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Clouse Favors Medicaid Expansion, Says ACA Saved AL Money

Lee Hedgepeth

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By Lee Hedgepeth
Alabama Political Reporter

Chairman of the Alabama House of Representatives Ways and Means General Fund Committee, Representative Steve Clouse, R-Ozark, has recently told media outlets that he favors the expansion of Medicaid under the Patient Protection and Affordable Care Act, more widely known as Obamacare, as long as Alabama’s share of funding for the expansion does not exceed ten percent of the its total cost.

Until now, Rep. Clouse, like nearly all Republican members of the Alabama Legislature, has opposed Medicaid expansion, citing unforeseen costs and increased government dependency.

Under the Affordable Care Act, the Federal government is required by law to fully fund the expansion of Medicaid in states until 2017. Then, their obligation would taper to 95 percent of total costs, leaving Alabama with a five percent funding burden, which would gradually increase to around ten percent in 2020, at which point the federally government would no longer, under today’s law, be required to fund the program.

Despite the gradual increase in cost to the State beginning in 2017, however, research from the University of Alabama in Birmingham and further review by the University of Alabama conclude that given the increased demand in the health care market that would occur, tax revenue form the program would top $1 billion, bring 30,700 to the state, and provide access to health care for 300,000 uninsured Alabamians.

One of the “good things” the Supreme Court did in their ruling on the Affordable Care Act, Representative Clouse told Capitol Journal’s Don Dailey, is that “you can come in and you can come out,” pointing to the fact that states do not necessarily have to keep the Medicaid program in its expanded form after their cost burden tops ten percent.

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“We can’t get a firm answer from the Federal government,” he said, alluding to unsure funding obligations for the State after 2020.

For now, though, the Ozark Republican thinks the expansion is a good idea.

“I can see us as we’re going forward probably maybe moving into the expansion of Medicaid,” Clouse told Dailey. “I can see a movement probably next year.”

When asked whether he thought that an expansion next year, after the 2014 election cycle had ended, was a political move on the part of lawmakers, Representative Clouse was rather candid:

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“Some of it is,” he said bluntly. “After the elections are over, cooler heads may prevail on this.”

At one point in the interview, elaborating on his favoring expansion, Clouse came back to the issues at hand, saying that not expanding Medicaid would be a “double whammy” for hospitals throughout the State, because the ACA reduces reimbursements that the Federal government expects to be paid for through the expansion.

He also – somewhat surprisingly – credited the Affordable Health Care (and himself) for saving Alabamians $10 million form the General Fund Budget by abolishing a program under which Alabama was required to subsidize health insurance for those who had exhausted their previous policies due to situation such as those with preexisting conditions. That subsidy program is now unnecessary given that such situations are covered under Obamacare, a label Clouse did not assign the President’s signature legislation during the interview.

Before, Clouse explained, “The states had to provide that… We had to help subsidize it. Now, with the ACA, they can go into the health exchange… that will save us some money there.”

Clouse said, however, that he has not approached Governor Bentley about his position. Bentley has long been opposed to the expansion, making the fight against “government dependency” one of the themes of this year’s State of the State address to the Alabama Legislature. “He is standing firm on that,” Clouse said.

As chair of the House Ways and Means General Fund Committee, Rep. Clouse is in the single best position to legislate on Medicaid possible. The committee appropriates the general fund budget, which includes all Medicaid expenses.

Representative Clouse, who was elected to the House in 1994, is facing Democrat Dr. Jennifer Marsden in the November election. Dr. Marsden, who has consistently supported expanding Medicaid, is a retired Army Major, was educated at Harvard University, earned a medical degree at the University of Pittsburgh, and is a family physician. She is the first woman ever to run for the seat representing Alabama House District 93.

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Health

Alabama hospitals nearing COVID-19 summer surge levels

Wednesday was the 18th straight day with more than 1,000 people in hospitals in Alabama with COVID-19. 

Eddie Burkhalter

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UAB Chief of Hospital Medicine Dr. Kierstin Kennedy.

Alabama hospitals reported caring for 1,483 people infected with COVID-19 on Wednesday, the highest number of patients since Aug. 11, when the state was enduring its summer surge. Wednesday was also the 18th straight day with more than 1,000 people in hospitals in Alabama with COVID-19. 

The seven-day average of hospitalizations was 1,370 on Wednesday, the 36th straight day of that average rising. The Alabama Department of Public Health reported 2,453 new cases Wednesday. The 14-day average of new cases was — for the eighth day in a row — at a record high of 2,192. 

Across the country, more than 80,000 people were hospitalized for COVID-19 on Tuesday, a record high and the 15th straight day of record hospitalizations nationwide, according to the COVID Tracking Project, a coronavirus tracking website.

The CDC this week recommended people not travel for Thanksgiving to help prevent the spread of coronavirus. 

“The only way for us to successfully get through this pandemic is if we work together,” said Dr. Kierstin Kennedy, UAB’s chief of hospital medicine, in a message Tuesday. “There’s no one subset of the community that’s going to be able to carry the weight of this pandemic and so we all have to take part in wearing our masks, keeping our distance, making sure that we’re washing our hands.” 

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Kennedy said the best way she can describe the current situation is “Russian Roulette.” 

“Not only in the form of, maybe you get it and you don’t get sick or maybe you get it and you end up in the ICU,” Kennedy said, “but if you do end up sick, are you going to get to the hospital at a time when we’ve got capacity, and we’ve got enough people to take care of you? And that is a scary thought.” 

The Alabama Department of Public Health on Wednesday reported an increase of 60 confirmed and probable COVID-19 deaths. Deaths take time to confirm and the date a death is reported does not necessarily reflect the date on which the individual died. At least 23 of those deaths occurred in November, and 30 occurred in other months. Seven were undated. Data for the last two to three weeks are incomplete.

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As of Wednesday, at least 3,532 Alabamians have died of COVID-19, according to the Department of Public Health. During November, at least 195 people have died in Alabama from COVID-19. But ADPH is sure to add more to the month’s tally in the weeks to come as data becomes more complete.

ADPH on Wednesday announced a change that nearly doubled the department’s estimate of people who have recovered from COVID-19, bringing that figure up to 161,946. That change also alters APR’s estimates of how many cases are considered active.

ADPH’s Infectious Disease and Outbreak team “updated some parameters” in the department’s Alabama NEDSS Base Surveillance System, which resulted in the increase, the department said.

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Corruption

Judge reduces former Alabama Speaker Mike Hubbard’s prison sentence

The trial court judge ordered his 48-month sentence reduced to 28 months.

Eddie Burkhalter

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Former Alabama House Speaker Mike Hubbard was booked into jail to begin serving his four-year sentence for ethics violations in September. (VIA LEE COUNTY DETENTION CENTER)

Lee County Circuit Court Judge Jacob Walker on Wednesday reduced former Alabama House Speaker Mike Hubbard’s prison sentence from four years to just more than two. 

Walker in his order filed Wednesday noted that Hubbard was sentenced to fours years on Aug. 9, 2016, after being convicted of 12 felony ethics charges for misusing his office for personal gain, but that on Aug. 27, 2018, the Alabama Court of Criminal Appeals reversed convictions on five of those counts. The Alabama Supreme Court later struck down another count.

Hubbard’s attorneys on Sept. 18 filed a motion to revise his sentence, to which the state objected, according to court records, arguing that “Hubbard’s refusal to admit any guilt or express any remorse makes him wholly unfit to receive any leniency.”   

Walker in his order cited state code and wrote that the power of the courts to grant probation “is a matter of grace and lies entirely within the sound discretion of the trial court.” 

“Furthermore, the Court must consider the nature of the Defendant’s crimes. Acts of public corruption harm not just those directly involved, but harm society as a whole,” Walker wrote.

Walker ruled that because six of Hubbard’s original felony counts were later reversed, his entrance should be changed to reflect that, and ordered his 48-month sentence reduced to 28 months. 

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Alabama Attorney General Steve Marshall on Wednesday said Walker’s decision to reduce Hubbard’s sentence was the wrong message to send.

“Mr. Hubbard was convicted of the intentional violation of Alabama’s ethics laws, the same laws he championed in the legislature only later to brazenly disregard for his personal enrichment,” Marshall said in a statement. “Even as he sits in state prison as a six-time felon, Mike Hubbard continues to deny any guilt or offer any remorse for his actions in violation of the law.  Reducing his original four-year sentence sends precisely the wrong message to would-be violators of Alabama’s ethics laws.”

Hubbard was booked into the Lee County Jail on Sept. 11, more than four years after his conviction. On Nov. 5 he was taken into custody by the Department of Corrections.

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News

Nick Saban tests positive for COVID-19, has “mild symptoms”

It’s unlikely Saban will be able to coach in person during Saturday’s Iron Bowl against Auburn.

Eddie Burkhalter

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University of Alabama head football coach Nick Saban.

University of Alabama head football coach Nick Saban has tested positive for COVID-19 ahead of the Iron Bowl and has mild symptoms, according to a statement from the university on Wednesday. 

“This morning we received notification that Coach Saban tested positive for COVID-19,” said Dr. Jimmy Robinson and Jeff Allan, associate athletic director, in the statement. “He has very mild symptoms, so this test will not be categorized as a false positive. He will follow all appropriate guidelines and isolate at home.” 

Saban had previously tested positive before Alabama’s game against Georgia but was asymptomatic and subsequently tested negative three times, a sign that the positive test could have been a false positive. He returned to coach that game. 

It’s unlikely Saban will be able to coach in person during Saturday’s Iron Bowl against Auburn, given the Centers for Disease Control and Prevention’s guidelines for quarantining after testing positive and with symptoms. Neither Saban nor the university had spoken about that possibility as of Wednesday morning.

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National

Civil rights leader Bruce Boynton dies at 83

The Dallas County Courthouse Annex will be renamed in honor of Boynton and fellow Civil Rights Movement leader J.L. Chestnut.

Brandon Moseley

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Selma attorney and Civil Rights Movement leader Bruce Carver Boynton

Selma attorney and Civil Rights Movement leader Bruce Carver Boynton died from cancer in a Montgomery hospital on Monday. He was 83. The Dallas County Courthouse Annex will be renamed in honor of Boynton and fellow Civil Rights Movement leader J.L. Chestnut.

“We’ve lost a giant of the Civil Rights Movement,” said Congresswoman Terri Sewell, D-Alabama. “Son of Amelia Boynton Robinson, Bruce Boynton was a Selma native whose refusal to leave a “whites-only” section of a bus station restaurant led to the landmark SCOTUS decision in Boynton v. Virginia overturning racial segregation in public transportation, sparking the Freedom Rides and end of Jim Crow. Let us be inspired by his commitment to keep striving and working toward a more perfect union.”

Boynton attended Howard University Law School in Washington D.C. He was arrested in Richmond, Virginia, in his senior year of law school for refusing to leave a “whites-only” section of a bus station restaurant. That arrest and conviction would be appealed all the way to the U.S. Supreme Court where Boynton and civil rights advocates prevailed in the landmark case 1060 Boynton vs. Virginia.

Boynton’s case was handled by famed civil rights era attorney Thurgood Marshal, who would go on to serve on the U.S. Supreme Court. The 1960 7-to-2 decision ruled that federal prohibitions barring segregation on interstate buses also applied to bus stations and other interstate travel facilities.

The decision inspired the “Freedom Rides” movement. Some Freedom Riders were attacked when they came to Alabama.

While Boynton received a high score on the Alabama Bar exam, the Alabama Bar prevented him from working in the state for years due to that 1958 trespassing conviction. Undeterred, Boynton worked in Tennessee during the years, bringing school desegregation lawsuits.

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Sherrilyn Ifill with the NAACP Legal Defense Fund said on social media: “NAACP LDF represented Bruce Boynton, who was an unplanned Freedom Rider (he simply wanted to buy a sandwich in a Va bus station stop & when denied was willing to sue & his case went to the SCOTUS) and later Bruce’s mother Amelia Boynton (in Selma after Bloody Sunday).”

His mother, Amelia Boynton, was an early organizer of the voting rights movement. During the Selma to Montgomery Voting Rights March in 1965, she was beaten on the Edmund Pettus Bridge. She later co-founded the National Voting Rights Museum and annual Bridge Crossing Jubilee in Selma. His father S.W. Boynton was also active in the Civil Rights Movement.

Bruce Boynton worked for several years at a Washington D.C. law firm but spent most of his long, illustrious legal career in Selma, Alabama, with a focus on civil rights cases. He was the first Black special prosecutor in Alabama history and at one point he represented Stokely Carmichael.

This year has seen the passing of a number of prominent Civil Rights Movement leaders, including Troy native Georgia Congressman John Lewis.

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