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Jones bill would Incentivize states to expand Medicaid

By CAROLINE BECK, Alabama Daily News

Senator Doug Jones, D-AL, is sponsoring a bill that would incentivize states like Alabama to expand Medicaid.

The States Achieve Medicaid Expansion (SAME) Act would provide states that choose to expand Medicaid after 2014 the same level of federal matching funds as states that expanded earlier under the terms of the Affordable Care Act.

This bill was first presented in 2016 by Sen. Mark Warner, D-VA, who is again a co-sponsor on the bill with Jones.

In an interview with Alabama Daily News, Jones said he hopes this bill will incentives states like Alabama who haven’t expanded Medicaid yet to do so soon.

“Even though I can’t vote to expand Medicaid, I can do things that I hope will give the states the incentive to expand Medicaid because I truly believe it’s in the state’s interest and the people of the state’s interest,” Jones said.

Medicaid is a state-run program providing health coverage for about 23,000 low-income residents. To qualify for current Medicaid coverage, families with children must have a household income at or below 18 percent of the poverty level. Expanding the program would take that threshold up to 138 of percent the poverty level, offering access to as many as 325,000 Alabamians.

Though the program receives much of its funding from the federal government, Congress cannot force state to expand Medicaid. Automatic Medicaid expansion was a key component of the Affordable Care Act, better known as Obamacare, but a subsequent Supreme Court ruling left that decision up to states.

Originally, states that expanded were offered 100 percent matching funds from the federal government, which gradually declined over time to just 90 percent. Jones’ bill would restore that level of 100 percent matching funds for states that choose to expand now. After that, states would receive 95 percent in the fourth year, 94 percent in year five, 93 percent in year six and 90 percent for each year after.

Jones said he believes expanding Medicaid coverage is important to improve health outcomes by getting more individuals covered.

“I care about folks and I’ve watched our rural areas in particular lose their access to healthcare,” Jones said. “Their hospitals are closing, their doctors are leaving and when that happens it is very difficult for a community to recover.”

According to the Alabama Hospital Association, 13 hospitals have closed in Alabama since 2011, including seven rural hospitals.

Opponents of expanding Medicaid argue that once the federal matching runs out, it would cost the state too much money to continue. Jones says that since the federal government would cover the costs completely for the first three years, that should give the state enough time to boost the economy to hopefully cover the costs further down the road.

“All you have to do is look at the anecdotal evidence to see that expansion has been an economic driver and it’s not just the Medicaid dollars that have been brought in, but it’s all the other benefits that are brought in with the health care system,” Jones said.

One study put out by the Department of Health and Human Services shows that if Medicaid was expanded in the state, the estimated economic impact for Alabama would be $20 billion and an estimated 30,700 in job growth.

Some Alabama state lawmakers have hinted about Medicaid expansion this session, but leaders says that it is up to Governor Kay Ivey to ultimately decide. Alabama House Speaker Mac McCutcheon, R-Monrovia, has already said that expansion is not a high priority on this year’s legislative agenda.  Other concerns like infrastructure and new prison facilities are what has the most attention this year.

Though federal lawmakers rarely prescribe policy controlled by their home state, Jones isn’t shy about saying he believes Alabama leaders should make this change.

“I think it’s time for everybody to stop pointing the finger to someone else and putting off the responsibility,” Jones said. “if enough leaders in Alabama, no matter where they are, it could be a city counsel member or a president of a chamber of commerce, and if enough people start speaking out then this will get done.”

Jones said that if Alabama chooses not to expand then that would mean that state could miss out on millions of taxpayer money that will end up going to other states.

“The statistics show that it would bring back about $2 billion in taxpayer money, and that’s just taxpayer dollars,” Jones said. “That doesn’t include the growth to the economy expansion would bring in.”

Jones remains hopeful about the possibility of Alabama expanding Medicaid, mostly because of the amount of attention the issue has gotten compared to years past.

“There is just so much more talk about it now and people now see the economic benefits and they also see better health outcomes,” Jones said. “The mere fact that it’s being discussed leaves me to be pretty optimistic about it.”

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