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Organizations urge Gov. Ivey to expand Medicaid; governor remains skeptical

MONTGOMERY, Ala. — The advocacy group Cover Alabama, along with more than 80 businesses and organizations signed on to a letter urging Gov. Kay Ivey to expand the state’s Medicaid program, citing the need to cover the nearly 300,000 uninsured Alabamians who fall into the coverage gap.

Ivey, however, remains skeptical of the proposal, with her office telling Alabama Daily News late last week the long-term costs of expansion remained a great concern for her.

“Gov. Ivey’s position remains unchanged,” Gina Maiola, communications director for Ivey’s office, told ADN Thursday. The governor has the authority to expand Medicaid without a vote in the Alabama Legislature. 

“Ensuring Alabamians all across the state have access to quality health care is important to the governor. However, on the question of expanding Medicaid, she remains concerned for how the state would pay for it long-term.”

The joint letter included statements aiming to address concerns related to cost, including that the federal financial assistance has only increased in recent years.

“Addressing any concerns about the long-term costs to the state, the American Rescue Plan Act includes a permanent provision that would allow Alabama to access an estimated $619.4 million in additional federal funds, making closing the health coverage gap more affordable and sustainable than it has been in years prior,” the letter reads.

“These additional funds, on top of the generous 90/10 match of federal and state funds, could result in the federal government paying $397 million in annual expenses currently paid by the state.”

“Closing the health care coverage gap is a strategic economic decision for Alabama,” Debbie Smith, Cover Alabama campaign director, writes in the joint letter. 

“By increasing health care access, we can bolster workforce participation, stimulate economic growth and enhance productivity. Moreover, improving access to health care services will help alleviate the strain on hospitals and health care providers, ultimately benefiting all Alabamians.”

Republican state lawmakers have historically been opposed to Medicaid expansion but recently began exploring options to get more Alabamians insured. 

In January, House Speaker Nathaniel Ledbetter, R-Rainsville, floated the idea of expanding Medicaid under a private-public partnership model, similar to that of Arkansas. 

In February, dozens of state lawmakers were briefed on the coverage gap issue from the Alabama Hospital Association, and in April, members of the Joint Health Committee heard presentations from Arkansas and North Carolina state lawmakers about the benefits of expansion in their own states.

Rep. Bryan Brinyark, R-Northport, a member of that committee, told Alabama Daily News he was “encouraged” by the presentation, and that he was open to continued discussions around expansion.

Rep. Susan DuBose, R-Hoover, another member of the committee, also expressed an openness after the meeting to continue the discussion, and on Friday, reaffirmed her openness to the idea.

“I think it is an important and timely issue, (though) I haven’t studied the issue any further since that meeting,” she told ADN.

Another member of that committee, Sen. Tim Melson, R-Florence, told ADN Friday that he too wanted to continue exploring the idea of expansion, but didn’t endorse the prospect.

“I think that whole discussion needs to be continued without the anticipation of expanding but not with the closed mind of just saying no,” he said.

Melson is one of two medical doctors in the Senate. Asked if he’d like to see Medicaid expanded, that he was “willing to have the conversation,” but that he didn’t “know enough information to make an intelligent decision.”

“I’m not saying we need to do it, but why not look into it and make an educated decision?” he said.

Alabama remains one of ten states that has not expanded its Medicaid program under the 2010 Affordable Care Act, a bill that provided states with incentive funding to expand Medicaid to cover residents making up to 138% of the federal poverty level.

As it stands today, Alabama has among the strictest Medicaid eligibility requirements in the nation. Income requirements, for instance, would disqualify a family of three that makes more than $4,656 a year.


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