Matthew Yglesias over at Slate is talking the Affordable Care Act and which states are likely to decline to expand Medicare. This is the part that caught my attention:
The way I see it playing out, in most places local health care providers—hospitals, doctors—plus the national pharmaceutical industry will exist as a powerful lobby in favor of expansion. More Medicaid equals more customers. Certain classes of low-wage employers should also favor expansion. That means the greatest opposition to expansion over the long term may come not from places like Texas but from the low-population states of the Plains.
This is honestly something I'd not considered. I figured as long as we have Republicans in charge, we can expect to be deprived of expanded Medicaid. Even the governor has come out in his somewhat controversial YouTube video and made noises about not expanding Medicaid. (The video is controversial because he tells folks to vote for Romney at the end. It should be controversial because he looks so resigned to having to tell people to vote for Romney. If I were Romney, I'd be asking Haslam to not do me any more favors.)
But we have an enormous medical industry in this state, most of it located in Nashville, where it can dispatch not only real lobbyists but other glad-handers on a moment's notice to the Capitol.
Haslam already blinked and vetoed legislation Vanderbilt didn't like. Is he really going to take on Vanderbilt, HCA, and all the other healthcare companies in Tennessee and tell them they can't have more customers?
I don't know, but it will be interesting to see if Haslam fears his social base or his financial base more.