Critics said an expansion would insure hundreds of thousands in the poor state and would almost be entirely paid for by the federal government. Sen. Hank Sanders, D-Selma, said last week that those who oppose expanding Medicaid were "standing in the hospital door, keeping hundreds of thousands from being able to go to hospitals."
Bentley said the refusal is a way of standing up to the new federal health care law.
"It gives us a way of pushing back on this legislation to give us some concessions and some changes we feel are necessary," Bentley said.
While some other GOP governors — including Michigan Gov. Rick Synder and Arizona Gov. Jan Brewer — have changed course and embraced the Medicaid expansion, Bentley has stood by his decision.
"They have, but thank goodness I live in a state that is the most conservative in the country, so I have some cover," Bentley said, adding quickly that he didn't "do things politically."
Bentley said he would not expand a broken system. He said he took an oath as a physician to do no harm but he also took an oath on the Alabama Capitol steps.
"When you talk about doing no harm, I believe that this piece of legislation harms not only Alabama, and businesses in Alabama, I think it harms the entire nation because we can't afford it."
"People say you are going to get billions and billions of dollars of free money. It is not free. Somebody is paying for it and it's taxpayers or it's China cause we're borrowing money every day to keep this country afloat."
Bentley said he believed the "defining moment" of his first two years came just 100 days into his governorship when a wave of killer tornadoes swept the state on April 27, 2011. More than 200 people were killed and thousands of homes destroyed.