‘The politics have changed’: South warms to expanded health benefits

Key Facts

And in Alabama, Speaker Nathaniel Ledbetter said the state has “got to have the conversation” about expanding coverage to more Alabamians and that a “private-public partnership” to do so “makes a lot of sense.”
“Eight years ago you would have had to dance around the jargon you used because Obamacare still had this bad branding with Republicans, but these days I don’t even think you have to do that,” said Brian Robinson, a Republican strategist in Georgia and deputy chief of staff to former Gov. Nathan Deal, who refused to expand Medicaid.
Beyond working-class interests, the strategists, lawmakers and health care advocates attributed the GOP’s shift to a constellation of factors: rural hospitals in conservative areas closing their doors; growing acknowledgement among Republicans that expanding coverage would mostly benefit people already working; a belief that the federal government won’t renege on its promise to foot most of the bill; states like North Carolina and South Dakota last year adopting expansion; and increasing frustration from the holdout states that they are losing out on millions in federal dollars.
“Once you change out some of this more established leadership — people who have been there for a long time, since the original Medicaid battles — they aren’t as beholden to that position,” Sharp said.