Alabama's Republican Gov. appears to be moving closer to supporting a lottery to support Medicai
By Charles J. Dean | cdean@al.com AL.com
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Last month in this space the question was asked:
Is Gov. Robert Bentley nudging closer to an attempt to expand Medicaid under Barack Obama's signature accomplishment as president: the Affordable Care Act (ACA), commonly called Obamacare?
Thursday the governor gave the most direct answer to date to that question.
"We are looking at that (Medicaid expansion). We have not made a final decision on that yet, exactly on how that will work," said Bentley in response to a question from an audience of lawyers.
The question now:
Is Bentley nudging closer to supporting a state lottery to provide the critical state dollars that will be needed to expand Medicaid under the ACA?
Thursday Bentley said a major stumbling block to expanding Medicaid is financial. Bentley said if he decided to try to expand the program, which provides health care for about one million mostly poor Alabamians and children, the state would have to come up with $710 million in matching money to qualify for the roughly $7 billion the state could initially receive.
The governor acknowledged that there is currently no revenue source in the state close to being able to provide the matching money.
But Bentley did seem to offer one possible source, a state lottery whose proceeds he said he would want to see go entirely to the state's General Fund Budget, where Medicaid dollars are allocated.
In responding to a question from his audience about funding government, the governor said he expects a lottery to be proposed in the Legislature next winter and said that "might" be something in his long-term plans.
In a public appearance Friday the governor was asked a follow-up question about his lottery comment on Thursday. Asked if he was mulling over supporting a lottery, Bentley said:
"I think there has to be a long-term stream of money for the General Fund. I'm going to leave that up to the Legislature ...Whether a lottery is the solution, I don't know. But the Legislature has to look at all revenue streams."
Asked if he would support a lottery bill if he saw one that was the right one Bentley said:
"I'll have to look at it and see. I just want to make sure that if the people are given the opportunity to vote on this that no one makes money on it other than the state. And that it's a clean lottery bill. And that way, I would be willing to talk about it positively. If not, I would have to go the other way."
By a "clean bill" Bentley means one that only calls for the creation of a lottery, not a bill that would also call for the creation of Las Vegas-style gambling in casinos. State Senate leader Del Marsh is expected to come with legislation in the next legislative session to do just that. Bentley has been critical of full blown gambling.
Historically Bentley has not been a supporter of any type of gambling including a lottery. In 1999 he said he voted against a lottery proposed by then Gov. Don Siegelman that would have funded education needs.
But Bentley since 2010 has also consistently said he would not block a public vote on a lottery if the Legislature approved a constitutional amendment allowing one. Such a change would have to be approved by voters.
Rep. John Rogers, D-Birmingham, praised Bentley for rethinking his position on expanding Medicaid, a move Rogers said the governor should have made four years ago. Rogers said that Bentley and some allies have quietly been urging Democrats to support a lottery to support expanding Medicaid, which has been the top priority for Democrats.
But Rogers said that a lottery alone won't generate enough money to pay for expansion and that he expects that Democrats will also want to see legislation like Marsh's that creates both a lottery and table games like roulette and card games like poker and blackjack.
"We are not going to get behind just a lottery," said Rogers. "That is what the governor is trying to sell us on because he can't get this done with just Republican votes."
Republicans hold the vast majority of seats in the Legislature but Rogers said that "super majority" is deeply divided.
"Look you've got three Republican parties right now – the religious faction, the Tea Party group and the old fashion regular pro-business Republicans," said Rogers. "They are all divided on lottery and gambling so while the Democrats are the minority we have some power right now if we vote as a block and Bentley knows it. But we know it too and we want a lottery and gambling."
Sen. Jabo Waggoner, R-Vestavia Hills, said that he thinks a majority of Republicans support a lottery in an up and down vote today. But Waggoner said that would not be the case if casino gambling was part of the deal.
"The votes for full blown gambling are just not there right now," said Waggoner.
Waggoner also said another problem passing any lottery to fund Medicaid expansion would be stiff opposition from some Republicans in both the House and Senate who have long opposed Obamacare.
"It would be an uphill fight for sure," said Waggoner. "But maybe, maybe if the Democrats were on board and you got just enough Republicans to come along because expansion would help a lot of people and hospitals across this state, including UAB and USA and all the others, it might get done. But if the Democrats are going to hold out for casinos, well I just don't see it happening.