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Medicaid, Lift Every Voice

By: Senator Linda Coleman
District 20 in Jefferson County

On Tuesday March 5th at 10:00 AM in the Capitol Auditorium, the Alabama Senate Democratic Caucus will host a Public Hearing on Medicaid expansion.  This hearing is to provide a forum to listen to the public, persons who are recipients of Medicaid, professional service providers who serve those on Medicaid and other elected officials. The Governor has said that he will not expand Medicaid, and Alabama will not be part of the Affordable Health Care Act passed by Congress.  In 2010, Alabama had approximately 332,000 uninsured citizens, and now, the authority to expand Medicaid to individuals with family incomes up to 133% of the federal poverty level (FPL), is the Governor’s decision. In his 2011 State of the State address, the Governor stated that he would work to provide healthcare for all our fellow citizens that is both affordable and accessible.  Governor, that opportunity is knocking at the door.  Expanding Medicaid provides just what you promised the people in 2011.

There is a saying the community of persons with disabilities, “Nothing about us without us”. When Governor Bentley made the statement that Alabama would not expand Medicaid, the people who are adversely affected by Medicaid, the seniors, the disabled, the elderly and children, rehabilitation homes, local medical providers, doctors, hospital representatives, and nursing homes, obviously were not at the table. They had no voice about such an important issue for many meant life or death. This lifeline, the extension of life giving care and treatment, and the quality of life that they will have. It appears that their voice did not matter.  I may not be a Medicaid recipient, but I know countless people who are. I visit nursing homes weekly and see the human faces of those who do depend on Medicaid, their families who have nowhere to turn for help, and the staff and administrators who serve them.

Alabama currently has a waiting list for almost every area, be it Medicaid E&D waivers to help people live in their home or community independently, mental health and others.  We should think long and hard before turning down these federal dollars.  Many state governors who said they would not expand Medicaid have since changed their stand.  Let’s look at the facts based on a report done November 5, 2012 by the Department of Health Care Organization and Policy School of Public Health, University of Alabama at Birmingham. “Under the Affordable Care Act (ACA), Alabama would receive a significantly higher Federal Matching Assistance Percentage (FMAP) for the expansion population than the 68.5% it currently receives for the non‐expansion population. The ACA provides for a uniform FMAP to all states of 100% in 2014‐2016, 95% in 2017, 94% in 2018, 93% in 2019 and 90% in all years thereafter.”  This six-year transition would allow the state to look for more stable funding in years to come; in the meantime, we will help hundreds of thousands of our citizens all over the state.

The Public Hearing at the Alabama State Capitol on March 5th at 10:00 A.M is appropriate and fitting because lawmakers will soon be voting to cut or extend Medicaid benefits as it relates to the General Fund, and Medicaid funding which touches over a fourth of the state’s constituents. When Governor Bentley campaigned for governor, his slogan was: “We need a doctor, and I want to be the Governor for all the people.” Now, he is the Governor of all Alabamians, not just those who are privileged or have the means to live comfortably. Alabama’s population is not healthy; while many are un-insured or under-insured, it appears that this administration and the majority party have put politics before its people. The question begs to be answered, “Who really represents the people of Alabama?”  While leaders talk about respecting life, there is no respect for the life in front of them like the elderly, the disabled, and the sick.

We know that broader access to medical care leads to preventative healthcare, healthier families, a healthier workforce and a healthier state. Expansion of Medicaid will offer access for preventative care versus acute care to thousands of Alabamians for the first time. This expansion will reduce state spending on Medicaid while creating a huge economic boost in job creation in the medical service industry.

According to the study done by UAB on the economic analysis projection, it is estimated that federal spending to support the coverage of Medicaid expansion would generate nearly $20 billion in increased economic activity between 2014 and 2020, that’s $20 billion. The Federation of Tax Administrators (FTA) estimates Alabama’s tax burden at 8.6 percent of income. The FTA computes the state’s tax burden as taxes collected by state and local governments from residents and non‐residents divided by the total incomes of Alabama residents. Taxes include personal and corporate income taxes, sales and property taxes and other taxes. Based upon this 8.6 percent tax burden, they project that the increase in federal Medicaid spending would generate over $1.7 billion in additional state tax revenues during this same period. The costs to the state of expanding the Medicaid program are the administrative and direct benefit costs which would be offset by these additional tax revenues. Therefore, after all the costs are paid, Medicaid expansion would still increase the state budget by approximately $935 million in tax revenues between 2014 and 2020.

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For a state that boasts to have the largest medical center in the southeast and is recognized internationally, it’s time for Alabama to stop living in the past, being penny wise and dollar foolish. Time to step up to the plate, help ourselves and help the citizens we represent.  Therefore, I invite all to come ad let your voices be heard in support of expanding Medicaid in our state.  Let’s put people before politics.



Expanding Medicaid is more than just adding job opportunities. This will literally save lives.


Alabama is one of 12 states that has chosen not to expand Medicaid.


Once the COVID public health emergency ends, millions will have to reapply for Medicaid or find coverage elsewhere.


Bentley said expanding Medicaid is not a political decision to be made, and is critical to saving lives.