 Alaskans who will not get care because of the governor and honestly, my opponents support the governor’s position. They might be the ... only ones who don’t support giving Medicaid.”

Begich conceded that the Medicaid argument is necessary, but not sufficient for Democrats in 2014 defending their health care votes.

“I think it’s a piece, it’s not by itself, a total, single driver,” Begich said. “And when people see the politics of the people who are running against me — who want to make sure 40,000 Alaskan families don’t have health care when it’s available right now by just making one decision, I think it will have an impact to some voters, no question about it.”

Republican operatives say the other “pieces” of the health care story will be enough to defeat Democrats and win the Senate majority. They insist that Democratic attempts to focus on Medicaid will prove futile if President Barack Obama’s approval ratings remain low and opposition to the health care law as a whole remains high. Multiple aides approached for this story suggested that separating out examples like rejected Medicaid expansion or state failures to establish their own exchanges would be “too nuanced” for an electorate that seems broadly disenchanted by the law.

“Politicians who seem to understand very little about the health care system running back and using this as a talking point shows how truly out of touch they are,” said National Republican Senatorial Committee spokesman Brad Dayspring, who noted the 2014 elections would be well in the rearview mirror for Democrats campaigning on Medicaid expansion by the time state bills come due in 2016. “It’s a lot of federal dollars [to turn down], but you know, rob Peter, pay Paul. Who’s paying those dollars? The taxpayers are.”

Meanwhile, national Democratic operatives said their candidates would launch wholesale defenses of the health care law on the trail. Democrats on the ground in some of these key states believe that going on the offensive against Republican opponents and challenging the decisions made in-state will help create separation between these incumbents and their conservative challengers.

This fight will be especially interesting in North Carolina, where the speaker of the state House, Thom Tillis, is a GOP front-runner to challenge Democratic Sen. Kay Hagan. Tillis backed Republican Gov. Pat McCrory’s decision to reject federal aid through the Medicaid expansion.

In December, Senate Majority PAC, a super PAC that boosts Senate Democrats, spent more than $700,000 on ads supporting Hagan and attacking Tillis for “siding with insurance companies.”

One North Carolina Democratic aide said that zeroing in on the Medicaid expansion issue will “definitely” be central to the case Hagan will try to make to voters in her tight race for re-election.

“If you look at any of our fact-checking and response, that’s key to our message,” the aide said.

Last week, Hagan made a relatively rare national television appearance on MSNBC and turned almost any question she received on the health care law back to expansion.

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