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Clouse: ‘hard to say’ on Medicaid expansion, wants rainy day fund

By TODD STACY, Alabama Daily News

MONTGOMERY, Ala – State Rep. Steve Clouse, who helps manage the state’s pursestrings as chairman of the House Ways and Means General Fund Committee, says it remains to be seen whether Alabama can expand its Medicaid program.

Part of the uncertainty comes from federal rules changing from year to year.

“It’s hard to say on Medicaid. The rules change so much,” Clouse said on Alabama Public Television’s Capitol Journal Friday. “There are some good points to Medicaid expansion, particularly for the providers like the hospitals that have to take on so much uncompensated care from emergency room visits by those without insurance. But the main thing we have to look at is the recurring costs.”

Clouse was responding to a new report from the Public Affairs Research Council of Alabama showing that the savings generated by expanding Medicaid services would more than pay for its cost. State leaders, including Gov. Kay Ivey, have generally pointed to the cost of expansion as the biggest hinderance to the policy choice.

In any case, Clouse wants to create a “rainy day” account for the Medicaid agency. He described the annual task of funding Medicaid as the Legislature’s biggest budgetary hurdle.

“For the last couple of years we’ve been in pretty good shape with Medicaid and we’re going to be in good shape this year, which helps us with the rest of the budget: prisons, DHR, mental health, ALEA, the list goes on and on,” Clouse said.

“We’ve got sort of an overage there in Medicaid from all the federal stimulus dollars and I’d like to build a rainy day fund within Medicaid to help us when that fund starts having issues again – and it will. When they lower that amount that we receive from the feds on the emergency order, that will begin to show in Medicaid.

“When enrollment goes up, health care costs are always going up, we’ll see some adverse effects there. So, I’d like to have this fund set up to help us get over some of those bumps.”

See Clouse’s full comments below. His interview starts at 25:25.

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