By Glynn Wilson —

WASHINGTON, D.C. — The word is coming out from Capitol Hill. While President Donald Trump and his coterie of converted Republicans push their agenda in this midterm election year, Democrats are pushing access to health care and Medicaid expansion in Washington and the states this summer as a centerpiece of their campaign to create a Blue Wave in November to take back control of Congress and offices in many states, including Alabama.

Last summer in Washington, the land Trump calls a swamp, the Republicans led the day in their ultimately failing effort to repeal and replace the Affordable Care Act, otherwise referred to as Obamacare. Karl Rove coined that phrase for political purposes. President Barack Obama embraced it and made it his own. We were here to cover that, and I was there the day Arizona Republican Senator John McCain showed up to cast the deciding vote against it, with video cam: Senate Democrats Join Protesters in Rally to Save American Health Care.

That failure left many Republicans on record voting to remove millions of Americans from the rolls of the insured — and Democrats are hammering them for it, according to coverage by USA Today.

After years of playing defense on health care, Democratic candidates have made it a top issue this election cycle. They are pledging to fix the flaws in Obamacare while targeting Republican attempts to “sabotage” it and take coverage away. And grassroots organizations that protested Republican efforts are keeping up the pressure with events planned around the anniversary.

“This is going to be a continuing conversation throughout the election,” said Sen. Chris Van Hollen, of Maryland, chairman of the Democratic Senatorial Campaign Committee. “I’m seeing this as an issue in every state.”

Rep. Ben Ray Lujan, of New Mexico, chairman of the Democratic Congressional Campaign Committee, told reporters recently, “Republicans are going to have one heck of a time having to explain themselves.”

Whether health care will really be a winner for Democrats was met with skeptical commentary in the New York Times.

But that is the plan from here.

IN A CONFERENCE CALL with reporters on Thursday, Alabama’s new U.S. Senator Doug Jones called the move by former Governor Robert Bentley to refuse Medicaid expansion in 2012 and beyond a “political decision” that “damaged the state economically and cost more than 200,000 people quality health care.”

As our reporting showed in 2016, something like 1,200 people a year were dying in Alabama alone because of the lack of access to health care.

“I have consistently said the decision to reject expansion was … politically motivated and (a) moral failure on the part of state leaders and it makes no fiscal sense,” Senator Jones said.

He is now talking about health care in the context of trying to create jobs in the state by recruiting job creators, and he said it is “tough” to do.

“How can we convince businesses to come to a community that does not have a healthy work force and access to affordable health care?” he asked.

“While the final decision to expand Medicaid will still rest with leaders in Montgomery, I think we have a responsibility as elected officials to do what is in the best interest of our constituents,” he said. “After six years of inaction I believe it has been proven that Medicaid expansion would be the best thing for Alabama, it’s citizens and the economy. As long as I have this platform I am going to continue to advocate for Medicaid expansion.”

Senator Jones said now that efforts to repeal and replace the Affordable Care Act, otherwise known as Obamacare, have died down in the Congress and “it’s not a political issue as much anymore, states are beginning to take another look.”

Virginia and other states recently come around to taking the federal money to help treat nearly all of their citizens, creating health care jobs at the same time.

“That got votes on both sides of the aisle,” he said. “So I’m hoping that is an issue we hear more about in the coming months as we get constitutional officers and the legislature in place for next year.”

In his own effort to make a difference in the fight for affordable health care for all, Senator Jones introduced a piece of legislation this week that would require the Medicaid and CHIP Payment and Access Commission (MACPAC) to publish an annual report on the estimated impact in each state, including the amount of federal funding that has been passed up by states that have not yet expanded Medicaid under the Affordable Care Act.

The Smart Choices Act, cosponsored by Senators Tim Kaine of Virginia, Bill Nelson of Florida, Angus King of Maine, Amy Klobuchar and Tina Smith of Minnesota, would quantify the impact of Medicaid expansion both for states that expanded their coverage and took the federal money and those that did not.

“Every American deserves access to quality, affordable health care, but by refusing to expand Medicaid in Alabama, we’ve turned down an estimated $14 billion of our own tax dollars and needlessly left more than 200,000 Alabamians without health coverage,” Senator Jones said in the press release announcing the bill. “This legislation will shed light on the extent to which failing to expand Medicaid is costing taxpayers and expediting the closure of our rural hospitals. Every year, Alabamians send hard-earned tax dollars to Washington – let’s bring billions of those dollars back to our state and put them to good use for a healthier workforce and a stronger economy.”

Senator Jones cited a multi-state study out of Colorado that shows how states could save more than $48 million annually across 102 adult primary care practices if prices for health care services were closer to the average across participating practices. Results found that Colorado’s total costs across all health care services were 17 percent higher than other states, and substantially (30%) higher with respect to outpatient services.

In addition to introducing the Smart Choices Act, Senator Jones also signed on as a cosponsor the States Achieve Medicaid Expansion (SAME) Act of 2017, a bill led by Senator Mark Warner of Virginia. It would provide each state expanding its Medicaid program with the same levels of federal matching funds, regardless of when it chooses to expand the program. This means that a state like Alabama would receive the same funding deal from the federal government if it expanded Medicaid today as a state that took the deal before 2014. Under current law, states that expand Medicaid after 2014 receive lower federal matching rates.

As it stands now, Alabama receives about 67 cents on the dollar for every dollar the state spends, while this bill, if successful, would push that up to 81 or 82 percent.

“We need to bring every possible tax dollar back home to Alabama that we can and at the same time make sure that our most vulnerable Alabamians get access to health care,” Senator Jones said in the release. “This legislation eliminates the last argument against Medicaid expansion and ensures that every state gets the same deal from the federal government. I’m proud to cosponsor Senator Warner’s legislation and show leaders in the state that we can put the people of Alabama first and do so in a fiscally responsible way for our state.”

In response to my question about the chances of either bill getting on the Senate calendar in this election year, passing the Senate and the House and being signed by the president and becoming law with Republican Majority Leader Mitch McConnell in charge, Jones said, that may be “an uphill fight.” But he said he and his colleagues are going to be talking up this issue in August “to push these bills to get up for a vote and let everybody be on record one way or another as to whether we can expand Medicaid, and put more and more pressure on the folks in the legislatures around the states that have not expanded Medicaid to do the right thing for their constituents.”

The legislation doesn’t have to pass, he said, as long as “there’s a buzz” around the “very serious” issue.

“I just hope the legislation generates some interest in Alabama and other places around the country,” he said.

In response to other questions, he said expanding Medicaid is critical for mental health as well as a substance abuse, which is “more and more seen as a health care issue as opposed to a criminal justice issue.”

Expanding Medicaid “would just give ultimately more access to health care in general … where people don’t have to worry,” he said.

Senator Jones said it would be tough for rural hospitals that have already closed to reopen.

According a state-by-state breakdown on rural hospital closures, 83 hospitals have closed across the country, five of them in Alabama already, including the Chilton Medical Center in Clanton, Elba General Hospital, Florala Memorial Hospital, Randolph Medical Center in Roanoke and Southwest Alabama Medical Center in Thomasville.

While Mr. Jones said he could not comment on the pledge by Tuscaloosa Mayor Walt Maddox, the Democratic Party’s nominee for governor, to expand Medicaid “on Day 1,” since he was taking questions from the Capitol’s radio room where it would be inappropriate to talk about politics, he recently Tweeted his support.

@DougJones
#MedicaidExpansion would help 200k Alabamians get health care. It would create a healthier workforce. And it would bring billions of our own tax dollars back to Alabama. So what are we waiting for?

@WaltMaddox
We will expand Medicaid on Day 1 and @SenDougJones is working to provide states like #Alabama an opportunity to take full advantage of the health care, mental health and economic benefits of #MedicaidExpansion #believe #ALpolitics

ON OTHER ISSUES, Senator Jones has been working on an effort to expand access to broadband, or high speed internet, in rural areas, and fought against allowing long-held Net Neutrality rules to expire in the FCC. The Senate did pass a resolution to overturn that decision. It’s now in the hands of the House.

“Hopefully the House will take that up and give it a very good look,” he said, although he’s not that optimistic. What needs to happen is for the House and Senate to pass legislation reinstating specific, legal net neutrality rules “and not leave it to the FCC and political appointees all time. We need to have a consistent policy going forward.”

While recently meeting with a group of high school students, the first question Jones was asked had to do with his position on net neutrality.

“This is a very important (issue) for young people,” he said.

When asked how he felt about President Trump’s summit meeting with Kim Jong-un of North Korea, he said he felt “hopeful.”

“I think this was an interesting breakthrough … a historic breakthrough,” he said, “although probably not as important as people make (it) out to be.”

The leaders of North Korea have been dying to meet with a president of the United States for decades, he said, and they all refused before, in part due to the abysmal human rights record of the dictators who have presided over the regimes in the north since the armistice that ended the war there in 1953.

“I want to make sure people understand that North Korea has never been a country we can trust,” he said. “They have a history of going back on their word … of saying one thing and doing another.”

The way they treat their people amounts to an atrocity, he indicated.

“They have a horrible history. The president has acknowledged that in the past, that they are one of the worst at human rights violations,” he said, but…

“I give the president credit for this breakthrough,” Senator Jones said. “But I want to see some verifiable movement on the part of North Korea” and not just “empty talk” not backed up by “absolute action.”

The only action so far is that North Korea made a show of blowing up one nuclear test site.

“Well that doesn’t really mean a whole heck of a lot,” he said. “We have no idea how many nuclear weapons they have (or) where they are stored.”

The president has also failed to provide a time table on providing that information, he said, and has committed to pulling back on military exercises with South Korea. “He caught the Japanese by surprise when he did that.”

“Right now it’s a lot of talk, hopeful talk,” he said. “It is good for peace. I feel better now than I did a year ago when it was a Twitter war of words calling each other junior high names. But the fact is, actions speak louder than words.”

So it’s not time to pull back on economic sanctions just yet, he indicated. “I would also like to see the president put a little bit more pressure on them with regard to the atrocities they commit against their own people.”