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Texas Governor Rick Perry Says Texas Will Not Expand Medicaid and Will Not Set Up State Run Health Insurance Exchange

Brandon Moseley

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By Brandon Moseley
Alabama Political Reporter

While the recent Supreme Court ruling that upheld the constitutionality of the Patient Protection And Affordable Care Act (PPACA) has been widely acclaimed as a victory for President Obama and his controversial takeover of the health care industry, there was one caveat to that ruling.  The Court ruled that Alabama, Florida, Texas, and the other state government plaintiffs can not be forced to participate in the program.  The President’s bill would have stripped states that refused to cooperate of federal Medicaid funds for children, expectant mothers, poor families, and indigent elderly.

Texas Governor Rick Perry became the 6th Governor to use that ruling to opt their state out of President Obama’s plans.  In a letter to Health and Human Services (HHS) Secretary Kathleen Sebelius, the gun toting Texas Governor wrote:

“In the ObamaCare plan, the federal government sought to force the states to expand their Medicaid programs by * in the words of the Supreme Court – putting a gun to their heads. Now that the “gun to the head” has been removed, please relay this message to the President: I oppose both the expansion of Medicaid as provided in the Patient Protection and Affordable Care Act and the creation of a so-called “state” insurance exchange, because both represent brazen intrusions into the sovereignty of our state.

“I stand proudly with the growing chorus of governors who reject the PPACA power grab. Thank God and our nation’s founders that we have the right to do so.”

“Neither a “state” exchange nor the expansion of Medicaid under the Orwellian-named PPACA would result in better “patient protection” or in more “affordable care.” What they would do is make Texas a mere appendage of the federal government when it comes to health care.”

“The PPACA does not truly allow states to create and operate their own exchanges. Instead, it gives the federal government the final say as to which insurance plans can operate in a so-called “state” exchange, what benefits those plans must provide, and what price controls and cost limits will apply. It leaves many questions to be answered later through federal “future rulemaking.””

“In short, it essentially treats the states like subcontractors through which the federal government can control the insurance markets and pursue federal priorities rather than those of the individual states. Through its proposed expansion of Medicaid, the PPACA would simply enlarge a broken system that is already financially unsustainable. Medicaid is a system of inflexible mandates, one-size fits-all requirements, and wasteful, bureaucratic inefficiencies. Expanding it as the PPACA provides would only exacerbate the failure of the current system, and would threaten even Texas with financial ruin.”

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“I look forward to implementing health care solutions that are right for the people of Texas.  I urge you to support me in that effort. In the meantime, the PPACA’s unsound encroachments will find no foothold here.”

Texas follows Florida, Wisconsin, South Carolina, Louisiana, and Mississippi in rejecting both the state exchanges and the Medicaid Expansion.  Expanding Medicaid would cost Alabama taxpayers over $500 million a year.  The current Medicaid system is costing the taxpayers $604 million a year.  Alabama voters will go to the polls on September 18th to decide if we should prop up Alabama Medicaid’s rising costs by raiding the Alabama Trust Fund of $250 million a year for the next three years.  Alabama Governor Robert Bentley is hopeful that the state will be able to fund the current Medicaid program with new sales taxes collected on internet purchases by then if the controversial diversion of trust fund principal dollars passes in September.  There is no current dedicated long term funding source for either a state of Alabama run insurance exchange or for the massive $5 billion expansion of the Alabama Medicaid program proposed by President Obama.

There is no word yet from Governor Bentley if the state will follow the path of other conservative governors and refuse to implement Obamacare in their states or not.

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Crime

Pardons and Paroles: Restarting parole hearings “under review” amid COVID-19 crisis

Eddie Burkhalter

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The Alabama Bureau of Pardons and Paroles is reviewing the possibility of restarting parole hearings through virtual means during the COVID-19 crisis, a bureau spokesman said Thursday. 

Terry Abbott, spokesman for the Bureau of Pardons and Paroles, in a message to APR said that both a Wednesday report by the ACLU of Alabama on a decline in parole hearings and the possibility of resuming hearings via teleconferencing are under review. He declined further comment. 

The ACLU of Alabama’s Campaign for Smart Justice’s report shows that almost 4,000 people were eligible for parole hearings before April 1, 2020, but since November, the bureau has scheduled an average of 173 parole hearings per month, which is “less than half the average number of monthly hearings in FY 2019, and only a third of the average number of hearings held in FY 2018.” 

In September 2019, Gov. Kay Ivey appointed former Attorney General Charlie Graddick as executive director of ABPP, and former Jefferson County prosecutor and Assistant Attorney General Leigh Gwathney as chair of the parole board. 

The report notes that Graddick suspended all hearings in September and October, and when hearings resumed in November, the number of persons receiving a hearing declined sharply. 

“Additionally, the current board has denied release in 85 percent of cases considered. Only 133 people were granted parole out of the 866 cases considered in the last five months, a grant rate of just 15 percent,” the report states. 

During fiscal year 2019, the board’s parole grant rate was 31 percent, and in FY 2018, was 54 percent, according to the report. 

“Unless there is a dramatic increase in the number of parole hearings and parole grants, Alabama’s prison population will continue to skyrocket,” ACLU’s report states. 

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Aabama’s prisons were at 170 percent capacity in January, according to an Alabama Department of Corrections (ADOC) report

As of Tuesday, the last day ADOC had updated testing figures, 30 inmates had been tested, but no inmate was positive for COVID-19. There were seven pending test results for inmates, however. 

Two ADOC employees have tested positive for the virus. An employee at Staton Correctional Facility in Elmore County and at the St. Clair Correctional Facility both tested positive for COVID-19. 

Rep. Chris England, D-Tuscaloosa, in numerous tweets this week has called on the bureau to restart parole hearings by using an order by Ivey that allows board meetings to safely take place during the COVID-19 crisis.  

Ivey’s March 18 order allows state government bodies to “establish a quorum, deliberate, and take action- by means of telephone conference, video conference or other similar communications equipment” in light of the COVID-19 pandemic. 

England on Thursday cited an Al.com article that quotes Ivey’s press secretary, Gina Maiola, as saying Ivey recognized the importance of keeping Alabama’s criminal justice system functioning and included the option of holding virtual meetings in her order. 

@ALBPP seems that @GovernorKayIvey expected the Board to use the March 18th order to figure out a way to hold hearings and not cancel them. It has become clear that the Bureau’s mission is basically not to parole anyone, crisis or not.” England said in a Thursday mornring tweet. 

England in one tweet also noted that the Georgia Board of Pardons and Paroles is considering releasing some inmates serving for non-violent crimes to community corrections programs to serve the remainder of their sentences outside of prison, as reported by WTVM

England told APR by phone Thursday that it doesn’t make sense that when all aspects of the state government are scrambling to address the crisis, a major component isn’t acting to help. 

“It would seem that the default position of the bureau has become, in times of challenge or controversy, just to stop holding hearings,” England said. 

England also said the bureau should be reviewing and releasing inmates who have serious medical problems, who are much more likely to suffer serious complications or death from COVID-19.  

“If COVID-19 ever invaded our prison system we would basically be giving them a death sentence,” England said.

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Health

ER doctors in frontline battle against COVID-19 are facing pay cuts

Bill Britt

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Emergency room doctors across the nation are experiencing cuts to pay, benefits and hours even as they battle COVID-19. Suddenly ER doctors in Alabama are facing the same slashes to their income.

“It’s crazy, cutting hours and pay right as hell breaks loose,” said an Alabama ER doctor who has spent the last month treating COVID-19 patients. “We are putting ourselves at risk, reusing supplies and dealing with constant uncertainty, and this is how we are treated.”

Healthcare professionals quoted in this report have asked that they not be identified by name because many hospitals have forbidden staff from speaking directly to the press.

“Testing is still so limited and the numbers are so inaccurate, and they don’t want the public to know how bad it is, so they tell us to shut up,” said an ER healthcare worker. “Now they are cutting our hours and pay, what are we supposed to do? I’m so frustrated.”

In other states, health system CEOs and leadership are forgoing or donating pay during the COVID-19 outbreak as systems face furloughing workers due to low revenue, according to a report in Fierce Healthcare.

Mount Sinai, a healthcare network in New York City, announced last week that the system’s leadership team would take a 50 percent pay cut “for as long as necessary so that these dollars can be directed to our front lines in this fight.”

Erlanger Health System, a seven-hospital system in Tennessee and North Carolina, announced March 30 it is reducing leadership pay as have other systems throughout the country.

Here in Alabama, cash strapped hospitals are cutting some frontline workers’ pay first while administrators so far have not offered to reduce their salaries to help those working in the middle of the calamity.

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Over half of Alabama’s hospitals were already facing financial difficulties before the coronavirus struck.

About 52 percent of the state’s hospitals had negative total margins before COVID-19, and 75 percent of them had negative operating margins before the outbreak, according to a report by APR‘s Chip Brownlee.

According to Brownlee’s report, nearly 90 percent of rural hospitals had negative operating margins before the COVID-19 pandemic invaded Alabama.

The recent $2.2 trillion stimulus bill known in congressional circles as COVID 3 was created in part to reimburse hospitals and other health providers to offer compensation for losses and additional expenses at the local level.

“The 2 trillion dollar package we passed — hospitals, health care facilities will get about $133 billion,” Alabama’s Democratic U.S. Sen. Doug Jones told APR in a phone conversation Wednesday evening. “That will be divvied up by the states and there’s a formula that they’ll use. Every hospital that’s dealing with this should get some of that money. That will help them in one way dealing with this crisis.”

But money from the stimulus package is slowly flowing and hospital administrators are not confident how much money they will receive. But even when the funds from COVID 3 are fully allocated, it will not be enough to fill the gaping hole in hospital budgets Jones believes.

“We all recognize that this [COVID 3] is not enough,” said Jones. “We’re going to have to put out some more money to help shore up these hospitals. So many of them have been operating in the red.”

In an effort to reduce stress on the state’s hospitals, all elective services were canceled. Elective surgeries, along with health and wellness programs, are profit centers for hospitals.

In some cases, more patients are coming into the hospitals, but they are not there for the high-profit procedures; they are sick needing immediate care.

“Now they’re focused on saving Alabamians, saving Americans, and so we’ve got to do our part to help backfill — we can’t afford to lose doctors and get them out of the profession,” said Jones. “We’ve already got a shortage. So we’re doing things I think to help that in COVID 3, and I think that’s going to be included in COVID 4.”

Senate Democrats are proposing that the fourth COVID-19 stimulus bill include additional pay for doctors, nurses, grocery-store workers, and other workers whose jobs are deemed essential.

“We are here at the hospital trying to help patients, protect the public and do our jobs under unbelievable circumstances,” said an ER doctor. “Who is watching out for us? Nobody?”

Jones says help is on its way but more must be done going forward.

“So now, people understand that your neighbor’s health — your health — is dependent on your neighbor’s health,” said Jones.

COVID-19 has exposed severe cracks in the state’s healthcare system. Jones sees expanding Medicaid under the Affordable Care Act as a vital part of restoring Alabama’s healthcare system while offering much needed relief to all individuals affected by COVID-19.

“This has shone a light on the deficiencies in our system,” said Jones. “This has shone a light on the racial disparities in urban and rural areas. Everybody in Alabama, and America, has an opportunity to fix it,” said Jones. “We must act now.”

Not all Alabama hospitals are cutting ER doctors’ pay, hours, or benefits, but for many healthcare professionals on the frontlines, they now have one more thing to worry about — paying the bills.

Update: East Alabama Medical Center announced after APR published this story that its leaders were taking a temporary reduction in pay.

EAMC President and CEO Laura Grill explained the decision, “In an attempt to avoid impacting frontline staff as we are seeing elsewhere in Alabama and across the country, we are making some temporary pay cuts. I asked our senior leadership team to take the first cut and then we asked our employed physicians as well. Then, yesterday, we communicated a reduction in pay to the rest of our leadership team—our directors and managers. I am very hopeful that these cuts will be temporary and that business will return to normal in the near future. However, leadership starts with all of us. I am immensely proud of our team and entire organization, and thankful for the support of our community as we navigate these challenges.”

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Congress

ADOL begins paying federal $600 stimulus benefit

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Alabama Department of Labor Secretary Fitzgerald Washington announced today Alabama has begun paying the Federal Pandemic Unemployment Compensation (FPUC) benefit that was established with the passing of the federal CARES Act on March 27, 2020.

ADOL began paying the FPUC benefits on April 8, 2020.  Claimants whose claims have processed should expect to see the funds within 2-3 days, if not sooner.  ADOL paid $40,060,495 in FPUC benefits to 60,848 claimants yesterday.

Under the legislation, anyone receiving unemployment compensation benefits is eligible for the additional $600 a week stimulus payment. The payment is added to the recipient’s state weekly benefit amount (maximum of $275/week). The payments will be made for eligible weeks beginning on March 29, 2020 through July 25,2020. This does not refer to the date the original claim was filed, but to the weeks being claimed.  For example, if someone filed their initial claim on March 16, 2020, and remains out of work, they will not receive the additional $600 for the weeks beginning March 15 or March 22, but would receive it for the week beginning March 29, and all weeks going forward.

ADOL will make payments retroactively for weeks already claimed since March 29, 2020.

“We understand the frustration of many Alabamians who are out of work due to the COVID-19 outbreak, and we know that they need these benefits to stay afloat,” said Washington.  “We are working as hard as we can to make sure that everyone gets the benefits they need as quickly as they can.  We are one of the first states to begin distributing these funds. We continue to urge patience as the department works to implement this vital legislation.”

Programs included in the legislation:

Pandemic Unemployment Assistance (PUA) – provides unemployment benefits to those not ordinarily eligible for them. This includes individuals who are self-employed or contract employees. This benefit is retroactive to January 27, 2020.

Federal Pandemic Unemployment Compensation (FPUC) – provides $600 per week to any individual eligible for any of the Unemployment Compensation programs. This benefit begins March 29, 2020. 

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Pandemic Emergency Unemployment Compensation (PEUC) – allows for an additional 13 weeks of benefits added to the end of regular unemployment benefits. This means claimants may collect unemployment benefits for a longer period of time than under normal circumstances.

ADOL is encouraging anyone who believes they may be eligible for these programs to file a claim at www.labor.alabama.gov or by calling 1-866-234-5382. Online filing is strongly encouraged.

Those who already have an active claim, or who have already filed a claim, DO NOT NEED TO REFILE to be eligible for these benefits. ADOL will begin processing PUA and PEUC claims as soon as administratively possible.

Important note: None of the benefits described above, nor unemployment benefits of any kind, are available to employees who quit without good work-related cause, refuse to return to work, or refuse to receive full-time pay. Refusing to return to work could result in a disqualification for benefit eligibility. Attempts to collect unemployment benefits after quitting a job without good work-related cause is considered to be fraud.

The CARES Act specifically provides for serious consequences for fraudulent cases including fines, confinement, and an inability to receive future unemployment benefits until all fraudulent claims and fines have been repaid. Employers are encouraged to utilize the New Hire system to report those employees who fail to return to work.

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Economy

Business Council of Alabama Small Business Exchange on APT tonight

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The Business Council of Alabama (BCA) will present the Small Business Exchange on Alabama Public Television (APT) tonight, Thursday, April 9. This event is designed to help small businesses applying for federal stimulus funding under the new CARES Act.

In partnership with APT, BCA will bring together experts in business, banking, accounting, and law to answer phone calls from Alabama business owners and employers as they grapple with the impact of the coronavirus on the state’s economy. New federal loans are now available for small businesses, but funding is limited in some cases and quick action is required.

The Small Business Exchange program airs tonight on APT from 7-8 p.m. BCA experts will be available to answer questions from 7 p.m. – 10 p.m. tonight. In addition, experts will be available for consultation from 9.a.m. to noon tomorrow, Friday, April 10.

To ask a question or consult with our BCA experts during these times, the phone number is 1-833-BCA4BIZ (1-833-222-4249).

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