Chris Christie of New Jersey on Tuesday become the latest Republican governor to support the Medicaid expansion under Obamacare.
“It’s simple. We are putting people first,” Christie said in a speech before the legislature unveiling his budget. “Which is why, after considerable discussion and research, I have decided to participate in the Medicaid expansion under the Affordable Care Act.”
“Let me be clear, refusing these federal dollars does not mean that they won’t be spent,” he said. “It just means that they will be used to expand health care access in New York, Connecticut, Ohio or somewhere else. … In fact, [New Jersey] taxpayers will save approximately $227 million in fiscal year 2014 alone.”
Christie’s pending decision on whether to accept the new Medicaid funding had been closely watched nationally for several months, both as a bellwether for other GOP governors facing similar decisions and as a particularly dicey choice for a Republican governor of a blue state facing reelection who has bucked his own party’s orthodoxy from time to time.
“Expanding Medicaid,” he said, “is the smart thing to do for our fiscal and public health” and will “ensure New Jersey taxpayers will see their dollars maximized.” Although he’s “no fan of the Affordable Care Act,” it is “now the law of the land,” Christie said. He vowed to “make all my judgments as governor based on what is best for New Jersey.”
“If that ever changes because of adverse actions by the Obama Administration or broken promises,” Christie said, “I will end it as quickly as it started.”
The Affordable Care Act originally mandated that states expand Medicaid, a provision Christie called “extortion.” He praised the Supreme Court for its decision holding that the federal government could not mandate the expansion but must leave it up to each state whether to accept it. In the end, he accepted it.
The expansion is projected to add 300,000 New Jerseyans to the Medicaid rolls, according to the New Jersey Policy Perspective, a liberal-leaning think tank, and bring in $1.7 billion to the state’s economy. Medicaid currently covers 1 million residents in the state.
The decision makes Christie the eighth Republican governor to call for expanding Medicaid, as authorized by Obamacare and made optional for states by the Supreme Court. The others are Rick Scott of Florida, John Kasich of Ohio, Rick Snyder of Michigan, Jan Brewer of Arizona, Brian Sandoval of Nevada, Susana Martinez of New Mexico and Jack Dalrymple of North Dakota. Numerous prominent GOP governors have so far rejected it, including Scott Walker or Wisconsin, Tom Corbett of Pennsylvania and Rick Perry of Texas.
The expansion makes residents up to 133 percent of the poverty line eligible for Medicaid. It’s a generous deal for states: the federal government will foot the entire bill for the first three years and 90 percent thereafter. The Obama administration says states may not partially expand the program but may opt in or out at any time.
Republican governors have been caught between the desire to accept a generous deal and the internal party politics of being seen as siding with Obamacare. While conservative activists are pushing governors to turn down the expansion, the influential retirees group AARP and the hospitals industry have been pressuring states to accept it.
Christie’s decision is the latest in a series of blows to the anti-Obamacare apparatus, which views the ability to opt out of Medicaid as its last line of defense against the law.
Sahil Kapur is a congressional reporter for TPM. He previously covered politics and public policy for numerous publications including The Guardian and The Huffington Post. He can be reached at sahil [at] talkingpointsmemo.com.