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“Indigent Care, Immigration, Medicaid, and ObamaCare”

By Alabama State Representative Allen Farley

Four issues connected to one question: Who pays?

In Jefferson County the question was: Who pays for Cooper Green Hospital?  Now the question for Alabama is:  Who pays for Medicaid and Obama-Care?  The central question involving all government programs is Who Pays???

We are the greatest nation in the world.  We have shown our ability to come together in two world wars.  And, we are always the first to rush to the aid of another country’s population suffering from the effects of earthquakes, typhoons, and famines.  Yet, we continue to see our population divided over “who pays” for taking care of our own. Let’s talk about it:

Note: The opinions are mine.  The data I will use is taken from several different published documents of the Alabama Policy Institute.

If there are fewer jobs, why have we seen the growth of Hispanic communities in Jefferson County and across Alabama?  There must be something here.  Is it our Southern Hospitality? (I know, I’m laughing too.) I believe it’s opportunity.

Now, if the Hispanic increase is due to opportunity, then why has the Medicaid recipients in Alabama increased 33.5% between FY 2001 and FY 2011?

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Important:  Medicaid covers “residents” of the state, U.S. nationals, citizens, permanent residents, and “legal” aliens.  (My, my, what have we here?)  In addition, applicants must be either pregnant, blind, have a disability or a family member in their household with a disability, be responsible for children under 19 years of age, or be 65 years of age or older.

In 1990 there were approximately 352,000 Alabamians receiving Medicaid assistance.  That was approximately 9% of our state population.  In 2011 the number of Alabama residents receiving Medicaid assistance rose to 1,070,781.  That was 21.2% of our state population.  However, if every person in Alabama who is eligible for Medicaid received services, approximately 1,538,941 residents would be enrolled or approximately 31.5% of the state population. Wow!!!

Alabama’s cost for Medicaid in FY 2011 has risen to slightly more than $5.23 billion.  Of this total, 35.1% was spent on hospital care, 18% on nursing facilities, and 10.9% on pharmacy expenses.  Medicaid is the second largest budget item in Alabama, behind only education expenditures.

Who pays? Every employer and employee who pays taxes.  (Your right, that group is getting smaller.)

The Patient Protection and Affordable Care Act (Obama-Care) requires that “individuals under 65 years of age with income below 133% of the federal poverty level will be eligible for Medicaid” beginning in January of 2014. [The 2012 federal poverty level of 133% is $14,856 for a single person and $30,657 for a family of four.]

In the short term, implementing Obama-Care would increase Alabama’s Medicaid enrollment from 1.02 million in 2010 to 1.188 million in 2014, an increase of almost 168,000 people (16.4%) according to data from The Heritage Foundation.  In the longer term, the ranks of Medicaid enrollees in Alabama may expand anywhere from 351,000 to 456,000 between 2014 and 2019, according to estimates by the Kaiser Family Foundation.

At first, the federal government will pay for the entire cost of those who are newly eligible, but only from 2014 to 2016.  After that, the federal government will pay 95% in 2017, gradually reducing its contribution to 90% by 2020.

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The Medicaid expansion could cost the state a total of anywhere from $470 million to $693 million from 2014 to 2019.

Question: Has our generation’s failure to sustain the principles of limited government through “individual responsibilities” and “strong families” encouraged dependency over opportunity? Will we continue to give the healthy and capable adults every excuse to continue to turn away from the opportunities God has given all of us in this great nation? (Has the Hispanic community been given opportunities we have turned away from?)

Who loses?

Matthew 25:28-30 “So take the bag of gold from him and give it to the one who has ten bags. (29) For whoever has will be given more, and they will have abundance.  Whoever does not have, even what they have will be taken from them. (30) And throw that worthless servant outside, into the darkness, where there will be weeping and gnashing of teeth.”

God Bless America

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