Ken Hare In Depth: States seek expansion dollars without expanding Medicaid

MONTGOMERY, AL (WSFA) - With the Alabama Legislature on "spring break,"let me touch on a little of this and a little of that, starting with thepossibility -- however slim -- that Alabama's Republican leadership will decideto expand Medicaid.

So far, Gov. Robert Bentley has remained firmly among thelist of Republican governors who seem intent on not expanding Medicaid in theirstates despite a growing number of studies suggesting it would mean a hugeboost to state economies and jobs.

When the U.S. Supreme Court left it to the states todecide if they would participate in the expansion of Medicaid under Obamacare,a host of Republican governors rushed to say that they would not expand. Butsome of them have since relented after seeing studies that suggested it wouldmean jobs and economic expansions for their states, not to mention additionalhealth care for many residents.

One scorecard recently listed 14 states (includingAlabama) still in the "no expansion" category, with 25 statesdeciding to expand. Three additional states were listed as "leaning towardnot participating" and two states "leaning towardparticipating," with six states undecided.

But now some states are exploring what appears to bemiddle ground -- a way to dip into federal Medicaid expansion dollars withoutexpanding Medicaid programs in their states.

The New York Times reportsthat Tennessee is considering joining Ohio and Arkansas in negotiating with theObama administration over the possible use of federal Medicaid money to paypremiums for commercial insurance that could be used to purchase private healthinsurance for low income residents through regulated insurance exchanges.

So far, no word if Alabama will pursue this alternative.

But another study is out that builds evidence that a trueMedicaid expansion would boost Alabama's economy.

This study, commissioned by Alabama Appleseed Center forLaw and Justice, suggests that a Medicaid expansion using virtually all federaldollars would in 2016 "supportapproximately 12,000 new jobs across all sectors of Alabama's economy."

That is actuallya more conservative estimate of the impact of expansion of Medicaid thanearlier studies found. But it adds to the growing evidence that Alabama willmiss a major economic boost if it does not take advantage of the federaldollars available for expanding health care coverage.

'Made In Alabama' rebrand misses history

Shifting gears to another jobs-related story, the new"rebranding" of Alabama's economic development efforts centers on thephrase "Made In Alabama," and highlights an image of a red labelcarrying that motto.

The new "brand" apparently will be the focus ofthe state's economic development efforts over the next few years.

There's a lot to like about the new image -- it's cleanand bright and easy to understand. The updated web site using the new image isalso clean and bright, with a nice modern feel about it.

But the phrase itself doesn't really reflect the realityof economic growth in Alabama over the past decade or so.

"Made In Alabama" comes across as being aimedat traditional manufacturing. But in fact, Alabama's job growth since 2000 hasbeen driven in very large measure by job gains in the health and educationsectors of the economy, not by traditional manufacturing. Manufacturing since2000 actually has seen an employment decline despite the growth of the state'sautomotive industry, according to

As the state's economy slowly rebounds, traditionalmanufacturing is rebounding as well. Such big projects as Airbus are gettinglots of attention. But I cannot help but believe that in the long run,Alabama's economic growth will continue to be fueled more by the health fieldthan nuts and bolts manufacturing.

The new brand can be stretched to fit the health sectorof the economy, of course. Alabamians should hope that state and local economicdevelopers pursue jobs no matter what sector of the state's economy they mightfit into.

Two stories make "You've got to be kidding" list 

Two stories -- one involving a Democrat and one aRepublican -- prove once again that in politics, certain types of publicityreally can be worse than no publicity, despite the adage to the contrary.

Let's start with the Republican. Dale Peterson won national mediaattention waving his gun as part of an online media campaign while unsuccessfullyrunning for the office of state agriculture commissioner.

Afew weeks ago he was back in the news after it was disclosed that he wascharged with shoplifting. He claimed it was all a misunderstanding.

Nowhe has been charged again, and this time he claims it's all a conspiracy.

Thelatest shoplifting allegation involved a claim that Peterson opened a can ofcashews, ate some, and returned the can to the store shelf. Yuck.

Asfor his allegations of a conspiracy, they are -- pun intended -- nuts. No oneis going to bother with developing a conspiracy against a losing politicalcandidate who already had no political credibility.

State Rep. Joe Mitchelldid have at least some political credibility before he went off the deep endrecently. When Mitchell received an email opposing gun control legislation thatwas sent to all legislators, the Mobile Democrat went off like a blunderbuss.

He responded through his official email site, referringto the family of the sender of the rather innocuous original email as"slave-holding, murdering, adulterous, baby-raping, incestuous,snaggle-toothed, backward-a**ed, inbreed, imported criminal-minded kinfolk."

The state Democratic Party rushed to distance itself fromMitchell, as did some fellow legislators.

Mitchell may still be able to win re-election despitethis abusive response, but it's difficult to see how anyone could take himseriously now.

There are lessons here for Democrat and Republicanelected officials alike -- when it comes to politics and most things in life,the adage that "there is no such thing as bad publicity" simply isn'ttrue.


Ken Hare was a longtime Alabama newspaper editorialwriter and editorial page editor who now writes a regular column for WSFA's website. Email him at

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