Alabama’s failure to expand Medicaid has hampered Alabama’s economy, said officials from the health-care and business communities at the Economic Development Association of Alabama’s summer 2014 conference.

Danne Howard, senior vice president of government relations and emergency preparedness for the Alabama Hospital Association, said the state’s unwillingness to expand Medicaid is adding to the economic distress of its rural communities and encumbering economic development efforts, the Birmingham News reported.

Howard added that Republican Gov. Robert Bentley’s decision not to expand Medicaid puts more pressure on health-care providers. At least a dozen rural hospitals have closed across the state, according to Howard, and more than a dozen more could shutter over the next two years.

Howard was the keynote speaker of a rural economic development session that kicked off the conference on Sunday. The conference ends Wednesday.

During his State of the State address in January, Gov. Bentley defended his decision to reject expanding Medicaid under the Affordable Care Act. “How can we believe the federal government will keep its word?” said Bentley. “The anything but Affordable Care Act has done nothing to gain our trust.”

Bentley also criticized the federal funding available for expanding Medicaid. “The money the federal government is spending with wild abandon is not ‘federal’ dollars. Those are your dollars, your hard-earned tax dollars,” said Bentley.

Under the Affordable Care Act, the federal government pays for 100 percent of the cost of Medicaid expansion in states for the first three years, and then 90 percent after that.

Bentley has come under criticism for his decision to reject Medicaid expansion, even from members of his own administration. David Bronner, the CEO of Retirement Systems of Alabama, said of the decision to not accept Medicaid expansion: “politics is taking precedence over the poor.”

The Alabama Hospital Association, the Business Council of Alabama, AARP Alabama, and the Alabama Primary Health Care Association have all voiced their support for expanding Medicaid in the state.

According to the Alabama Hospital Association’s study, expanding Medicaid in the state would create 30,700 new jobs over the next six years. Conducted by the University of Alabama’s Center for Business and Economic Research, the study also found that if all eligible individuals enrolled in an expansion the number of new jobs could reach more than 51,000.

A study by health-care economists at the University of Alabama at Birmingham also found that the expansion would provide the state nearly $1 billion in tax revenue and provide Medicaid coverage for 300,000 more state residents.

A report from Troy University’s Manuel H. Johnson Center for Political Economy challenged those findings. According to that study, the new tax revenue would exceed additional costs only during the first three years of expansion.