MONTGOMERY, Ala. — Two bills that would more strictly enforce eligibility for Medicaid and food stamps in Alabama passed out of the Senate Finance and Taxation Committee last week amid pushback from low-income and child advocacy groups.
The two bills are sponsored by Sen. Arthur Orr, D-Decatur. Senate Bill 245 is related specifically to the Alabama Medicaid Agency.
“The bill is pretty simple in that it doesn’t reduce the eligibility (or) any of the terms, it just says we are going to check what is represented by the applicant using the databases that are available to us, and that we’ll do cross checks,” Orr said. “Right now, we just take the applicants’ more or less face value of what they say and don’t do a lot of cross checking after the fact.”
Under the bill, which the chair of the committee, Sen. Greg Albritton, R-Range, said he was “very comfortable with,” Medicaid would be required to first verify an applicant’s eligibility before admitting them to the program. The proposal would essentially prohibit what is known as presumptive eligibility, where an applicant is taken at their word initially and granted coverage, with their income and other factors independently verified later.
The bill would also mandate monthly cross-checking with various state and federal databases to verify eligibility, and require regular publications of Medicaid fraud and agency non compliance.
Carol Gundlach, senior policy analyst for the low-income advocacy group Alabama Arise, called the proposal “an unfortunate bill,” and warned of its potential impact on rural hospitals.
“We think this could have an effect on rural hospitals, which very often when someone is admitted to the energy room, gets them signed up for Medicaid very quickly without a lot of cross checking so that we can get federal dollars into those rural hospitals,” Gundlach said at a public hearing. “It would prohibit that.”
Gundlach also said if passed the legislation would effectively negate a bill the Alabama House passed in March, which would provide presumptive Medicaid coverage for pregnant Alabamians, sponsored by Rep. Marilyn Lands, D-Huntsville.
“It’s simply too much,” Gundlach said.
Linda Lee, the executive director for the Alabama chapter of the American Academy of Pediatrics, also warned that the bill could have a dramatic impact on Alabama’s children, 50% of which she said were enrolled in the state’s Medicaid program.
“Alabama runs the most barebone program possible; here in Alabama, we cover very few able-bodied adults,” Lee said. “If they’re bouncing off and on once a month throughout the year, I can tell you that our doctors, those people who see Medicaid patients, it will be chaos for them.”
Alabama’s Medicaid eligibility is among the strictest in the nation, with coverage restricted primarily to pregnant women, parents, children, and individuals with disabilities, all of whom must adhere to strict income caps.
The bill passed out of committee in a partisan vote of 11-3.
Senate Bill 246 would target eligibility for the Supplemental Nutrition Assistance Program, or SNAP, often referred to as food stamps and administered by the Department of Human Resources.
Under the bill, Orr is hoping to target what is known as Broad-Based Categorical Eligibility, a policy within SNAP that allows states to expand access to food assistance by loosening income and asset caps in certain circumstances.
“In states like Alabama that use the Broad-Based Categorical Eligibility loophole, even millionaires can qualify for food stamps,” Orr said about applicants’ potential assets.
“Alabama should follow the lead of states like Tennessee, Mississippi and Arkansas that do not use the Broad-Based Categorical Eligibility loophole and simply enforce the federal asset test to limit food stamps to the truly needy, and encourage able-bodied adults to work.”
Close to 800,000 Alabamians receive food assistance from SNAP, and receive around $2 per meal under the program, with strict eligibility requirements that include caps on monthly income and savings.
The bill would prohibit DHR from using Broad-Based Categorical Eligibility, and instead require the agency to adhere strictly to the state’s own eligibility criteria, which for a family of four is capped at $3,007 per month of gross income.
Like the previous bill, Gundlach warned that imposing stricter eligibility requirements on the program would end up harming Alabama’s most impoverished. Unlike the previous bill, Gundlach also warned that SB246 would end up costing the state federal dollars.
“First of all, 43 or 44 states use broad-based categorical eligibility, and they do so because it saves dollars in order to not have to capture pennies,” she said. “Usually, the cost of doing the kind of assets test that Sen. Orr talks about costs the state more than we actually save in benefits.”
The administrative costs of administering SNAP are split between the state and the federal government, while the benefits are entirely funded by the federal government. Gundlach said that due to this funding model, which she argued would likely see countless Alabamians lose SNAP eligibility, the majority of the states’ savings would be in lost federal dollars.
“So we’re going to be spending state dollars to save federal dollars, and not even getting a return on investment,” she said.
Apreill Hartsfield, policy and data analyst for the child advocacy group Voices for Alabama’s Children, noted that more than 355,000 children and youth under 20 were eligible for SNAP in 2024, and that the bill would particularly impact adolescents.
Democratic committee members, including Coleman and Sens. Robert Stewart of Selma and Linda Coleman-Madison of Birmingham shared similar concerns.
Orr clarified that his bills would not cut benefits, and asked that it be taken up for a vote. The bill passed in a partisan vote of 10-4.
Both bills now head to the full Senate.