Stacey Abrams Hopes Medicaid Expansion

Stacey Abrams Hopes Medicaid Expansion Can Be a Winning The issue in Rural Georgia.

ATLANTA — For the upscale urban audience at a campaign government building here, it might have

been enough for Stacey Abrams to pitch Medicaid expansion as an ethical issue — the health-care-as-human-right argument that appeals to progressives everywhere.

Instead, Ms. Abrams, the Democrat within the tossup race for Georgia governor, stuck to the pragmatic line of reasoning she has pushed in making Medicaid expansion a top priority of her campaign: it'll help save the state’s struggling rural towns without busting its budget, since the Affordable Care Act, requires the federal to pay 90 percent of the cost.

“Raise your hand if you'd say no to someone who said, ‘Give me a dollar and I’ll give you $9 back,’” Ms. Abrams said to appreciative laughter at the event earlier this month at Clark Atlanta University, a historically black college.

“It is economically false, a falsehood overall, to say we can’t afford to expand Medicaid.”

With health care dominating many a midterm campaign this year, Medicaid expansion has been a serious point for Democratic gubernatorial candidates in many of the 17 states that have rejected the choice, including Florida, Kansas, Oklahoma, Tennessee, and Wisconsin.

But none have promoted it as forcefully as Ms. Abrams, 44, who would be the nation’s first black female governor if elected and therefore the first Democrat to steer Georgia since 1998.

Her momentum with the difficulty reflects the experience of Democrats around the country, the whole argument that Republicans won't protect access to health care, especially for the sick seems to be influencing voters more than almost anything, from proposals on immigration and therefore the economy to the battle over Judge Brett M. Kavanaugh’s appointment to the Supreme Court.

Guarding protections for people with pre-existing medical conditions, in particular, is proving a potent closing argument for Democrats and forcing Republican candidates, many of whom voted to repeal the Affordable Care Act last year and support a new lawsuit seeking to invalidate it, on the defensive.

The federal health care law has grown in popularity since it had been enacted in 2010 — reaching a high earlier this year.

About half of Americans now say they support it, according to this month’s Kaiser Family Foundation tracking poll.

By framing the expansion of state health coverage for the poor as a sensible business move that would save teetering small-town hospitals and create thousands of jobs outside metro Atlanta, Ms.

Abrams, an unabashed liberal is hoping to feature enough rural votes in her column to beat Brian Kemp, her Republican opponent, a Trump-style conservative who is against expanding Medicaid.