not a smart move, i'd say. if there's a reason for giving to the country boys and girls but not to the city boys and girls, it would be useful for all of us to hear it. and that's "hardball" for now. thanks for being with us. "all in with chris hayes" starts right now. good evening from new york. i'm chris hayes. tonight, we continue our special series, "all in america," on the road in the conservative heartland with a special look at just what happens when a state refuses to expand medicaid for political reasons. but first, today, amidst a growing chorus of outrage on capitol hill, president obama came forward to address the firestorm erupting around allegations of mismanagement, long wait times, and cooked books at v.a. hospitals. >> so when i hear allegations of misconduct, any misconduct, whether it's allegations of v.a. staff covering up long wait times or cooking the books, i

will not stand for it. not as commander in chief, but also not as an american. none of us should. so if these allegations prove to be true, it is dishonorable, it is disgraceful, and i will not tolerate it, period. >> the president's strong words coming after a controversy driven by investigative reporting in the arizona republic and elsewhere last month, which appeared to show that not only was the department of medical affairs medical center in phoenix mired in a long backlog with sick veterans waiting a month, even a year to see a doctor, but there was a secret set of books created to hide the fact that administrators were systemically violating the maximum wait time that the v.a. brass ordered for all veterans seeking care. subsequent reporting has revealed similar patterns of alleged misconduct and cover-up in v.a. hospitals from florida to wyoming, to colorado. the v.a. inspector general is

now investigating at least 26 facilities that have been accused of falsifying records and both white house deputy chief of staff rob nabors and embattled veteran affairs secretary, eric shinseki, are also conducting reviews. congressional republicans have used the scandal to go after the president and push a theme of administrative incompetence, with representative kevin mccarthy suggesting that americans should doubt the president's ability to properly manage the leviathon government that he helped create. >> this government is an impairment and the president's response is an impairment. >> what i heard this morning from the president's remarks is a parroting. >> it is time for our president to come forward and take responsibility. >> well, republicans are eagerly seizing on this issue in an election year, it's worth noting the criticism has not been entirely partisan. >> i was disappointed with president obama today.

there was no urgency. mr. president, we need urgency! we need you to roll up our sleeves and get into these hospitals! >> but, before this story gets sucked into a hashtag benghazi-like vortex that obscuring the reality of what actually happened, it is worth taking a moment to ask, how did we get here? in 2005, a great journalist named phillip longman wrote a cover story for the washington monthly about a health care system that almost seemed too good to be true. it's getting arguably the best care of the country. it was titled, the best care anywhere, the article chronicled an integrated single-payer system that had pioneered implementation of electronic health care records, created the best practices for continuum of care across doctors. and because it dealt with patients for their entire lives, it had every incentive to invest in prevention. it was efficient, cost-effective, and provided high quality. longman cited a 2003 study by the "new england journal of

medicine" that found that facilities within this health care system exceeded fee for service medicare on all 11 different quality of care metrics they used to evaluate. that system was the v.a. system. and yet, just two years after longman published that piece came this. >> wounded veterans returning from iraq and afghanistan have been living in appalling conditions and fighting a dysfunctional bureaucracy at the outpatient clinics of this nation's premiere military hospitals. >> the walter reed neglect scandal revealed that at least part of the veteran's health care system is outrageously underfunded and underperforming, failing to meet the basic standards of decency. president obama came into office with a promise to fix things at the v.a. and fix funding after a bush administration he said had ignored deplorable conditions at some v.a. hospitals and neglected the planning and preparation necessary for to care for our returning heroes.

and yet, while backlogs in veterans' disability claims have been cut in half over the past year and v.a. funding has increased 38% under president obama, according to the administration, a poll just last year found that 58% of post-9/11 veterans said the v.a. is doing an only fair or poor job of meeting their needs. so what happened? who or what broke the v.a.? well, for starters, we can look at the budget. it certainly did not help matters when republicans in february blocked senator bernie sanders' bill to provide $21 billion in medical and other benefits for veterans. >> i don't think our veterans want their programs to be enhanced if every penny of the money that's going to enhance those programs is added to the debt of the united states of america. >> but here's the thing. the problem appears to be deeper than simply one of resources. it appears to be tied to sheer institutional capacity.

think about it in terms of what might happen in an urban school district, anywhere in america. a fully functioning school is serving the needs of its community with a large enough facility, enough teachers for every student, and then a bunch of tall apartment buildings pop up around it. the student population skyrockets, and the school can't keep up. now, even if the budget goes up a comparable amount to the influx of enrollment, that doesn't mean you can immediately recruit enough teachers or that you have the physical space in your school for all those kids. something similar appears to be happening in the a v.a., where the longest period of continued war in the nation's entire history has produced a demand for services the v.a. appears to lack, the institutional capacity to provide. so, while primary care visits at v.a. hospitals rose 50% over the last past three years, the number of full-time primary care physicians has only risen 9%. there aren't enough doctors to meet the increased need. that has resulted in long wait times and complaints about backlogs and justifiable outrage

that people returning from battle are not caring the care and attention that they deserve. and so last year, the v.a. established a goal for new patients seeking primary care to be seen within 14 days of calling for an appointment. but here's the thing. without the institutional capacity to actually make good on that promise, a decree such as that appears to have simply produced cheating and gaming. and that's not new. and it's not just a problem at the v.a. anyone who's watched "the wire" knows what happens all too often when big city police departments announce quota for crime reduction. stats get juked. >> juking the stats. >> excuse me? >> making robberies into larcenies, making rapes disappear. you juke the stats and joirs become colonels. >> that sort of thing has happened in school system after school system, where high-stakes testing and teacher accountable policies intended to boost student performance have instead led to cheating scandals.

none of this is an excuse for deception and malfeasance, and anyone that willfully engaged in that behavior should be held to account and punished, no matter the political fallout. but let us not lose sight of the fact that we have more veterans needing more care than we have in a generation. so when people start asking the question, who broke the v.a., the prime suspect, it seems to me, is 13 years of war. joining me now, senator bernie sanders, independent from vermont, senator sanders, this is something you've been working on a lot. what is your reaction to the fallout from the revelations that have been reported in the press and the president's comments today? >> well, i think a couple of things. we held a big hearing on this issue on thursday, and if you listen to the -- all of the veterans operations, what they tell you, chris, is that when veterans get into v.a. health care, in fact the quality of care is quite good. and there are a number of independent studies out there which suggest that in many

republicans, v. health care does better than health care in the private sector. but as you have indicated, one of the serious problems that we face is that in the last several years, i think significantly because of the wars in iraq and afghanistan, 2 million new veterans have come into the system. and i have no doubt that there are parts of the country where we simply do not have the staff needed to accommodate these veterans in a timely and effective way. and that is a real problem. the second point that i would make is that i am glad that my republican colleagues are now paying attention to our health care issue. but, remember, these are the same folks in the house who voted to end medicare as we know it, make devastating cuts in medicaid, have voted 50 times to repeal the affordable care act, and in states throughout this

country, are putting in jeopardy millions of people, because they refuse to accept the medicaid proposal in the affordable care act. >> and i should note, some of the 5 million folks that would qualify for medicaid expansion that's not being implemented, some tens of thousands of those themselves are inadvertence. but how much of this is a resource issue? you had this bill, it was $21 billion. it was filibustered by the republicans. we've seen spending go up 38%. is it just not enough? is this a money issue? is this a mismanagement issue? is this an institutional capacity issue? >> you know what, i think you hit all three. i think you're absolutely right, in those three points. is it a money issue? yeah, i think it is. not only have we seen more and more people coming into the v.a., because they need the care, and they appreciate the good care that the v.a. provides, but many of these cases are not easy cases. these are difficult issues. we have 200,000 men and women who have come back from iraq and afghanistan who are dealing with

ptsd and traumatic brain injury. you have other people coming home without legs, without arms, losing their hearing. these are tough issues. so for a start, i think it is probably the case that while obama has been pretty good in his budget, pretty good in his budget, i think we probably need more resources and i have advocated for that in the last several years. second point, though, i think it is fair to say that management of v.a. has not been as strong as it should be. i think there are areas where the v.a. should have been much quicker to pick up on the problems and allocate resources. >> let me interject there for a second, because you are already seeing on the right in the conservative media, basically, a whole -- dozens of pieces today, this shows government-run health care can't work, this is the bankruptcy of liberalism. and, obviously, this thing is going to be a mismanaged bureaucracy, because it's a big state enterprise. what do you say to that? >> well, these are -- look. it is no great secret that if people want to repeal the

affordable care act, if they want to end medicare as we know it and convert it into a voucher program, if they want to slash medicaid and leave millions and millions of people out on the street without any health insurance, it's fair to say these guys are not great fans of public health. i think that's a fair statement. i would argue that in many ways, and according to many studies, despite its problems, v.a. today provides good quality health care in a cost-effective way. >> i would say to you, senator, i hope republicans either in the senate or the house have the courage or the convictions to introduce legislation to privatize the v.a. and we can see how the voters feel about that. senator bernie sanders, i know where you would be on that. thank you so much. >> thank you. coming up, 13 years after 9/11, we're still officially, legally a nation at war. who are we at war with? that turns out to be a surprisingly difficult question to get an answer to. richard clark, president george

w. bush's chief counterterrorism adviser will try to help me answer it, next. female narrator: through memorial day at sleep train,

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coming up, our special series, "all in america" continues tonight. we're on the road in kansas to find out what happens when people are too poor for obamacare and not poor enough for medicaid. stay with us.

i want a yes or no answer. are you authorized under the 9/11 aumf to go after isif? >> sir, i can't speak publicly about which groups we may or may not have -- >> is this a classified answer, is that the reason? >> that's my understanding, yes, sir. >> it appears who we are at war with is a secret. but what we do know, even if the

last american troop ever leaves afghanistan, will, 13 years after 9/11, still be at war, officially and legally. thanks to the 60 words that make up the authorization for use of military force, or aumf. that the president is authorized to use all necessary and appropriate force against those nations, organizations, or persons he determines planned, authorized, committed, or aided the terrorist attacks that occurred on september 11th, 2001, or harbored such organizations or persons in order to prevent any future acts of international terrorism against the united states by such nations, organizations, or persons. it was passed one week after 9/11. the lone dissenting voice of congresswoman barbara lee. that document puts the u.s. on more footing and we will continue to be on more footing until it is repealed. just last year, the president indicated he was interested in finally moving the country away from a perpetual state of official war. >> i intend to engage congress about the existing authorization to use military force, or aumf.

to determine how we can continue to fight terrorism without keeping america on a perpetual wartime footing. soy look forward to engaging congress and the american people in efforts to refine and ultimately repeal the aumf's mandate. >> today, there was a hearing before the senate foreign relations committee about the scope of the aumf. and in a somewhat surprising turn of events, two of the administration's the top lawyers says they don't think the president even needs the aumf to continue waging war against terrorist groups in a carte blanche fashion. >> i would just like to know, yes or no, if the 2001 aumf was undone, can the president carry out the activities that he's carrying out right now? >> yes, i believe he could, senator corker. >> it sounds like i don't think we need an aumf at all? so it's kind of becoming an irrelevant question, but are

there terrorist groups per the aumf that you don't think is relevant that you don't have the ability to go against. >> i'm not aware of any foreign terrorist group that presents a threat of violent attack on this country that the president lacks authority to use military force to defend against as necessary, simply because they have not been determined to be an associated force with the aumf. >> joining me now, richard clark, the chief counterterrorism adviser to the national security council under george w. bush. author of the new book, "sting of the drone." richard, do we know the aumf? if the legal analysis presented to the committee today is true, why do we still have this thing? shouldn't we repeal it? >> chris, i was also the chief adviser during all eight years of the clinton administration, and we used force during the clinton administration against al qaeda and we had no aumf. i think every president

certainly in my lifetime, has used force without having an aumf. so the president has inherent authority to use military force when he thinks the united states is threatened. and whether or not we have the aumf, a president will have that authority. the question is, can we use a debate in congress about the aumf resolution, to have some discussion about what is authorized and what is not authorized, in terms of nsa activity, in terms of drone activity. you know, we've killed 2,500 people in five countries with drones. and it's a little bit difficult to argue in all of those cases, the people involved were threatening the united states. >> well, that's the question. what's -- there's a kind of constitutional question, a basic question that seems to me as a citizen, i would like to be able to have a clear answer from the government, who we are at war with. that doesn't seem like asking too much.

and yet, that seems to be past the capability, apparently. and then there's an efficacy question, a moral question, about whether it's justifiable to be raining down the kind of violence we have been across the world, and whether that's getting us anything that's tangibly improving american security? >> i don't think it's a mystery who we're fighting. we're fighting al qaeda. al qaeda has morphed, however, into a number of deferent organizations, and organizations have self-declared themselves to be al qaeda and changed their name to al qaeda. i suppose when they do that, they automatically become a target of the united states -- >> but let me just stop you there. because we also have been fighting groups that don't have that name, particularly, but share, essentially, a kind of militant, violent jihadi ideology. i believe the operations we've done in somalia aren't against a group that calls itself, necessarily, al qaeda -- >> actually, it does. >> it does? >> the shabab organization, self-declared last year, that it

was now a part of al qaeda. but i think real issue here is not what they call themselves or what the name is, but whether or not the organization actually threatens the united states. and some of them do, certainly, al qaeda in the arabian peninsula has tried to blow up american planes and tried to have bombs go off on the united states. >> that's a group located in yemen? >> it's largely in yemen. the one in the somalia, shabab, has also tried to recruit americans, but that hasn't actually happened. so i think having a debate in congress about which organizations threaten us and what are the acts that you have to do to threaten us, well, there's a terrorist group have to do to qualify, i think that's worth having. >> finally, today, nancy pelosi announced the five democrats who would be appointed to the benghazi select committee, that bob corker line we've played had to do with one of the groups that appears possibly responsible for the violence

that happened in benghazi. do you think this is a serious inquiry, or someone who's spent a lot of time thinking about counterterrorism, does this strike you as a side show? >> we've had serious inquiries, several, this is a side show, but we've had serious inquiries run by the highest ranking officer in the united states and the longest serving foreign service officer in the united states. men appointed repeatedly by republicans and democrats. we have their report. they did a very good job. their recommendations are being implemented. there's no need to do anything more on this in the way of an investigation. it seems to me that this is entirely about politics and entirely about trying to smear a potential democratic candidate for president. >> richard clark has a new book out, it's called "the sting of drones," it's a novel actually about war in this 21st century. richard, thank you so much. >> thank you. coming up tonight, we're a lot closer to solving the mystery of why it was time for some traffic problems in ft. lee. an update on chris christie's bridgegate is next.

the wiggest mystery in politics, for months now, one we've been reporting on and trying to solve, why was it time for some traffic problems in ft. lee? why did chris christie's appointees and staffers shut down traffic lanes on the george washington bridge? what was the motive? we know the crime, the details, the perpetrators. we just don't know why. now, finally, we have come much, much closer to solving that mystery, thanks to new testimony from the ongoing investigation of new jersey legislature select committee.

matt mauers is 24-year-old former aide to governor chris christie's re-election campaign last year, who was charged with cultivating mayoral endorsements. he testified the christie re-election campaign was pursuing ft. lee mayor, mark sock lidge's endorsement last year. in fact, briggette kelly at the time called mauers on august 12'd. >> she just called to check in and said, if i recall correctly, and you know, some of this is going to be paraphrasing from recollection, he said, is mayor sokolich endorsing? i said, no, you know, he's not. he's definitely not endorsing, right, not going to happen? i said, no, not going to happen. you know, from everything i know, just, door shut. not going to happen. she said, okay, that's all i need to know. >> and you know what happened the very next day? kelly sent this now-infamous e-mail. now, we still don't definitively know christie's level of involvement or non-involvement. it does appear, though, that the

motive behind it was as petty as we first thought. and the really bad news for chris christie is that his biggest problem has absolutely nothing to do with this. his biggest problem is that the signature issue he ran for governor on, the cornerstone of his political appeal, what made him a republican star and darling of the party's donor class, is all falling apart, right before our eyes. i will tell you what it is, next.

all right. some wednesday night word association. chris christie. if you've been watching this network, you might say, bridgegate! bully. town halls. sandy. stronger than the storm. guy who yells at teachers. presidential hopeful. former presidential hopeful. but the number one phrase that governor chris christie wanted to be associated with himself, the thing that made him the star he was was pension reform. >> what i'm doing is trying to change the pension system in new jersey so the pension's actually there for them. >> we have a benefit problem. it's not an income problem from

the state, it's a benefit problem. and it's got to change those benefits. >> i would love to send the bill to whitman, mcgreevey, cody, and corzine. what i won't live with is sitting off in my retirement somewhere, watching police officers and firefighters and teachers in new jersey not get their pension. when i get this done, ten years from now, when you retire, you're going to be looking for my address on the internet to send me a thank you note, because you're going to have a pension. never said i wasn't going to make the payment. i will make the appropriate payment to the pension this year. >> all right. that was the thing that made chris christie, blue state republican, wins on running against the big, bloated pensions, against the corrupt democratic establishment that kicked the can down the road and raided the pension fund year after year. and the first thing he does when he gets in office, he does the tough thing. christie reaches out across the aisle and gets bipartisan compromise to pass a tough, accountable pension reform bill. no longer would it be the case that profligate liberals in new

jersey would be stealing from the future to pay off the big public sector unions now. that was the thing that made chris christie a darling in the eyes of national republicans. made the wall street donor class swoon. that was his defining thing. but that was then. here's the news now. you'll never guess what's happening new jersey. mr. fiscal probity is overseeing more than $800 million budget shortfall. that's $800 million, as in close to $1 billion with no way to pay for it. the state constitution requires a balanced budget, and so, guess where christie's hand is creeping towards? good old wallet that's been sitting there on the dresser since time memorial, the public pension funds. christie halts $900 million due for pensions. >> i have been talking since january about the fact that we need to be more aggressive in this regard. and despite the steps that we took in 2011, the reality for new jersey is that what we've done so far is not come close to

closing the gaps quickly enough. >> joining me now, executive director of the new jersey working families alliance. all right. is this just a complete and total 180 flip-flop, doing exactly the thing he said he wouldn't do? am i wrong in thinking that? >> i think bottom line, the grn has continuously walked the state into this idea of he is the fiscally responsible candidate. he was a fiscally responsible governor. and the reality is that he has continuously decided to protect tax breaks for the rich, corporate loopholes, and at the expense of regular new jerseyans. the governor has said that he was going to fix the pension problem. he asked regular people to pay 25% more to get 30% less in their pension. >> that was what the pension reform was. >> exactly. >> you paid more and got less. that's where the money came from. >> exactly. and so he's asked regular hard-working new jerseyans to make those tough sacrifices.

and then what does he do? he moves the goalposts, he changes the rules. this is chris christie at his best. this is what he's done continuously. it's not to be -- it's not a surprise to us in new jersey, but it's unacceptable. >> he ran around the state, denigrating every one of his predecessors, democrat and republican, basically being like, these shiftless losers hustled and conned all you people, because every year, year over year, they had a shortfall. and instead of paying the money into the pension, they just took it to close their budget gap. that was the great sin. he is, am i wrong that he is just doing that now? >> he's exactly doing that. and what's interesting is you hear the governor talk about that it is a benefit problem and not a revenue problem. he's absolutely wrong. his gross estimates led to this huge budget shortfall. the fact that he hasn't actually looked at revenue and really trying to seek real revenue coming into the state is just resulting in a fiscal crisis. our roads are crumbling, our infrastructure is down, he shorted education. this is chris christie's

playbook. it's just catching up with him now. >> there was also the issue that you had a sort of independent, technocratic guy who was part of the legislature -- >> dr. kevorkian. >> he basically said, look, you're projecting these very optimistic, rosy scenarios about low employment, high growth, and he took hatchet to the guy, killed him. and now he's got the shortfall. >> absolutely. so the governor, when you don't agree with the governor, when you show facts to the governor, all he does is personal attack. but here's the reality. all right? the governor worked with a small number of democrats to move this pension reform. the real promise, the promise that he made to new jersey was that they were going to fix the system, ask public sector workers to pay more. and in exchange, he was going to fully fund this. they were going to put in one seventh each year, growing, growing -- >> that's the key, the social contract. the promise was, yes, it's going to be tough, you'll pay more and get less in benefits, but you

saw the tape, it will be there, i won't do what everyone else has done, which is essentially rob peter to pay paul, i won't rob from the future to pay the present. >> but that's exactly what he's done. and it doesn't just end with this shorting the pension payments. the reality is that the governor also today, his treasurer said that they were going to make toughs to new jersey transit, which is a tax on the working poor. he's going to delay or skip allowing for the property tax credits, which, by the way, is a tax on homeowners in new jersey. >> and here's the other thing, politically to me, it seems that, forget all the bridge stuff, everything. you're running in iowa, in the iowa caucuses, and an ad about you having a $800 million budget deficit -- >> or not living up to your word. >> that you paid by taking money out of the pension fund. that's brutal. >> breaking the law. >> thank you so much. >> thank you. coming up, our special series, "all in america" continues. we've traveled to kansases with where that state's republican

insurance commissioner went head to head with a member of her own party, the governor, who decide not to expand medicaid. we'll have that story for you, next.

all this spring and summer, we're leaving the studio and heading out across the country to bring you stories that illustrate the big political fights in this country. our series is called "all in america." this week, we've been looking at kansas, looking at everything from the koch brothers' team to stymie renewable energy in their home state, the republican governor's defunding of public education, and what that's doing to small-town schools. to a brand-new story tonight about the state's refusal to expand medicaid, and the republican fighting to change that. later this week, we'll be looking at how the nra is looking to kansas as a model for pro-gun legislation. how women are getting access to much-needed health care. it's a lot, but we're sure you have lots of lingering questions about the stories we're telling. so tweet those questions to @allinwithchris. we'll be right back. [ male announcer ] imagine this cute blob is metamucil.

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as a spirited crowd waited for word of the court's most important ruling in decades, the decision came a few minutes after 10:00 a.m. >> today's decision was a victory for people all over this country, whose lives will be more secure because of this law and the supreme court's decision to uphold it. >> next month marks the two-year anniversary of an historic supreme court ruling that upheld obamacare, to the delight of its supporters and disappointment of its critics. there was, however, another ruling that same day that did something both destructive and vastly underappreciated at the time. that ruling made it possible for states to refuse to comply with one of obamacare's most important provisions. you see, under the original affordable care act, states were required to expand medicaid eligibility for low-income residents, or risk losing their existing federal payments for medicaid.

but in june 2012, the supreme court ruled by a 7 to 2 margin that such a penalty was unconstitutional, which meant that medicaid expansion became voluntary. the affordable care act had been crafted with the presumption that all of the states would have to raise their medicaid eligibility to a nationally acceptable level. so, it created tax credits to help low-income people buy health insurance, but it's only really affordable for people earning more than 100% of the federal poverty level. the law presumed that those who earn less than that would be automatically covered by the states. but since the supreme court made medicaid expansion optional, 19 states have decided not to expand medicaid, leaving nearly 5 million low-income people in this country in the tragically absurd situation of being too poor for obamacare, and not poor enough for medicaid. tens of thousands of them live in kansas. >> you see, you don't change america by changing washington, you change america by changing the states. the medicaid expansion has

largely been talked about as a red state, blue state issue. but the real divide and the real obamacare medicaid battleground is inside the republican party. if you look only at red states, you might be surprised by which states decided to take billions of federal dollars to give poor people health insurance and who decided simply out of spite to give the president the finger. for example, jan brewer, arizona's tea party governor, of presidential finger-wagging fame, the very person who triumphantly signed into law the infamous papers please, anti-immigration law. jan brewer is expanding medicaid. but head on over to kansas, the land of rock-ribbed eisenhower republicans and bob dole pragmatist skpps not only is republican governor sam brownback not interested in expanding medicaid, he signed into law a bill designed to prevent any future governor from expanding medicaid without going through the legislature first. >> it's illogical, it's unreasonable, and it's immoral, what they're doing. >> there are so many examples

and so many stories that we hear, and i just can't believe that really the citizens of kansas can ignore this. it's frightening. >> so is there anyone listening to the kansans fighting the good fight? meet sandy prayinger, the state's republican insurance commissioner. >> the goal is not just to have a piece of paper that says you have insurance, the goal is to have people get health care, and not sick care, which is what i call it when you end up in an emergency room. you're in a crisis. >> commissioner praeger fought hard, but eventually lost. >> i kept hoping the governor would eventually seeing the rationale behind getting those tax dollars. >> in kansas, the expansion could have been especially powerful, because the state is already so stingy with medicaid. right now, if you're an adult without children, you cannot qualify for medicaid. if you're adult with children, you can't qualify unless you make under $8,000 a year for a

family of four. that means thousands of kansans make too much to qualify for medicaid, but too little to qualify for insurance tax credits under obamacare. leaving state health care navigators to deliver the heartbreaking news. >> i know many times, people just looked at them and cry kd, because they thought the aca was going to provide coverage for anyone, when, in fact, without that medicaid expansion, it doesn't. >> reporter: gracemed provides sliding coverage, so they've been getting an up close look at those falling in the gaps. >> these are hard-working folks that are trying to make ends meet, and many times paying for health care is a last priority to them. >> so what exactly is the argument for walking away from the medicaid expansion anyway? well, there isn't one. >> you know, i think it's mostly political. i think it's mostly about who the next president's going to be. i think it's about not giving this president a political win,

because i can't find any other logical reason that you would not want people in our country to have access to health care services. >> reporter: if you want to understand the rift in the republican party, this is it in its most essential form. the dividing line in the gop over the medicaid expansion is a line that divides republicans who can govern and those who can't. i'll talk to former governor of vermont, dr. howard dean, and wendy davis' running mate in the texas gubernatorial election about all of this, up ahead.

georgia, are you ready to make history? >> last night, georgia's michelle nunn became the democratic nominee for the senate seat being vacated by senator saxby chambliss. she's pro-choice, and pro-medicaid expansion. >> our state did not expand medicaid, which i think was a mistake. but we need to make sure we repeal the cuts that are happening or could happen to our rural hospitals. >> michelle nunn isn't the only mid-term candidate who's actively campaigning on expanding medicaid in his state. so is tom wolfe, and jason carter, the challenger to nathan deal in georgia. >> the governor has decided to put that washington politics of what he calls obamacare ahead of our taxpayers. we're paying today as georgians for the medicaid expansion dollars that the government has, yet we're refusing to take them.

that is a terrible stewardship by our governor of our tax dollars. >> while georgia is still one of the 19 states that has not expanded medicaid, indiana just joined the ranks of states that have, at least in some form. republican governor mike pence announcing this week he'll be seeking a waver to broaden his state's help indiana plan as an alternative to medicaid. joining me now, laticia vandaput, and former governor of vermont, former chair of the dnc, howard dean. governor dean, i will begin with you. if i could get in a time machine right now, interview you on the day of the aca decision before the court that upheld the aca, but made medicaid expansion eligible and i were to ask you two years from now, how many states will not have expanded medicaid, what would have that governor dean said? >> well, i news this was going to happen, because some of the republicans are so interested in embarrassing the president. and they don't care about their own citizens.

it was interesting to have jason carter on. jason carter is now four points ahead of jason deal. four hospitals have already gone broke because of the medicaid and closed. and that's going to happen all over the country. there are real governors, and as you said in the introduction, real governors that understand how to govern. jan brewer is one, rich kasich in ohio, and governors that are mostly political, bobby jindal, rick perry, sam brownback in kansas, nathan deal. and there's a big difference between the two, and the i think the voters will know that. >> senator vandaput, if i'm not mistaken, you are in a senator that have the largest number of citizens who would qualify in the medicaid expansion, who are denied that because governor perry is opposing it. is there political pressure manifest in the state? or is it just considered a done deal, and heck, what are you going to do? life's tough? >> well, unfortunately, when governor perry decided to say no to almost a million texans, he said no to 200,000 jobs.

governor perry is not running for re-election, but it is a matter of concern. as i travel the state on campaign trails, and it's a big state, people are asking about health care. and about what happened. and these are hard-working texans. they know that their tax dollars now are being used in other states. >> but let me ask you this. let me ask you an honest question. can you go to your immediatian texan voter, who you and wendy davis need to win in a very tough political terrain in the red state of texas, and talk about medicaid expansion, or is that just like, what are you talking about and why do i care? >> well, it's all about a conversation. and i've ban pharmacist for 33 years and have been having conversations right across the precipitation counter. but when 22 chambers of commerce beg the legislature to find a texas solution that would add 200,000 jobs, it would also add that 68,000 veterans and their spouses to be able to have.

you know, when i talk to people, i ask them one question. and that is, do you believe that every american family deserves to have a family doctor? if the answer is yes, then you're in support of the affordable care act. if the answer is no, there is nothing about it that you're going to like. but it's just that simple. >> governor dean, what senator van de putte said about the chambers of commerce, if you were a governor and sat in the governor's chair, and put yourself in the situation where you have an expanded medicaid, out of this ideological spite or you don't want people to have health care, what are the phone calls coming into the governor's office like, not just from the power of big poor people, which is not the most powerful lobby in these states, but from the whole panoply of interests that want to see this expansion happen? >> one of the reasons i know a lot about this is because this is how we got to universal health care for everybody around 18 in my state when i was governor 20 years ago. we expanded medicaid, up to 300% of poverty, made it a middle class entitlement program. i still run into people today in

the hardware story, who come up and say how grateful they are to have health insurance, at least for their kids. i still run into people all over the country who grew up in that generation, a whole generation now of kids in vermont have universal health care. you know, business people are not crazy. they are not these right-wing lunatics. they get smart economics. and smart economics, as senator van de putte has said, is getting jobs into your state. i find it ironic governor perry is running around saying, get jobs into texas, this is a guy who just turned down 200,000 jobs. >> and billions of dollars in federal money. senator van de putte, 100% paid in the first year and it goes down in a time span, but does that argument have traction, or is this something that greg abbett is saying, not even in the realm of the possible? >> if you keep hearing the

rhetoric and the vilification of the affordable care act, you might say in a state like texas, no, people are going to think obamacare is bad. but it's not. it was a bad decision not to expand medicaid. it was a bad decision to say no to that many jobs. and if any other comments that i'm getting on that leticia van de putte website are any indication, people are getting it. they know that people are finding a way and asking, why can't texas? >> in a state like texas, i've got to imagine that the eligibility is pretty low already. how poor do you have to be to get medicaid in a state like texas? >> we are not a luxurious state. we are a proud state. we value that you pull yourself up from your own bootstraps mentality, but we always know when neighbor needs to help neighbor. and it's been very disrespectful to the taxpayer, because 85% of the texans are paying high property taxes to hospital

districts, because it's our hospital districts that are paying for the uncompensated care. this is a really bad business decision, not to accept those medicaid dollars. and find a way to do this. >> state senator from texas, leticia van de putte, and howard dean, thank you both. on "all in america" tomorrow, the nra is calling kansas a model state, thanks to a new law that stops local governments from regulating guns. >> can you carry, openly carry weapons into municipal buildings now, public buildings? can you take them into the rec center? can you take them into the library? >> this issue does not belong at city level. if we want to have a law that gets involved in the second amendment, it needs to be a statewide, uniform law. >> we'll bring you that amazing report tomorrow as part of our week-long series as part of "all in america" on the road. and you can find lots more on our reporting so far. other stories from the

conservative heartland on our website, all in.msnbc.com. "the rachel maddow show" starts right now. >> good evening, chris. appreciate it. and thanks to you at home for joining us this hour. on february 25th, 2003, in the united states senate, the army chief of staff at the time was called to testify about whether or not u.s. troops invading iraq might reasonably expect to have weapons of mass destruction used against them on the battlefield by saddam's forces. >> if force is required, move saddam hussein and to dismantle the weapons of mass destruction, we could be confronted with in the early stages of that combat, weapons of mass destruction. and inflicted upon our own forces. i think each of you this morning should touch on the training and your level of confidence in that training and our ability of the troops to carry out their mission. general shinseki, we'll start th