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Governor Bentley’s Road to the Alabama Healthcare Exchange

Bill Britt

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By Bill Britt
Alabama Political Reporter

MONTGOMERY–No one should be startled that the Alabama Healthcare Exchange exists. But many see the news that Governor Robert Bentley is building a healthcare exchange system for the state as a new revelation.

This can only be a shock to those who have not been paying attention for the last two-plus years. On then candidate Bentley’s website it plainly states, “ I have real-world solutions that will result in affordable and accessible health care for all without bankrupting our nation or pushing us closer toward a government-controlled, single-payer system,” [Source: Campaign website, robertbentley2010.com].

But what is “affordable and accessible health care for all,” but a state-run Affordable Healthcare Act for Alabama?

Again then candidate Bentley, speaking to Rose Ann Haven of WKRG in October 2010 about Obama’s health care plan said, “Don’t start by taking over total healthcare in this country. Don’t do it that way. Let’s find out if it works on a smaller population and then you can expand it”, says Bentley.

He goes further by saying according to the report, “Dr. Bentley admits there are a few issues of the government takeover of healthcare that are probably good such as allowing people to get insurance if they have pre-existing conditions. “But, the way you do that in the state is you have an insurance exchange”, says Bentley.”

In running for governor Bentley made it clear that he had an idea and a plan for an Alabama healthcare exchange. As governor he has reiterated this idea and plan many times. In a question posed by Publisher and Editor Steve Spencer of the Birmingham Medical News in May 2011 about the way to reduce health care costs in Alabama, Bentley said, “There are a lot of things we can do. For example, before the Affordable Healthcare bill was even considered, I talked about creating an insurance exchange for the state of Alabama. And we’re looking at that now. We’re trying to set up the framework, crafting it a way that it would fit the Affordable Healthcare Act if it’s implemented. But our exchange will include so many other things, like health savings accounts.

We’ve got to work with the insurance companies. We have to decide whether or not all insurance will have to come under this exchange, or whether insurance companies can come under this, and have a plan outside of the exchange. Personally, I think that for an exchange to work, everything has to come under it.”

In May 2011 the Governor was saying “everything,” has to come under his idea of a statewide plan. Lawmakers did not question the governor who according to his staff is always prone to speak exactly what is on his mind.

In June 2011, in the Left-leaning news site Politico, Sarah Kliff reported, “Alabama is a deep red, Deep South state with a health policy that is taking on a decidedly blue tinge these days. Last week alone, Republican Gov. Robert Bentley issued an executive order to move forward on an Alabama health insurance exchange and lashed out at the state’s Republican-controlled Legislature for attempting to scale back his proposed $247 million increase in Medicaid funding by a mere $7 million.”

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On June 2, 2011, Governor Bentley signed Executive Order 17, creating the Alabama Healthcare Insurance Exchange. It reads: “WHEREAS, creation of a Health Insurance Exchange (the “Exchange”) for Alabama citizens is a paramount priority of this administration; WHEREAS, upon its creation, the Exchange will facilitate the purchase and sale of health plans in the individual markets and the small employer market; and, WHEREAS, the Exchange will present consumers with broader choices and more individualized options for fulfilling their health care needs by fostering a consumer-centric health insurance market in the State of Alabama.”

Tricia Brooks, a senior fellow at the Georgetown University Health Policy Institute who was in Alabama in 2011 said to Politico, “‘The state “is interested in moving forward on health reform [and was] interested in the exchange concept before the law was passed,” said Tricia Brooks. “In so many ways, they [Alabama] get lumped in with the other Southern states. But I think they appreciate when they are recognized for taking the lead and really doing the right thing on getting kids enrolled.’”

The Governor has made it plain that “..Creation of a Health Insurance Exchange for Alabama citizens is a paramount priority of this administration.” Why have the words of the Governor been ignored by the state’s lawmakers?

On September 16, 2011Governor Bentley said, “Every Alabamian deserves access to affordable health insurance. My vision for the Alabama Exchange is to improve the health of our citizens by providing them with a gateway to purchase health insurance that best fits their needs while also promoting competition among health insurers,” said Governor Robert Bentley. “This insurance exchange will enable us to better manage the cost of health care while also providing Alabamians with more affordable choices for health insurance coverage.”

Bentley’s point man for the Exchange is Richard Fiore, at the first meeting of the Alabama Health Insurance Exchange Study Commission, he said, “Governor Bentley has worked hard to make his vision of a health insurance exchange a reality. I am privileged to join with him and the commission members to recommend ways to create a health insurance exchange that will be beneficial to the citizens of this state.”

In Executive order 17 it also says

BE IT FURTHER ORDERED that the commission shall study the establishment of the Alabama Health Benefits Exchange and shall make recommendations to the Governor and Legislature by December 1, 2011. The recommendations shall address, at a minimum, the following: (i) whether to create the Alabama Exchange within an existing governmental agency, as a new governmental agency, or as a not-for-profit private entity; (ii) the make-up of a governing board for the Alabama Exchange; (iii) an analysis of resource needs for operating and sustaining the Alabama Exchange; (iv) a delineation of specific functions to be conducted by the Alabama Exchange; and (v) an analysis of the potential effects of the interactions between the Alabama Exchange and relevant insurance markets or existing health programs and agencies including Medicaid and Public Health. These recommendations shall be presented to the Governor and to the Alabama Legislature by December 1, 2011, in order that any required legislation is prepared for consideration during the 2012 Regular Session of the Alabama Legislature as to the creation, governance and implementation of an Alabama Exchange.

Rejected the plan offered, fought legislation and has continued to build the exchange.

A House Bill introduced by Representative Greg Wren (R-Montgomery) that would have established a joint committee on a healthcare exchange. Wren’s bill had a provision that would have killed the ability to create an exchange if the Affordable Healthcare Act was not upheld by the court.

The bill sponsored by Wren and a companion bill by Senator Greg Reed (R-Jasper) was defeated in the state legislature by the governor’s efforts leaving a clear path to mold his own Alabama Healthcare Exchange.

Gubernatorial spokesperson Jennifer Ardis told ‘The Alabama Political Reporter’ that all this work was being done in preparation for the implementation of Obamacare. But the Supreme Court could rule on the Constitutionality of Obamacare as early as Today. If the U.S. Supreme Court declares the Patient Protection and Affordable Care Act unconstitutional (as Alabama and the other plaintiffs contend) then there is no pressing need for the state to set up any kind of healthcare exchange and up to $15 million has been wasted on a website and consultants for a project that was never authorized by the state legislature. If the Supreme Court leaves Obamacare intact, Republican candidate for President Mitt Romney has vowed to repeal President Obama’s healthcare Act if he is elected. A Romney win undoes Obamacare Most Republicans running for the U.S. Congress have similarly pledged to undo Obama’s takeover of the American healthcare industry. If Obama is reelected; but the Republicans control both Houses of Congress, they likely will kill Obamacare one piece of legislation at a time. Since the fate of Obamacare is going to be decided by either the Supreme Court or by the voters, why did the Governor feel the need to rush in and create a state healthcare exchange when he easily could have implemented the exchange after the November election–if that is even necessary by then?

Robert Bentley as a candidate and as Governor has expressed the desire to give Alabama a Healthcare exchange. He has said that he opposes the one planned by President Obama but it appears he has his own exchange in mind for the people of the state.

Bill Britt is editor-in-chief at the Alabama Political Reporter and host of The Voice of Alabama Politics. You can email him at [email protected] or follow him on Twitter.

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Health

Three mental health crisis centers coming to Mobile, Montgomery and Huntsville

“Today marks a culture change in Alabama for treatment of individuals with mental illness and substance use disorders,” Mental Health Commissioner Lynn Beshear said.

Eddie Burkhalter

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Gov. Kay Ivey Press held a press conference with Alabama Dept. of Mental Health Commissioner Lynn Beshear for the announcement of Crisis Center Awards Wednesday, October 28, 2020 in Montgomery, Ala. (Governor's Office/Hal Yeager)

Gov. Kay Ivey on Wednesday announced an $18 million project to create three new mental health crisis centers to be located in Mobile, Montgomery and Huntsville. 

These centers, once in operation, will reduce the number of people suffering from mental health crises who are hospitalized or jailed, Ivey said during a press briefing in front of the Capitol Building in Montgomery. 

“When these facilities are open and fully staffed, these centers will become a safe haven for people facing mental health challenges,” Ivey said. 

Lynn Beshear, commissioner of the Alabama Department of Mental Health, said during the briefing that the centers will provide “recovery based” care with “short term stays of a few hours, or up to a few days, to provide treatment, support, and connection to care in the community.” 

“Today marks a culture change in Alabama for treatment of individuals with mental illness and substance use disorders,” Beshear said. 

Beshear said AltaPointe Health in Mobile will operate one of the three facilities, and once built it is to serve Mobile, Baldwin, Clarke, Conecuh, Escambia, Monroe and Washington counties with 21 new beds, including 15 temporary observation beds. Altapointe will begin with a temporary space while constructing the new facilities, she said. 

Beshear said the Montgomery Area Mental Health Authority is partnering with the East Alabama Mental Health Authority and the Central Alabama Mental Health Authority to serve the 11 counties in Region 3 with 21 new beds, including 10 temporary observation and respite beds. 

“The regional crisis center will be located in Montgomery, and will be open to walk-ins and for drop off by law enforcement, first responders and referrals from emergency rooms,” Beshear said. 

Wellstone Behavioral Health in Huntsville was selected to open the third center, and will do so at a temporary site while a new facility is being built, with the help of an additional $2.1 million from local governments, Beshear said. That facility will eventually have 39 beds, including 15 for temporary observation and 24 for extended observation.

“There’s not a day that goes by that after-hours care is not an issue in our state,” said Jeremy Blair, CEO of Wellstone Behavioral Health, speaking at the press conference. “And so I applaud the Department of Mental Health and the leaders for their efforts in recognizing that and taking it a step further and funding our efforts here.” 

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Asked by a reporter why a center wasn’t located in Jefferson County, one of the most populous counties with a great need for such a center, Ivey said those residents will be served in one of the other regions. 

“Plans are underway to continue this effort. Today’s beginning, with these three crisis centers, is just the beginning,” Ivey said. 

Ivey added that request for proposals were sent out for these three centers and “it was a strong competition for the location of these three crisis centers.” 

Alabama House Majority Leader Nathaniel Ledbetter, R-Rainsville, said during the briefing that more than a year ago, Ivey asked him what the state should be looking at, and that he replied “we’re failing miserably in mental health.”

Gov. Kay Ivey Press held a press conference with Alabama Dept. of Mental Health Commissioner Lynn Beshear and House Majority Leader Nathaniel Ledbetter for the announcement of Crisis Center Awards Wednesday, October 28, 2020 in Montgomery, Ala. (Governor’s Office/Hal Yeager)

Ledbetter said Ivey asked him to take on the challenge of correcting the state’s response to mental health, and a team was created to do just that. 

“Working together, today’s announcement will not only change Alabamians lives, but will help to save lives,” Ledbetter said.

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Health

Ainsworth returns to work after testing positive for COVID

Ainsworth’s office on Sept. 21 announced he had tested positive earlier that week, having been tested after someone in his Sunday school class tested positive for the disease. 

Eddie Burkhalter

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Lt. Gov. Will Ainsworth speaks during a video message. (LT. GOVERNOR'S OFFICE)

Alabama Lt. Gov. Will Ainsworth on Wednesday announced that he was returning to work that day and had met public health requirements for quarantining after testing positive for COVID-19 some time last week.

Ainsworth’s office on Sept. 21 announced he had tested positive earlier that week, having been tested after someone in his Sunday school class tested positive for the disease. 

“While many have battled with coronavirus, my symptoms never progressed beyond some mild congestion that I usually experience with seasonal allergies,” Ainsworth said in a statement. “During the quarantine period, I participated in several Zoom calls, caught up on some office work, spent some quality time with my family, and completed a number of overdue projects on my farm.”

Members of Ainsworth’s staff who were in close contact with him haven’t tested positive for COVID-19 but will remain in quarantine for a full 14-day period as a precaution, according to a press release from Ainsworth’s office Wednesday. 

“Ainsworth once again urges all Alabamians to practice personal responsibility, which may include wearing masks, maintaining social distancing whenever possible, and taking other precautions to lessen chances of exposure to COVID-19,” the press release states.

Ainsworth still disagrees with Gov. Kay Ivey’s statewide mask mandate, he said. According to the release, he considers such orders “a one-size-fits-all governmental overreach that erodes basic freedoms and liberties while removing an individual’s right to make their own health-related choices.” 

The wearing of cloth or medical masks has been proven to inhibit the spread of COVID-19 and the more people who wear masks, the better. While not perfect, masks limit the spread of respiratory droplets that may contain infectious virus shed from the nose and mouth of the mask wearer.

It is possible — even likely — for symptomatic, pre-symptomatic and mildly symptomatic people to spread the virus. That’s why it’s important to wear a mask even when you’re not sick.

Cloth masks offer only minimal protection from others who are not masked, meaning that masks are not simply a matter of personal safety but safety of others. Masks are also only effective when worn over both the mouth and the nose. [Here’s a guide on how to wear masks properly.]

VIA UAB

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Dr. Deborah Birx, coordinator of the White House’s coronavirus task force, told Ivey after she announced the statewide mask order that it was a “brilliant” idea. The order has been credited by Alabama infectious disease experts as having dramatically reduced the number of cases, hospitalizations and deaths in the weeks after the order went into effect. 

Dr. Don Williamson, president of the Alabama Hospital Association, told APR on Tuesday that from personal observation he is seeing more people not wearing masks, or wearing them improperly, and said the state could dramatically reduce the risk of COVID-19 if the public regularly wore masks and wore them properly.

Hospitalizations of COVID-19 patients in Alabama on Monday crossed the 1,000 mark for the first time since Aug. 31 — a sign that Alabama may be headed for another peak in hospitalizations as the state prepares for winter and flu season.

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Elections

Faith in Action Alabama calls on law enforcement to protect voters from harassment

“In these harrowing days it is incumbent upon all of us as citizens and you and your colleagues as law enforcement professionals to do all we can to maintain this right secured by so much courage and sacrifice.”

Micah Danney

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(STOCK PHOTO)

Nine clergy members from across the state have signed an open letter calling on local and state law enforcement to protect voters against intimidation and harassment at the polls.

The clergy are leaders in Faith in Action Alabama, a regional association of Christian congregations affiliated with the national group Faith in Action, the largest grassroots, faith-based organizing network in the country. It seeks to address a range of issues like gun violence, health care, immigration and voting rights.

This is their letter:

Across our country and here in Alabama, it is being seen that citizens are turning out in record numbers to vote early and by absentee ballots. It is very heartening to see so many of our fellow citizens energized and committed to exercising that most fundamental and critical duty of citizenship, the use of their franchise.  As servant leaders of an ecumenical association of nearly 2,000 faith communities across our state we are certainly encouraging our congregants to fulfill this duty either through early, absentee or day of election voting. For us this is not only part of our civic duty, but as people of faith obligation as well.

Unfortunately, it it also largely known that there are forces in our country that are actively, publicly and fervently at work to suppress the votes of some of our fellow citizens. We write to implore you to use the full authority of your office and department to ensure that those who seek to vote, especially on November 3, 2020 are not assailed or intimidated by illegal harassment in their polling places. We believe these threats are pervasive enough and real enough that proactive measures should be in place as citizens come to vote throughout that day. The strong, visible presence of uniformed legitimate law officers will hopefully prevent any attempts at confrontation or intimidation and violence.

The history of our state is marked by the efforts of tens of thousands of Alabamians who marched, protested, brought legal actions, shed their blood and some even gave their lives that every citizen of this state might have full and free access to the ballot box. In these harrowing days it is incumbent upon all of us as citizens and you and your colleagues as law enforcement professionals to do all we can to maintain this right secured by so much courage and sacrifice.

Please be assured of our prayers for you and the men and women of your department who have the awesome responsibility of providing public safety and equal protection under the law for every Alabamian. If we, the members of Faith in Action Alabama’s Clergy Leadership Team, can be of assistance please do not hesitate to call upon us.

Sincerely,

Rev. Jeremiah Chester, St. Mark Baptist Church, Huntsville

Rev. David Frazier, Sr., Revelation Missionary Baptist Church, Mobile, and Moderator, Mobile Baptist Sunlight Association

Bishop Teresa Jefferson-Snorton, Fifth Episcopal District of the Christian Methodist Episcopal Church

Bishop Russell Kendrick, Episcopal Diocese of the Central Gulf Coast

Bishop Seth O. Lartey, Alabama-Florida Episcopal District of the African Methodist Episcopal Zion Church

President Melvin Owens, Alabama State Missionary Baptist Convention

Bishop Harry L. Seawright, Ninth Episcopal District of the African Methodist Episcopal Church

Dr. A.B. Sutton, Jr., Living Stones Temple, Fultondale

Father Manuel Williams, C.R., Resurrection Catholic Missions of the South, Montgomery

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National

Report: Alabama’s Black Belt lags behind state in economic prospects

Black Belt counties lag behind others in economic prospects and investments in businesses.

Eddie Burkhalter

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(APR GRAPHIC)

It took Marquis Forge five years and 18 banks before he and his partner were able to open their company, Eleven86 Water, in Autauga County, just north of the Black Belt, and a report released Tuesday shows how Black Belt counties lag behind others in economic prospects and investments in businesses. 

Forge, a former University of Alabama football player, told reporters during a briefing Monday that he considers Autauga County, which borders the Black Belt’s Lowndes County, part of the Black Belt, and said it shouldn’t have been so difficult to access the capital needed to start a business. 

The report released Tuesday by the University of Alabama’s Education Policy Center titled “Black Belt manufacturing and Economic Prospects” is the last in the center’s Black Belt 2020 series, and found that only four of the state’s 24 Black Belt counties, as defined by the center, are above the statewide average of 22.4 businesses per 1,000 residents, and just one, Montgomery County, was above the 2018 statewide average of personal income of $43,229. 

Researchers also found that just three Black Belt counties are above the state’s average in gross domestic product being produced by counties of $45,348. 

“To achieve Governor Ivey’s ambitious goal of 500,000 a million more Alabama workers with skills by 2025, all hands have to be ‘on deck.’ It will require higher labor force participation rates, particularly in the Black Belt, where the average is 20 points below the statewide average,” said Stephen Katsinas, director of the university’s Education Policy Center and one of the authors of the report. 

“Due to smaller economies of scale, our approaches to  education, workforce development, and community building will have to be different to reach Alabama’s Black Belt,” Katsinas continued. “In the longer term, we first must define the Black Belt, because you can’t measure what you can’t define. Then we must do what West Alabama Works is doing–go where the people are to bring hope by connecting them to a well-aligned lifelong learning system that makes work pay.”   

Donny Jones, COO of Chamber of Commerce West Alabama and Executive Director of West AlabamaWorks, told reporters Monday that one of the keys to helping the Black Belt will  be helping state and Congressional legislators understand the nuances of rural Alabama. 

Jones said the state should look at how colleges are graded, and that many smaller colleges don’t get credit for putting students through programs that get them short-term certificates that lead to jobs. 

“Those are some of the things on the statewide level that we can really start to work on,” Jones said, adding that they’ve already begun teaching modern manufacturing in Black Belt high schools that gives students college credits toward an associates degree while still in high school. 

“I think that’s very important for individuals to understand the impact that we can have in our higher ed and our K-12 system, really works hand in glove to move the needle for workforce development,” Jones said. 

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Jim Purcell, State Higher Education executive officer of the Alabama Commission on Higher Education, told reporters that it’s also important to look at one’s own community and identifying what is “unique and special,” and said he was recently in Autauga County, where he is from, and bought two cases of Eleven86 Water because he remembered how good the water there was. 

“I think that’s what you’ve done, is you’ve taken the gift that Autauga’s environment has and enhanced it, so that the people can benefit from it,” Purcell said to Forge. “I think that’s the key.” 

Asked what he’d tell state legislators to spur them to make changes so that other entrepreneurs wouldn’t have to struggle as hard as he did to open a business, Forge said he would ask for a clearer path for assistance. 

“Instead of digging down through a tunnel with a spoon I would have someone outline the tracks on getting funds and assistance from local, state and the national level, because there are funds out there,” Forge said. 

After going to 18 banks to get the financing he needed, he still had to liquify all his assets to make it happen, Forge said. 

“How many people are going to do that?” he asked. “We shouldn’t have to do that.”

To read all of the Education Policy Center’s reports on Alabama’s Black Belt, visit here.

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