States run by Republican governors and legislatures are slowly adopting the Medicaid expansion under ObamaCare, boosting Democratic hopes they can run on the issue in the midterm elections.
Sen. Mary LandrieuMary Loretta LandrieuCassidy wins reelection in Louisiana Bottom line A decade of making a difference: Senate Caucus on Foster Youth MORE (D-La.) has launched a petition on her website urging Gov. Bobby Jindal (R-La.) to agree to the expansion, which she argues would bring health insurance to more people who cannot afford it.
The issue is giving Landrieu a chance to run not only against her GOP opponent Rep. Bill Cassidy (R-La.), who opposes the extension, but against Jindall as well. She argues the expansion would close “the Jindal Gap.”
“Our governor may not like the president, but this is not about the president,” she writes. “It's about providing health coverage for 240,000 Louisianans who work 40 or 50 hours a week, but still make too little to qualify for assistance in the new marketplace — and too much to qualify for Louisiana’s current Medicaid.”
Democrats have seen a number of states embrace the Medicaid expansion, including a number run by Republican governors, including Chris Christie (N.J.), Susanna Martinez (N.M.), Brian Sandoval (Nev.) and Jan Brewer (Az.).
In total, 25 states and the District of Columbia have said they will either expand Medicaid outright or work with the administration to design a more politically-palatable workaround.
An additional five states – Utah, Missouri, New Hampshire, Arkansas and Pennsylvania — are considering some sort of expansion, and a sixth, Virginia, is reconsidering its initial rejection now that a Democratic governor has been elected.
Every incremental gain in the push to expand Medicaid is cheered by Democrats, who view the state-level victories as furthering the primary goal of ObamaCare, which is to extend coverage to as many of the uninsured as possible.
“Lives will be saved, health will be improved, and insurance premiums will come down in New Hampshire as a direct result of what the state Senate did today, and they should be proud,” Americans United for Change president Brad Woodhouse said in a statement on Thursday after the Granite State’s GOP-controlled Senate sent a bill to the Democratic governor to accept additional federal funds for the program.
Republicans downplay any benefits to Democrats from the strategy.
“To me, ObamaCare is 1,000 times bigger than the Medicaid issue,” said GOP strategist Matt Mackowiak, who described Medicaid is a peripheral issue.
“It’s kind of like when you’re drowning, you grab for anything you can,” he continued. “So they’re pulling out minimum wage, equal pay, violence against women, and their other go-to issues. But to me, ObamaCare is so much bigger than all that.”
But polls show widespread support for the Medicaid expansion, even in some parts of the Deep South, where governors and statehouses have rejected the possibility outright.
While Republicans have already begun hammering Landrieu and fellow vulnerable Democratic Sens. Jeanne Shaheen (D-N.H.), Mark Warner (D-Va.), Mark Pryor (Ark.), Kay Hagan (N.C.), and Mark Begich (Alaska) for supporting ObamaCare, Democrats believe they have an opening on the issue to potentially neutralize that advantage.
Landrieu’s race is perhaps the case study for how this will unfold.
Republicans have zeroed-in on the Louisiana Democrat as one of their primary targets in the 2014 election cycle, and Landrieu has responded by seeking to create as much space as possible between herself and the unpopular healthcare law.
She’s become one of the most vocal Democratic critics of the botched ObamaCare rollout, and has sponsored legislation to delay the individual mandate and to allow consumers to keep their old healthcare plans, even if they don’t meet the minimum requirements under the law.
But Landrieu is equally as vocal about her support for Medicaid expansion under the law.
While the polling in Louisiana is sparse, a Pew study released last year showed that 63 percent in the state support an expansion.
The fight is already playing out among outside groups in Louisiana.
Americans for Prosperity, the group backed by the billionaire Koch brothers, is making opposition to the expansion a top priority through a “Stop the Madness” ad campaign.
The liberal nonprofit group MoveOn, meanwhile, has launched a campaign targeting some of the highest profile Republican governors in the country, including Jindal, over their continued opposition to expanding Medicaid under ObamaCare.
Some other Democrats on the vulnerable list are also embracing the Medicaid issue.
In New Hampshire, Shaheen lauded he legislature’s work this week to advance a bill, and in Virginia, Warner is pressuring the legislature to work with Gov. Terry McAuliffe (D-Va.) on an expansion, while accusing the GOP in the state of “putting a right ideological agenda over the well-being of their constituents.”
The fight is also playing out nationally.
Last month, Health and Human Services Secretary Kathleen Sebelius lashed out at the governors in four Southern states that have some of the highest levels of uninsured: North Carolina, Georgia, Florida, and Texas, among others, for “playing politics with people’s lives” by refusing to expand Medicaid under ObamaCare.