Alabama's Republican governor says he is considering expanding Medicaid under ObamaCare in his state.
Bentley indicated that expanding Medicaid, the government health insurance program for the poor, could help get more doctors into rural parts of the state.
"I am concerned about the plight of the working poor,” he said. “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.”
If Alabama did expand Medicaid, it would be a significant turning point in bringing expansion into the Deep South, where, so far, the Republican leadership has rejected it.
Still, there are major questions. Bentley has in the past indicated that he would seek to alter the program to make it more conservative, such as requiring people to work in order to receive benefits.
Those changes would require approval from the Obama administration. The administration has made compromises with other Republican-led states on areas, including requiring people to pay premiums, but has rejected work requirements.
There is also the question of resistance in the Republican legislature. Republican governors in some states, such as Tennessee and Utah, have tried to expand Medicaid but have been halted by lawmakers.
The AP reports that Bentley pointed to the cost and the legislature, which previously opposed his call for tax increases. The federal government initially picks up the entire cost of expansion, but eventually the state has to pay 10 percent of costs.
"If we were to accept that you have to realize that it's going to cost the state of Alabama over the next six years $710 million dollars in the general fund,” Bentley said. “Folks, I can't even get them to raise $100 million, so we've got to look at a funding stream for that if we are going to do it.”
Thirty states have so far accepted the expansion of Medicaid eligibility up to 138 percent of the poverty line, or about $33,000 for a family of four. The administration has been urging more states to expand the program.