By Bill Britt
Alabama Political Reporter
MONTGOMERY—Recently, talk radio, Facebook and Twitter were buzzing with accolade for a State Representative who wrote that we need to “cut the luxuries” out of state government including Medicaid.
When Dr. Henry Mabry was reminded of the legislators remarks he said, “What luxuries? Is that providing dialysis? Is that a luxury? I think the people receiving dialysis would beg to differ. Providing help for quadriplegics? I don’t think that is a luxury.”
Mabry points out that Alabama is dead last among all states when it comes to providing service to its citizens.
“We should be ashamed of that but that has traditionally not been the case,” said Mabry. “People don’t want to talk about this but state and local funding is 50th in the country out of all of the states.”
“I would say we could go through a list of a thousand things, provided on the General Fund side that you would not consider luxuries by any stretch of the imagination,” says Mabry.
According to Mabry, Alabama sits at 23rd in population and has a median income that is in the middle when compared to other states, “It’s the basics. Alabama funds the basics and it doesn’t fund the basics well.”
He says that most of the services that are provided for Alabama’s poorest citizens is done in the form of healthcare, and even at that Alabama has the most barebones Medicaid system in the country.
“It is not honest to say, ‘We are going to do away with waste and fraud’ when you are 50th,” Mabry said. “Waste and fraud is minuscule in Alabama’s programs.”
Last year the state received an award for its lack of fraud and its ability to keep it at bay.
Currently, the state provides around 250 thousand school children with school lunches.
“Is food a luxury?” he asks. “A hungry child is not going to learn. A sick child is not going to learn. Children with sick parents are going to have difficulties. There is a whole host of services provided by the state that have an influence on education, just as education has an influence on state services. Because if you don’t have an educated child and the child doesn’t learn at an early age, that child is going to be more susceptible to going in the path of being a criminal.”
Mabry acknowledge that there is a growing population of parents who, “have been derelict in their responsibilities.” He continues, “I’m not saying all parents, most parents do a good job but a lot of parents don’t do what they should.”
He make a case that there is a necessity to provide for the mental and physical health of Alabama’s children as well as looking out for their security.
“Somebody has to do all that if the parents aren’t willing to.”
He says that maybe that is what some might consider a luxury, “But we are providing for those children because their parents are unwilling to do their job. It may be a luxury for those parents but it is a necessity for those children.”
He says that we can offer these children a helping hand now or face the consequences that may come in the future, “You can pay for it now in the form of these services, or you can pay for it later when they are incarcerated.”
Mabry says it is time for more creative thinking, “How to squeeze more out of the turnip. Not from the waste and fraud because I think that is overdone, but trying to look at alternative funding.”
He says that when he was state finance director they looked at ways to acquire more federal dollars to cover services for the needy.
He cites mental health as an example of where more money might be obtained from the federal government without substantially increasing the state contribution.
“For instance, we’ve been looking at how to fix some of these schools that are not performing. You might have a class that has a lot of special needs children. You’ve got a large class size and then you’ve got say 5 kids that may be special needs, out of 20,” said Mabry. “Those 5 can’t be tended to by just one teacher and one aide. So if we had a couple of mental health workers in there maybe they could help keep those special needs children on track while at the same time all the other students get what they need so there attention is not taken away from them.” He says that during his tenure as finance director,”we did that in mental health and DHR, we successfully got a lot of additional federal dollars to meet state needs.”
Mabry knows that the state is going to have to continue contributing to Medicaid or risk losing the federal matching dollars, “That’s the whole thing about this is that they don’t talk about is here we provide $200 million per year out of this constitutional amendment. Well, if we don’t do the $200 million per year then we are losing $400 million a year in federal funds at least. So, why would we do that? It doesn’t make any sense.”
He says he grows tired of hearing people talk about cutting vital services as an answer to the state’s problem. Being ranked 50th out of 50 states leaves us with little or nothing to cut.
“We could be in a situation where CMS tells us that we are out of compliance with our program, Mabry said. “Are we going to be stuck with no Medicaid program with a million people without healthcare needs being addressed? That’s a whole lot of people.”
He continues by pointing out that the that the hundreds of millions of dollars the state contributes to Medicaid actually becomes billions of dollars because of the multiplier effect. “If the constitutional amendment fails we are talking about $2 billion being sucked out of the economy when we have had a weak economy anyway for the last 6 years. It’s not the time to do that.”
In our next installment Dr. Mabry speaks about more fixes and the cost of prisons.