By Bill Britt
Alabama Political Reporter
MONTGOMERY—A new study by Carol Gundlach and M.J. Ellington, policy analysts at Alabama Arise, shows that, “nearly 100,000 Alabamians – almost one-third of those eligible” – were among the millions nationwide who signed up for coverage under the Affordable Care Act. This is good news according to the report, but the authors suggest that, “2015 could bring even better news for working families if the State closes the coverage gap for hundreds of thousands of uninsured Alabamians by expanding Medicaid coverage.”
Obamacare/the Affordable Care Act has come to be known as a law that Republicans love to hate. The promised fight to repeal the Act has generated piles of campaign cash and lots of votes. So, what’s not to love?
However, according to the report, around 342,000 Alabamians – most of them low-income working adults, would benefit greatly from the expansion of Medicaid under the ACA.
The State’s Republican super majority —which, in recent elections, gained even more seats in the House and Senate, have repeatedly said that the expansion it not affordable.
Currently, the Federal government covers 100 percent of the cost of expanded coverage, but over time, that will fall to 90 percent, with the State having to make-up the deference.
For a State with serious budget woes and an ideological propensity to challenge all things Obama, the expansion of Medicaid is a long row to hoe.
However, Ms. Gundlach contends, “It costs more not to expand Medicaid than it does to truly expand it.”
Gundlach says that taxpayers are already paying for other people’s medical care, but, “we are doing it in the most stupid way…they will go to the ER instead of going to a family doc and they wait until they’re too sick and it’s very expensive to provide treatment. That’s no way to run a medical system.”
According to the report, “More than one in five Alabamians between the ages of 18 and 64 lacked health insurance last year (2013). The coverage gap was especially large among the State’s young adults. More than one in four Alabamians between ages 19 and 25 were uninsured in 2013.”
The State’s overall rate of uninsured people was better than the National average in 2013, according to the report, but that was because Alabama has been very successful in providing Medicaid and ALL Kids coverage to low-income children. “More than 7 percent of children were the uninsured nationwide, compared to fewer than 5 percent in Alabama,” the study shows.
Gundlach is quick to point out that Alabama was one of the first states to implement the CHIPs program that provides health care for low/moderate income children.
“If you look at our numbers, we’re doing a dynamite job of providing healthcare for children in Alabama. We’re doing better than the Nation is. And that’s because we were offered a Federal program and said this is gonna make a big difference and we went out and we really worked to make sure every child in this State has insurance through Medicaid Insurance or their parents’ insurance. We know we can do this because we’ve done it and we done a good job of it. We just have to treat the expanded Medicaid program as intelligently as we did the CHIP program and we can make a difference,” said Gundlach.
Gundlach says that recent studies by UAB and UA show that expanding Medicaid is actually a job creator: “…by expanding Medicaid we would actually generate new revenue…increase medical jobs in the State…every time a dollar rolls over it’s better for the economy.” According to the report, an expansion would create “more than 30,000 jobs, many of them in the high-paying health care industry.”
However, hard-right groups like the Alabama Policy Institute, (API), have loudly disagreed with the UAB and UA, studies citing a contra-position paper produced at Troy University. That study was roundly criticized because the Chair is funded by the conservative-billionaire Koch brothers.
API says that “ State lawmakers must find Alabama solutions for Alabama problems and create lasting reforms that rein in cost and create quality care access.”
Gundlach does not disagree that Alabama must find its own solutions and says that the creation of Regional Care Organizations as a starting point. “If they work the way they’re supposed to they are going to provide great savings because, they are coordinating preventative care and that’s the way to get savings…keep people out of the hospital and take care of problems before they become serious.” She further states that, “Prevention is always better. You prevent crime, you reduce correction’s costs. You prevent illness, you decrease your healthcare costs. It’s just common sense to put your money in the prevention basket.”
Gundlach, says that other states are working to create homegrown solutions, “experimenting on different ways to deliver Medicaid services…there is nothing wrong with that.” Gundlach, says she is hopeful that the State’s plan for Regional Care Organizations will make for a better Medicaid system, but adds, “We need to get past, ‘We won’t expand’ and get into ‘How can we do this in a way that makes sense for Alabama.’”
Open enrollment for Marketplace coverage began Nov. 15, 2014, and continues through Feb. 15, 2015.
The report concludes that by expanding the number of Alabamians who would qualify under Medicaid expansion, “…would be a huge step toward a healthier, more secure Alabama for all.”