Political Insider

An AJC blog about Atlanta politics, Georgia politics, Georgia and metro Atlanta election campaigns. Because all politics is local.

A red-state shocker: Alabama eyes Medicaid expansion


"I am concerned about the plight of the working poor," Bentley said at a legal conference, according to the Associated Press. "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," Bentley said.

Republican leaders across the South have firmly opposed Medicaid expansion, the centerpiece of President Barack Obama's healthcare overhaul, largely because of fears over the long-term costs of the program.

But cracks are starting to show. The Republican and Democratic contenders for Louisiana's governor's race both say they could support an expansion with conditions. Other GOPers press for waivers, block grants or other measures to give them more flexibility on healthcare spending.

In Georgia, Gov. Nathan Deal briefly flirted with a "Medicaid experiment" to ply the feds for more healthcare funds to help the state’s struggling rural hospitals and its big “safety net” hospitals like Grady Memorial in Atlanta.

But his administration soon backtracked from the idea when the state's main health agency cited the "significant costs to the state" to implement the proposal. And any expansion would require a majority vote by state lawmakers, whose leaders remain opposed.

And Deal doubled down on his opposition with an AJC op-ed questioning the financial risks of an expansion. Wrote Deal:

Medicaid's milestone anniversary provides federal lawmakers an opportunity to address serious challenges to the long-term sustainability of this critical safety net. Providing block grants to states would increase flexibility and allow for more control of program services, requirements and delivery methods. This will result in better outcomes for our most vulnerable patients.

Our subscription site has a broader discussion of the Medicaid issue in Georgia. Click here to read it.

***

Every time you read an article in which Republicans worry about their appeal as a national party, keep in mind these paragraphs from this New York Times piece:

While Mr. Obama’s 2008 election helped usher in a political resurgence for Democrats, the president today presides over a shrinking party whose control of elected offices at the state and local levels has declined precipitously. In January, Republicans will occupy 32 of the nation’s governorships, 10 more than they did in 2009. Democratic losses in state legislatures under Mr. Obama rank among the worst in the last 115 years, with 816 Democratic lawmakers losing their jobs and Republican control of legislatures doubling since the president took office — more seats lost than under any president since Dwight D. Eisenhower.

“Republicans have more chambers today than they have ever had in the history of the party,” said Tim Storey, an analyst at the National Conference of State Legislatures. “So they are in a dominant and historic position of strength in the states.”

***

Donald Trump went to Iowa on Thursday night and asked "How stupid are the people of Iowa?" in reference to Ben Carson. He also mocked Carson's famous story about stabbing his friend. It's best watching in video form, via CNN:

Trump also compared Carson's "pathological" temperament to a child molester's. These are strange times we live in.

***

Heidi Cruz, the wife of Texas Sen. and presidential contender Ted, will visit Georgia next week as a surrogate for her husband. Her two-day itinerary covers the whole state:

-- Monday, Nov.  16.  3 p.m. at Cobb County GOP headquarters, 799 Roswell Street, Marietta;

-- Monday, 7 p.m. at Conservative Republican Women reception, 550 Trackside Event Center, 550 North Clayton St., Lawrenceville;

--  Tuesday, Nov. 17, 8 a.m. Meet-and-greet at Bare Bulb Coffee, 1117 Ga. 96, Kathleen, Ga.;

-- Tuesday, 1 p.m. Okefenokee Golf Club, 1204 South River Oaks Drive in Blackshear, Ga.

-- Tuesday, 5 p.m. Meet-and-greet at Old City Hall, 1229 Newcastle St., Brunswick, Ga.

***

Ben Carson is building out in the Deep South. This morning he announced his Mississippi chairman will be retired federal judge Charles W. Pickering, who chaired the Mississippi GOP way back in the late 1970s.

***

One of the most influential women in business breezed through Atlanta on Thursday, in the company of a new partner.

Savannah-born, Georgia Tech grad Suzanne Shank this week became the majority owner of Siebert Brandford Shank & Co. LLC, a Wall Street underwriting firm that has more than $2 trillion in infrastructure financing in its 19-year background. Shank’s new partner is former HUD Secretary Henry Cisneros.

The African American-owned public finance firm in the country is now the largest female-headed, African-American/Latino-owned public finance firm in the country.

”It’s the only one of its kind,” Cisneros said. We were in the lobby of the Hyatt Regency in downtown Atlanta for a quick chat.

The firm was founded in 1996 by Muriel Siebert, the first woman to own a seat on the New York Stock Exchange. She died recently, and chairman Napoleon Brandford III is retiring. Shank, a founding partner, inherits the titles of chairman and CEO. Siebert’s estate wanted out, which provided Cisneros, the former mayor of San Antonio, his opportunity to buy in.

Shank and Cisneros have their eye on Atlanta and Georgia in a number of areas. The firm was involved in the financing for the recent expansion of Hartsfield-Jackson International Airport, and the Atlanta sewer system remake under then-Mayor Shirley Franklin.

Asked where the next potential for infrastructure growth is, Shank rattled off a list:

“Certainly, the water and sewer issue was big. Atlanta did a lot. Transportation is always big. Georgia is one of 20 states that passed its own increase in funding. Schools, including higher education.”

In the Northeast, infrastructure replacement is largely a matter of crumbling systems that have aged out, Cisneros noted. In the South, it’s about growth – and Atlanta has more than its share. Said Cisneros:

“But as it grew, in some sense it was unprepared for that growth and that role. So the highway system was not built for that. And the suburban growth moved quickly, but schools didn’t follow at the same pace, so they’re overcrowded.

“Now you’re dealing with the next iteration of infrastructure, like broadband and higher education. It’s very clear that if you’re going to have a poster child for where infrastructure is a challenge, Atlanta would be right there.”

And then they were off to Atlanta City Hall, to introduce their new partnership to Mayor Kasim Reed.

***

It looks like lawmakers will have to find another quarter-of-a-billion dollars in next year's budget. From our AJC colleague Ty Tagami:

A committee working for Gov. Nathan Deal is recommending that the state add $258 million to the educational budget as part of a new formula for distributing money to school districts.

The proposal agreed upon Thursday by eight of the governor’s volunteers now goes to the more than 30 members of the full Education Reform Commission for a vote on Nov. 19.

Critics contend that if the amount of new money, up from $241 million when the committee met last in October, is formalized in a new funding formula, it will lock in shortfalls of about a quarter billion dollars. The $8 billion state educational budget is shorting schools about half a billion dollars this year, according to the formula in use since 1985.

***

Conservative blog RedState has a wild tale about staff for Arizona congressmen taking Roswell Republican Rep. Tom Price's name in vain on an Indian gaming bill:

Aides to Arizona GOP Reps. Rep. David Schweikert (R-AZ) 85%, Rep. Paul Gosar (R-AZ) 90%,Rep. Matt Salmon (R-AZ) 86%, and Rep. Trent Franks (R-AZ) 85% took umbrage with an October 26th RedState column, “The Billion Dollar Bill No One Is Talking About,” in which H.R. 308, a narrow Indian gaming bill with an outsized price tag, was criticized for its potentially billion dollar impact on taxpayers, as forecast by the nonpartisan Congressional Budget Office earlier this year.

The quartet’s aides, which included chiefs of staff and legislative directors, argued the CBO scoring was inaccurate. By way of proof they repeatedly made reference to an alleged review of the proposed legislation’s scoring by Congressman Rep. Tom Price (R-GA) 75%, the Georgia deficit hawk who chairs the Budget Committee. ...

But, no such report exists. A senior Budget Committee member confirmed Wednesday in an email that the panel had not made the determination that the legislation would cost nothing.

***

Former Georgia senator Saxby Chambliss launched a "Chambliss Fellows" D.C. internship program for University of Georgia students this week. The first event raised $350,000 for scholarships.


Reader Comments ...


About the Author

Greg Bluestein is a political reporter who covers the governor's office and state politics for The Atlanta Journal-Constitution.