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Question Remain on Future of ACA in Alabama, Rep. Wren Believes, Hard Data Can Lead to Good Decisions

Bill Britt

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By Bill Britt
Alabama Political Reporter

MONTGOMERY—While the political battle is still being waged over the politics of the Affordable Care Act, one Alabama State representative is mining for clarity and hard data.

“We are continuing to drill into the Supreme Court ruling and doing a lot of analysis on it and the Medicaid expansion piece,” says, Representative Greg Wren (R-Montgomery).

Wren is considered by most as Alabama’s leading authority on the ACA.

Wren is the National Chairman of NCSL’s Healthcare Reform Committee, a national bipartisan group of state legislators that is focusing on protecting the individual states, with state specific plans with regards to the Affordable Care Act.

“We are doing a thorough evaluation of full supreme court decisions so that we understand its full implications,” Wren joked. “Unlike the press reporting in the first few moments of the Court’s ruling, we are determined to get it right.”

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Wren says that because in his opinion the Chief Justice’s specific reference to a code section as too penalties there are some questions that will be clarification.

A portion of the Roberts opinion, which was joined by Justices Stephen Breyer and Elena Kagan, said that the federal government had gone too far when imposing requirements on states as a condition of accepting federal dollars to expand Medicaid.  In his opinion Roberts said that “in this case the financial ‘inducement’ Congress has chosen … is a gun to the head.” The Roberts ruling struck down the mandate that states expand Medicaid to more citizens.

Wren explained that the section Justice Roberts referenced when striking down the Medicaid expansion mandate was talking about expansion on Medicaid for adults.

“The question then arises, what does this mean for pregnant woman and children?” asks Wren.

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The way the opinion is written there is a lack of clarity as to if the expansion portion of the ruling —that had the penalty—only applies to adults and not pregnant woman and children.

“This would greatly affect Alabama were half the live births are covered by Medicaid,” said Wren, “This is a serious question mark.  This could add tens of thousands of people onto the Medicaid rolls in Alabama.”

Wren and other lawmakers are grappling with the details of the ruling and the subsequent implementation of Medicaid.

“We can’t sit around gazing into the crystal ball anymore,” says Wren.  “The crystal ball got it wrong.”

Wren is referencing those in Alabama, including the governor, who had hoped the Supreme Court would overturn Medicaid.

Wren says that the state must be prepared and no longer engage in wishful thinking.

Many are still pinning their hopes on a Romney presidency overturning the Patient Protection and Affordable Care Act (ACA), but no serious constitutional scholars and policy wonks see an easy road to total repeal of the ACA, even if the Republicans win the presidential election.

“We must have hard data to make good choices,” says Wren.

Wren and company are working tirelessly to gather the necessary facts to enable the state government to make the best choices for the state.

“As a legislature we will have to look at multiple scenarios, concerning the option to expand Medicaid,” Wren said.

The group at which Wren sits at the helm is mining all of the data to present states like Alabama with a clearer picture of choices in considering Medicaid’s expansion.

“There is an interesting paradox in play here with the enhanced federal matching funds for Medicaid,” said Wren.

In the original ACA the government had offered state a carrot and a stick to expand Medicaid. The stick was taken away but the inducements to expand the program remain.

“I am not arguing for or against expanding Medicaid,” said Wren, “I just want to have the facts, so we know what we are looking at.”

If a state choses to expand Medicaid, between 2014 and 2019 the federal government will provide 100 percent funding decreasing to 90 percent funding over that six year period ostensibly expanding the program with a massive infusion of federal dollars.

The initial data gathered thus far shows that the federal dollars flowing into Alabama would be around $8 billion dollars.  Alabama’s portion of the match money would be around $500 million.

“Obviously I understand the problem of where are we going to get $500 million,” said Wren, “but this is a huge return on investment.”

Wren points out that in a small state like Alabama, where the entire medical infrastructure is built on Medicaid dollars, this would be an enormous boost to the system.

“Look at the provider community that is not getting anything from the uninsured population over that six year period,” said Wren, “Then you add some 9 to 10 billion in new dollars infusion.  In the health care community, that would be massive.”

Wren continues, “It would be easy to say, ‘no way are we going to let the feds tell us what to do,’ and I’m there. However, if you take a deep breath and take a step back and look at the return on investment and see how that money infuses itself into the system, then maybe you take two step back and two deep breaths and say let’s not be too knee jerk, because of the political reaction to this idea.”

Wren says this is why he and others are working hard to gather all the facts, “so that we will be armed with good information to make the best decisions for Alabama and its people.”

He says that in the next ten days he will be ready to start submitting the research and hopes that he can work together with the governor and the legislative body to look at all Alabama’s options.

“We can take this information as a template and lay it against the existing Alabama plan, then ask the questions,” says Wren, “Then we put some dollar signs behind each one of them from launch out to a ten year projection on Medicaid and then make decisions.”

Wren says he believes we are going to have to be, “intellectually honest on these decisions by letting fact based evidence drive the discussion and not wholesale politics.”

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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Jones says Senate race a choice between “substance and leadership, and nothing”

“One of the great disappointments in this campaign is that Alabama is not really getting choices between substance and substance,” Jones said.

Eddie Burkhalter

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Incumbent Sen. Doug Jones speaks at a rally in Anniston. (EDDIE BURKHALTER/APR)

Speaking outside the Calhoun County Democratic Party headquarters in Anniston on Friday, Sen. Doug Jones, D-Alabama, told a group of supporters that Alabamians haven’t gotten a look at what his Republican opponent might do if he wins the Nov. 3 election. 

“One of the great disappointments in this campaign is that Alabama is not really getting choices between substance and substance,” Jones said. “They’re getting a choice between substance and leadership, and nothing — nothing. We have not heard anything from Tommy Tuberville about what he really wants to do.” 

While Jones has held numerous interviews with the media, and regular web briefings over the summer and in recent weeks, Tuberville’s campaign seems to prefer the safety of keeping Tuberville from making possible gaffs or damaging statements in interviews. 

Tuberville hasn’t agreed to interviews with traditional media outlets, or to debate Jones, and instead has focused on conservative talk radio spots, speaking to smaller Republican groups and at private parties.

Tuberville’s campaign has ignored or denied our numerous attempts to interview Tuberville, including another request on Friday. He also declined to attend a student forum held at Auburn University on Wednesday, which Jones attended. The forum was sponsored by the Auburn College Republicans and College Democrats.

“If you ever hear something Tommy Tuberville says, it is just simply this: ‘Build a wall. No amnesty. Drain the swamp.’ That ain’t him. That’s Donald Trump,” Jones said. “He cannot think for himself. He doesn’t think for himself.” 

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Jones spoke of his record of working to help veterans through legislation. And he referred to Tuberville’s nonprofit for veterans and reporting that indicates, through tax records, that less than a third of the money raised for Tuberville’s charity went to help veterans. 

“I don’t just create charities and send only pennies on the dollar. I do things for the veterans of this state and this country,” Jones said. 

Jones also made a case for Alabamians to remember the contributions past Democrats made in the state. Jones said it was Democratic Sen. John Sparkman who helped build Alabama’s Redstone Arsenal. 

“It was a Democrat, Lester Hill, who built the rural hospitals around here that Donald Trump and Mitch McConnell and Tommy Tuberville are trying to destroy,” Jones said. “It was Howell Heflin who built up agriculture in this state. Those are the Democrats. It was Franklin Rosevelt that put electricity in this state. We’re going to do the same thing for broadband. People forget those things. They forget those things because we’ve let other people define us with lies.”

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Jones plans to visit Jefferson County on Saturday, then on to the Black Belt and Mobile on Sunday with another stop in Birmingham on Monday afternoon. 

“The goal is to get everybody out. That’s the thing if we want to continue to ensure Alabama moves forward — moves forward and not backwards, to continue to have somebody, if I do say so myself, somebody that’s just not going to damn embarrass us,” Jones said.

Supporters of Democratic Sen. Doug Jones rally in Anniston on Oct. 30, 2020. (EDDIE BURKHALTER/APR)

“We’ve had too much of that in Alabama,” Jones said, “and I bet you it won’t be a year that Tommy Tuberville would be an embarrassment to this state because he doesn’t know the issues. He doesn’t know what to do, and he’s dang sure not going to know what to do when Donald Trump is not president of the United States.” 

Jones encouraged supporters to be skeptical of recent polling. One such recent poll, by Auburn University at Montgomery, puts Tuberville ahead of Jones by 12 percentage points, 54 to 42.1. An internal poll by Tuberville’s campaign puts Tuberville ahead by 15 percentage points, while an internal poll from the Jones camp put Jones ahead by one percentage point. 

“Don’t listen to these polling folks that come in, and they don’t know Alabama, and they don’t know what they’re doing. We’re tracking this race, and I can tell you, everything has been moving in our direction the last two months,” Jones said. 

People standing along roadsides holding his signs and showing support, Jones said, is “the energy we’ve got out there. That’s what you can’t poll.”

Ellen Bass of Anniston, standing outside the Calhoun County Democratic Party headquarters just after Jones spoke, told APR that she has numerous Republican friends who are voting for Jones.

“My hat’s off to them because they’re coming out,” Bass said. “They recognize that he is a better candidate.”

Ciara Smith, 21, newly elected to the Anniston City Council, told APR outside the headquarters building that Jones is the better candidate.

“I think that he’s educated. I think that he speaks with passion and heart,” Smith said. “And he knows what he’s talking about, which is important, and which is more than we can say about the other candidate.”

Speaking to APR after his speech to supporters, Jones said that he feels very good about the state of his campaign.

“Everything we’re seeing is moving in our direction,” Jones said. “And the more he stays hidden, the better it is for us.”

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Crime

Inmate assault injures two St. Clair prison correctional officers

The assaults happened at approximately 7:30 p.m. and both officers were taken to a local hospital and treated for those non-life-threatening injuries.

Eddie Burkhalter

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(STOCK PHOTO)

Two correctional officers at St. Clair Correctional Facility were injured in an inmate-on-officer assault on Monday, the Alabama Department of Corrections confirmed to APR.

Among the two officers who sustained non-life-threatening injuries was a basic correctional officer (BCO), a position created in May 2019, who are not Alabama Peace Officers Standards and Training Commission (APOST) certified and who cannot transport inmates, work perimeter fencing or in towers.

The other officer injured was a full correctional officer, Alabama Department of Corrections spokeswoman Samantha Rose told APR in a message Friday. The assaults happened at approximately 7:30 p.m. and both officers were taken to a local hospital and treated for those non-life-threatening injuries and subsequently released, according to Rose.

“The ADOC condemns all violence in its facilities, and the actions taken by the inmate against ADOC staff are being thoroughly investigated,” Rose said. “As the investigation into this incident is ongoing, we cannot provide additional detail at this time. More information will be available upon the conclusion of our investigation.”

The ADOC created the new basic correctional officer position to bolster the state’s woefully understaffed prisons. The creation of the position was also at the suggestion of experts ordered by a federal court to study the department’s staffing problems, ADOC attorneys wrote to the court in a filing in 2019.

The ongoing lawsuit is over the state’s handling of mental health in prisons.

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The Southern Poverty Law Center and the Alabama Disability Advocacy Program filed the 2014 suit arguing the state was indifferent to the health of inmates dying by suicide in greater and greater numbers.

Attorneys for the plaintiffs in June argued that ADOC was far behind on the court-ordered hiring new additional officers. It has been more than two years since U.S. District Judge Myron Thompson ordered the Alabama Department of Corrections to hire an additional 2,000 correctional officers by 2022.

U.S. District Judge Myron Thompson in a previous opinion wrote that prison understaffing “has been a persistent, systemic problem that leaves many ADOC facilities incredibly dangerous and out of control.”

“Taken together, ADOC’s low correctional-staffing level, in the context of its severely overcrowded prisons, creates a substantial risk of serious harm to mentally ill prisoners, including continued pain and suffering, decompensation, self-injury, and suicide,” Thompson’s previous opinion continued.

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The SPLC in court filings late last year expressed concern over the use of basic correctional officers in Alabama’s overcrowded and understaffed prisons. ADOC attorneys have argued to the court, however, that BCO’s are adequately trained to do their jobs and are needed for the department to hire the necessary number of officers per the court’s timeline.

In a court filing on Thursday, attorneys for the plaintiffs asked the court not to again delay site visits to Alabama prisons by two experts who are tasked by the court to determine which positions should be filled by correctional officers and which by BCO’s and which by another new position, called cubical correctional officers, who are to have no direct interaction with inmates.

Those visits were to begin in May, but both parties in the suit agree to wait due to the COVID-19 pandemic and the threat it posed to the experts, who are particularly vulnerable to the disease due to “age and other factors,” according to court records.

Both parties again agreed to postpone those visits in June for those same reasons, those records show. ADOC seeks a third extension but attorneys for the plaintiffs argue that the experts can visit the prisons while keeping themselves, prison staff and inmates safe from harm of COVID-19 and that thousands of employees and contractors enter Alabama prisons daily.

The plaintiff’s attorneys argue in the court filing that the expert guidance is needed because ADOC wishes to use BCO’s and cubical correctional officers to comply with the court-ordered hiring of additional staff by Feb. 20, 2022.

“Ensuring adequate staffing is of upmost importance to address the constitutional violations underlying mental health care within ADOC,” the plaintiffs’ attorneys wrote to the court Thursday.

ADOC in May was employing 494 BCO’s, a 57 percent increase in the number of BCO’s employed in Oct. 2019, according to ADOC’s staffing numbers. The number of correctional officers working in Alabama prisons fell by two percent during that time, dropping from 1,319 to 1,287.

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Elections

Slow absentee voting in Tuscaloosa sparks outrage, possible legal action

Among the issues were incredibly long lines that left some voters waiting more than five hours and an inefficient process that managed to take in fewer than 100 absentee ballots in six hours. 

Josh Moon

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(STOCK PHOTO)

Long lines and slow absentee ballot processing in Tuscaloosa County have left voters outraged and incumbent Sen. Doug Jones’s campaign threatening legal action. 

On Wednesday, Jones’s campaign attorney, Adam Plant, sent a letter to Tuscaloosa County Circuit Clerk Magaria Bobo, outlining a number of issues with ongoing absentee voting and promising to take legal action if Bobo doesn’t improve the process on the final day, Friday. Among the issues documented by Plant were incredibly long lines that left some voters waiting more than five hours and an inefficient process that managed to take in fewer than 100 absentee ballots in six hours. 

Additionally, Plant noted that Bobo has hired her family members to help process absentee ballots and at least one family member had made disparaging remarks on social media about voters. 

“You and those acting on your behalf are suppressing the vote of qualified Alabama voters,” Plant wrote in the letter. “If you are unable or unwilling to execute your duties competently, and allow Tuscaloosa voters to exercise their voting rights without undue burdens, we will take further action.”

In an interview with the Montgomery Advertiser on Wednesday, Bobo noted that her office had received more than 13,000 requests for absentee ballots — a remarkable uptick from the 3,000 or so her office usually receives — and there had been problems in managing that number of ballots while also adhering to social distancing guidelines within the office. 

However, as Plant’s letter notes, the massive increase in absentee ballots for this election shouldn’t have been a surprise. Also, Secretary of State John Merrill had made additional funds available to absentee managers to facilitate hiring extra staff, purchasing additional computers and staying open for longer hours to accommodate the anticipated increase. 

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In a press release on Wednesday, the Alabama Democratic Party criticized Bobo and her family members, and the release included screenshots of Facebook posts from Bobo’s daughter lashing out at voters who complained about the long wait times. 

“No voter should have to wait in line for hours to exercise their rights,” said ADP executive director Wade Perry. “We should leverage every tool we have to make voting easier, not harder. Also, it should go without saying that election workers should not insult the very people they are employed to serve. If Ms. Bobo is incapable of processing voters quickly, someone else needs to do the job.”

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Elections

Jones campaign calls Tuberville a “coward” after no-show at Auburn forum

“Tuberville is hiding because he knows that on every front — policy, experience, character, competence — he loses to Doug Jones. Hands down,” Jones’s campaign said.

Brandon Moseley

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Sen. Doug Jones, left, and Senate candidate Tommy Tuberville, right.

There are only four days left before election day, and incumbent Democratic Sen. Doug Jones’s re-election campaign is slamming Republican challenger Tommy Tuberville, accusing him of “hiding” and calling him a “coward.”

On Wednesday, Jones addressed an Auburn University forum. Tuberville did not attend.

“Tonight, the College Democrats and College Republicans at Auburn University co-hosted a debate between Doug Jones and Tommy Tuberville, offering students a chance to ask the candidates about the issues that matter most to Alabama,” the Jones campaign said in an email to supporters. “But Tuberville never showed up – he’s too scared to face Doug… even on his own home turf. Tuberville has repeatedly refused to debate Doug Jones. He’s consistently refused to be interviewed by the press. He’s refused to tell Alabama the truth about who and what they’re voting for – and it’s clear why.”

“Tuberville is hiding because he knows that on every front — policy, experience, character, competence — he loses to Doug Jones. Hands down,” the campaign continued. “If he won’t tell the truth, we will. Tuberville expects to win this race off of his blind allegiance to the President and his party affiliation. But Alabamians know better.”

“People deserve to know who they’re really voting for if they vote for Tuberville: someone who … won’t protect our health care, doesn’t believe in science, has no idea what the Voting Rights Act is, and doesn’t care about the lives and livelihoods of Alabamians,” the Jones campaign concluded. “Alabama will never elect a coward. Pitch in now and help us spread the truth about the man hiding behind the ballot.”

“I am disappointed that Tommy Tuberville is not here,” Jones said. “I think it is important that people see two candidates side by side answering the same questions.”

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Tuberville meanwhile is canvassing the state, speaking to rallies and Republican groups to turn out the Republican vote for himself and President Donald Trump. Tuberville spoke at Freedom Fest in Madison County on Thursday and at the Trump Truck Parade rally in Phenix City.

“It’s time Alabama had a U.S. senator who represents our conservative beliefs and traditional values,” Tuberville said in Phenix City. “It’s time Alabama had a U.S. senator who supports the Second Amendment, the right to life, and putting God back in the classroom.”

Polling consistently shows Tuberville with a commanding lead over Jones. Real Clear Politics lists the race on their current board as a likely Republican win. FiveThirtyEight’s election model gives Tuberville a 79 percent chance of defeating Jones.

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