Marie Sanderson in POLITICO Pro: Southern Democrats Hope for Unlikely Asset in Governors Races

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Rachana Pradhan, POLITICO Pro

October 7, 2019

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Obamacare is again shaping gubernatorial races deep in Trump country this fall — and this time, it’s by Democrats embracing it as a winning issue.

Off-year governors races in Kentucky, Louisiana and Mississippi are turning partly on Obamacare, particularly the millions of poor adults who have gained coverage under the health law’s Medicaid expansion.

All three states are Trump strongholds, where the president is popular and conservative resentment over the Affordable Care Act lingers nearly a decade after its enactment. But instead of avoiding Obamacare, the Democrats in these races are embracing it — a strategy that helped the party win the House last November and pick up several governorships.

Just a few years ago, it would have been unthinkable for a Democratic candidate to hug Obamacare so closely. But the political calculus has changed as the law became more popular and more Republican-led states joined Medicaid expansion, no longer able to pass up the program’s major infusion of federal funding.

“You just needed long enough for the law to start having tangible effects,” said Democratic strategist Isaac Wright, who has worked on southern campaigns. “You needed long enough to know, you know what, despite what Sarah Palin said there are no death panels.”

In Mississippi, one of 14 holdout states that haven’t expanded coverage, Jim Hood, a popular conservative Democrat who’s now the attorney general, is campaigning on a pledge to cover 300,000 more people in one of the poorest and unhealthiest states in the country. Republican Lt. Gov. Tate Reeves, a small-government conservative vying to succeed the outgoing Republican governor, says he opposes adding more people to a government-run health program.

Hood said in an interview Medicaid is bringing “people into my lane that may have not been there before.”

“The craziness in Washington, the wingnuts on both sides are driving us to the middle,” Hood said. “They want to see something done and see things change.”

A Reeves campaign spokesperson did not respond to a request for an interview.

In Kentucky, Republican Gov. Matt Bevin had been looking to roll back the state’s Medicaid expansion before he even took office in 2015; his Democratic challenger, Attorney General Andy Beshear, says he would undo work requirements and premiums Bevin added to the program. The Republican governors’ campaign arm in attack ads has labeled Beshear “radical” for supporting taxpayer-funded coverage for people able to work.

Louisiana Gov. John Bel Edwards made Medicaid expansion his top priority upon taking office in 2016. Edwards, one of the few Democrats holding statewide office in the Deep South, is airing campaign ads highlighting Medicaid’s benefits and his role in securing them for the state.

His two Republican challengers have said they would keep Medicaid expansion but have accused him of wasting tens of millions of dollars through mismanagement of the program.

In Mississippi, Hood’s message has focused on the financial benefits federal expansion funds would bring to the state’s economy and the lifeline it would provide to struggling rural hospitals. Like many other red states, Mississippi has faced a rash of rural hospital closures. Six have shut down in the state since 2005, and a recent study warned more than 30 are at risk of closure.

Critics say the states’ refusal of expansion funding has contributed to the hospitals’ financial woes. Though the federal government provides no less than 90 percent of expansion costs, Republican opponents say states don’t have room in their strained budgets to take on tens of millions of dollars each year in new costs.

Collectively, more than 1 million people qualify for Medicaid expansion benefits across the three states, which are mostly rural and have higher than average poverty rates.

“It’s very energizing to rural populations in particular,” said Democratic strategist Matt Erwin, who worked on the successful 2011 reelection campaign of former Kentucky Gov. Steve Beshear — Andy’s father. “I’m pleasantly surprised to see people embracing it.”

Most people in states that haven’t expanded Medicaid believed their states should join the program, polling from the Kaiser Family Foundation found last year. The overwhelming majority of Democrats in those states favored expansion, while about two-thirds of Republicans opposed.

“That helps explain why you’re hearing Democratic candidates for governor talk about it,” said Liz Hamel, director of public opinion and survey research at the nonpartisan organization.

But support for Medicaid expansion wasn’t enough to help two high-profile Democratic candidates in gubernatorial contests last year. Stacey Abrams in Georgia and Andrew Gillum in Florida narrowly lost after campaigning heavily on Medicaid expansion in two of the larger states refusing the program. Some other Democratic governors who campaigned on expansion and won, including Laura Kelly in Kansas last year and Roy Cooper in North Carolina three years ago, have faced stiff resistance from GOP-controlled legislatures.

All three governor races this fall appear close. In Kentucky, Bevin’s dismal approval ratings after a contentious first term has made the race competitive. In Louisiana, Edwards leads his two Republican rivals ahead of Saturday’s “jungle primary” election, but he could be forced into a competitive run-off next month if he fails to get at least 50 percent of the vote. Mississippi’s election is believed to be closer than usual, but Republicans said they’re confident because of the state’s conservative bent and Trump’s enduring popularity there.

“You can definitely tie Hood to the liberal policies of his party,” said GOP strategist Marie Sanderson. “And that’s exactly what Republicans are going to do in Mississippi.”

The Democratic candidates are trying to keep a focus on local problems and avoid national issues that don’t play well in conservative-leaning states. You won’t hear any of the candidates talking up “Medicare for All” or backing the Green New Deal, for instance.

“They make it clear they’re not working for the party, they’re working for the people in their state. I think this is particularly important for governors races,” said Carrie Glenn, a veteran of multiple red-state Democratic campaigns.

But Republicans are trying to nationalize the contests, tying their opponents to Democrats’ leftward lurch. And they’ll get help from Trump and Vice President Mike Pence, who are becoming more involved in the races.

On Tuesday, Pence is holding a fundraiser in Washington for Reeves, who secured the Mississippi GOP nomination only after being forced into a runoff election. Trump will headline a rally in Louisiana on Friday, a day before the state’s primary, and he has implored Republicans to vote against Edwards, implicitly dismissing the governor’s reputation as a conservative Democrat.

“Don’t be fooled, John Bel Edwards will NEVER be for us,” Trump tweeted last week.