By Bill Britt
Alabama Political Reporter
Editors note—Since May the “Alabama Political Reporter” has published over two dozen stories on Medicaid and the upcoming September 18 constitutional amendment.
We have looked at the issue from many sides and see the pros and the cons of the debate. Perhaps the biggest take away has been that the lack of funding for the Medicaid agency and the Department of Corrections is a systemic problem. It has been a continuous crisis never faced in any meaningful way by democrats or republicans.
The time for finger pointing and recrimination will, in 24 hours, be replaced by a vote. It would not be fair to call it a vote by the people as most Alabamians will go about their business on September 18 happily unaware of what is taking place in their name.
The few, the powerful and the informed will cast their ballots and the result will show whose will won the day.
MONTGOMERY —On Tuesday, the voters of Alabama will be asked to vote on a constitutional amendment that will give the government leaders of Alabama the right to transfer $145.8 million a year for the next three years from the Alabama Trust Fund (ATF) to the General Fund.
What follows are the words of some of the state’s leaders.
Governor Bentley said in a recent interview, “Already, Alabama provides among the lowest level of benefits for Medicaid recipients when compared to other states. Any significant cuts would have devastating consequences. In order to avoid those cuts, Medicaid needs at least $600 million in the next fiscal year. If the constitutional amendment passes, we will be able to fund Medicaid at that level.”
Governor Bentley like many in the medical field understands the dire consequences of not funding Medicaid, the health delivery system of Alabama is dependent on Medicaid being whole. “If Medicaid is funded at less than $600 million, the strain on the entire healthcare system would be severe.”
House Minority Leader Craig Ford, (D-Gadsden), sees the picture differently, “In less than two years, the Republicans have chosen to raid the Alabama Trust Fund and make devastating cuts to our schools, public safety, and public health.
“The budget passed by the Republican supermajority does not provide enough money to provide those services, meaning Alabama will lose that federal matching money and Medicaid would collapse unless voters approve a constitutional amendment to allow the state to raid the Alabama Trust Fund.
“So not only did the Republicans pass a budget that relies on raiding the state’s savings account, they passed the responsibility of making that choice on to the voters. They put you, the voter, in a position where you have to decide if we are going to raid the state’s savings account or if we are going to let the state’s Medicaid program – which provides 70 percent of payments to nursing homes, 60 percent of payments to pediatricians, and 30 percent of payments to family practitioners – collapse.”
Ford has urged voters to say no to the September 18 amendment.
Senator Dick L. Brewbaker (R-Montgomery), has had strong words for those who are for and those who oppose the amendments, here are some of his thoughts on the issue.
“The voters have a big decision to make on September 18. The voters will decide whether to take $145 million a year for three years from the principal of the Alabama Trust Fund to shore up Alabama’s General Fund Budget. This is a game changing decision. It will decide the direction of state government for a long time to come. Supporters say a ‘yes’ vote will ensure an orderly reform of state government and warn of mass prisoner releases and a collapse of the healthcare system should the amendment fail. Opponents argue that a ‘no’ vote will force state government to live within its means, protect the state biggest savings account from greedy legislators and will force reform now instead of some time in the future. Both sides are oversimplifying a complicated situation.
“So, how should you vote? It depends on your view of your elected leadership. If you believe that the Governor and the legislature are sincere when they say they need time to insure orderly reform and that they are committed to pass such reform, by all means vote ‘yes.’ If, on the other hand, you think what this is really all about is a bunch of politicians trying to get themselves off the hook for three years so they can put all this off until after the next election, vote ‘no.’
“This is a big deal. Whatever you decide, go vote. This is not one the citizens can afford to sit out.”
Representative Patricia Todd, (D-Birmingham) recently stated, “I am conflicted like probably a lot of people in the state about this for many reasons.”
However, Todd said that she has come to understand that the September vote is not about Medicaid. “This is about those in control not wanting to do what is necessary to ensure a sound fiscal policy for our state.” She continues, “The majority party [republicans] and the Governor signed this stupid no-tax pledge which they feel locked into, yet they turn around and raise fees.” Todd laughs, “Do they think the people of Alabama are so stupid they don’t know the difference between a tax and a fee?”
She says that the constitutional amendment is another attempt by the legislature to pass the buck, “Whatever happens they will say, ‘We didn’t make that decision, the voters did.’”
An exasperated Todd concludes by saying, “I know I am on a tear about this but none of this is rocket science, it’s common sense, transparency. I mean discussion, dialog, agree to disagree, civil discourse. You bring in experts, you find out what has worked in other states make sound choices, but by George lead!”
Mary Scott Hunter, of the Alabama School Board had this to say in an editorial.
“In the future, our prosperity will totally depend on how well we use our limited resources, and I certainly understand this as a member of the State Board of Education. I also understand that this vote is a close call, and I do not question the members of my party who have decided to support the plan.
“I, however, cannot find enough positives in the plan to overcome my concerns that this plan is a provisional not a permanent solution. This initiative will, I predict, pass if the voter turnout is low. Low voter turnout will mean organized special interests will turn out their voters and will sway the vote.
“When will we live within our means in Alabama if not now? I recognize that there will be a lessening of services, but we have options that have not been properly explored Medicaid Reform, Sentencing Reform, Cigarette Tax, Gaming Compacts with our Indian Casinos all come to mind. I respectfully disagree with my colleagues in state government who believe that borrowing from our state’s oil and gas trust fund is the best option.”
Dr. Henry Mabry, Executive Secretary of the Alabama Education Association said in our interview with him, “It was obvious at the beginning of the session that the General Fund was going to need more revenue, it was obvious last year, it’s the same every year,” Mabry began. “The Governor had proposed that the money to cover the General Fund shortfall come from the Education Trust Fund, we tried to work with legislators to come up with some alternatives to address the problem facing the state.”
Mabry points out that traditionally the General Fund has “lived hand-to-mouth because it doesn’t have revenues that grow that much.” Over the years, the state legislature has passed some laws that have raised state revenues but not enough to even keep up with simple inflation.
“Take for instance drivers licenses, those costs have been stagnant since around 1983,” said Mabry. “The ABC board taxes have remained the same and the cigarette tax has actually declined over time.”
He says that because we have a general fund that relies on a “quilted patchwork of revenue sources that just don’t get the job done” the state will forever remain underfunded unless there are more revenues.
“Now, because the General Fund has remained mainly static, the resources have not grown to meet the demand,” says Mabry.
“A million of our citizen are served by Medicaid. That is one million out of 4.8 million, that is a huge part of our population. Is that going to change? No it’s not, because our people are poor. We are supporting this amendment because there is a responsibility to take care of the weakest among us,” said Mabry. “We want to see that those responsibilities are addressed.”
There have been many who gave voice to the vote on September 18, these are a few, now it is your turn.