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New Report Suggests Expanding Health Coverage Good for All

Bill Britt

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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.”

(See report here.)

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.

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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.”

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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.”

Bill Britt is editor-in-chief at the Alabama Political Reporter and host of The Voice of Alabama Politics. You can email him at [email protected] or follow him on Twitter.

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National

Today is Thanksgiving

Today is a national and state holiday. Schools, banks, government offices and many private businesses are closed.

Brandon Moseley

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(STOCK PHOTO)

Four hundred years ago, on Nov. 11, 1620, after 66 days at sea, a group of English settlers landed near what is today Cape Cod in Massachusetts. Onboard the Mayflower were 102 men, women, and children, including one baby born during the Atlantic crossing, who made up the Pilgrims.

The Mayflower, captained by Christopher Jones, had been bound for the mouth of the Hudson River. The ship took a northerly course to avoid pirates, but the decision to avoid the then widely traveled sea lanes to the New World took the ship into bad weather, which had blown the Mayflower miles off course and left the ship damaged. Off Cape Cod, the adult males in the group made the fateful decision to build an entire colony where none had existed prior. They wrote and signed the Mayflower Compact.

“In the name of God, Amen. We whose names are underwritten, the loyal subjects of our dread Sovereign Lord King James, by the Grace of God of Great Britain, France, and Ireland King, Defender of the Faith, etc. Having undertaken for the Glory of God and advancement of the Christian Faith and Honour of our King and Country, a Voyage to plant the First Colony in the Northern Parts of Virginia, do by these presents solemnly and mutually in the presence of God and one of another, Covenant and Combine ourselves together in a Civil Body Politic, for our better ordering and preservation and furtherance of the ends aforesaid; and by virtue hereof to enact, constitute and frame such just and equal Laws, Ordinances, Acts, Constitutions and Offices from time to time, as shall be thought most meet and convenient for the general good of the Colony, unto which we promise all due submission and obedience. In witness whereof we have hereunder subscribed our names at Cape Cod, the 11th of November, in the year of the reign of our Sovereign Lord King James, of England, France and Ireland the eighteenth, and of Scotland the fifty-fourth. Anno Domini 1620.”

After a few weeks off Cape Cod, they sailed up the coast until they reached Plymouth. There they found a Wampanoag Indian village that had been abandoned due to some sort of plague. During the Winter of 1620-1621 they lived aboard the Mayflower and would row to shore each day to build houses. Finally, they had built enough houses to actually move to the colony, but the cold, damp conditions aboard the ship had been costly.

Some 28 men, 13 women (one of them in child birth), and 8 children died in that winter. Governor John Carver would die in April. His widow, Kathrine White Carver, would follow a few weeks later. There is some recent archaeological evidence suggesting that some of the dead were butchered and eaten by the survivors.

The Mayflower and her crew left for England on April 5, 1621, never to return.

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About 40 of the Pilgrims were religious Separatists, members of a Puritan sect that had split from the Church of England, in defiance of English law. In 1609, they immigrated to Holland to practice their religion but ran into problems there too. Others in the group had remained part of the Church of England but were sympathetic to their Separatist friends. They did not call themselves Pilgrims, that term was adopted at the bicentennial for the Mayflower voyage. The members of core Separatist sect referred to themselves as “Saints” and people not in their sect as “Strangers.”

In March 1621, an English speaking Native American, named Samoset, visited the Plymouth colony and asked for beer. He spent the night talking with the settlers and later introduced them to Squanto, who spoke even better English. Squanto introduced them to the chief of the Wampanoag, Massasoit.

Squanto moved in with the Pilgrims, serving as their advisor and translator. The friendly Wampanoag tribe taught the Pilgrims how to hunt and grow crops. The two groups began trading furs with each other.

William Bradford, a Separatist who helped draft the Mayflower Compact, became the longtime Plymouth Governor. He was also the writer of the first history of the Plymouth Colony and the Mayflower. Bradford’s more notable descendants include author, dictionary writer and scholar Noah Webster; TV chef Julia Child; and Supreme Court Chief Justice William Rehnquist.

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In the fall of 1621, 399 years ago, the Pilgrims invited their Wampanoag Indian friends to a feast celebrating their first harvest and a year in the New World with a three-day festival. This has become known as the first Thanksgiving.

Today is a national and state holiday. Schools, banks, government offices and many private businesses are closed.

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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 one counts. The Alabama Supreme Court later struck down another five counts.

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 sentence 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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