By Bill Britt
Alabama Political Reporter
With only three days remaining in the 2016 Special Session, lawmaker’s willingness to come together for a Medicaid solution is waning, and hopes of letting the people vote on a lottery are faint; if not totally beyond reason.
If we believe that, “The sleep of reason produces monsters,” then we must acknowledge that reason has fallen into a somnolent haze these last few weeks.
Governor Robert Bentley did not lay the ground work necessary for a successful session, which led to confusion and strife. His letters and exhortations from across Union Street lacked a sincerity of purpose, or any force of will to drive debate forward. In fact, his muddled efforts produced nothing of value, unless he considers scorn and ridicule to be rewards.
So, then with a mere 72 hours remaining, an ancient question appears: “What then shall we do?”
Setting aside the lobbying interests of ALFA, the Business Council of Alabama (BCA) and the Poarch Band of Creek Indians (PCI) for a moment, let’s turn to the real stakeholders in this matter: The voters, and those who rely on Medicaid for basic healthcare.
Currently, Alabama provides Medicaid recipients with only the most basic of services, far behind those offered in other states. Medicaid reformers in Alabama are placing their hopes on the Regional Care Organizations (RCO’s), which may deliver better care, while lowering overall cost by adding more preventative care. But, the legislature must fund the RCOs if they have even a chance of reforming Medicaid.
According to the American Academy of Pediatrics, “Historically, children represent half of all Medicaid enrollees, but they account for only 25 percent of Medicaid spending.” This statistic holds true for our State as well.
Children’s Hospital in Birmingham and Women’s and Children’s in Mobile saw the highest hospital inpatient Medicaid occupancy rates at 57 and 71 percent respectively, according to a report by issued by Medicaid Commissioner Stephanie McGee Azar, in April. Medicaid pays for over 40 percent of the live births in Alabama.
We cannot afford, as some Senators have advised, to abandon Medicaid. It would be an immoral negligence of duty placing the State’s entire healthcare system in peril.
Bentley’s plan to raid the BP oil spill fund looks to be the only answer, but even that is a band-aid, not a solution.
A lottery introduced as a more permanent solution was a bridge too far for many lawmakers for various reasons.
Bentley claims he wants to let the people vote on a lottery, but also seeks to dictate the terms in a most limiting way. A “paper only” lottery is a doomed enterprise in a digital world, and the proceeds from such a venture will diminish rapidly, as have all games played on dead trees. So, passing a constitutional amendment with restrictive language guaranties eventual failure.
Surely Bentley knows that technology has advanced beyond passing love notes on scraps of paper. Today, we text…but he knows that too.
Many lawmakers want to restrain gambling, and few would disagree that unfettered gaming is bad. But, if legislators are honest, gaming is alive and prospering; just not for the people of Alabama.
Indian casinos in our State are seeing record earning without paying one cent in taxes. Sure they give money to the communities which surround their casinos, but it’s just “chump change” to buy good will and a few politicos. They pat government officials on the head like good little doggies. Meanwhile, the money goes to expand their tax-free tribal empire.
In 2014, the Tribe spent over a million dollars in the State’s Attorney General’s race just to send a message, not just to Luther Strange, but every elected official. The message was clear: “mess with us, we’ll mess you up.” This one group, the PCI, which represents less than four thousand people, is the most powerful political force in our State, and they don’t contribute a dime to its welfare.
PCI is not the only monster in the room. ALFA wants to reassert its power in the wake of Mike Hubbard’s conviction, and BCA needs to show its dominance, even after the fall of its greatest ally.
Many question who prompted Rep. Connie Rowe (R-Jasper) to place a poison pill into the House version of the Governor’s lottery bill? According to House sources and others, Sen. Phil Williams (R-Rainbow City), aided by the District Attorney’s Association, mixed the foul concoction.
To enact any longterm solution for Medicaid, a gun and a bitter pill lie side by side on a table. For some, the bitter pill is a rethinking of the lottery. For others, it’s the gun. Still, others see it in reverse.
There may remain time for a compromise, but it requires leadership, imagination and something for everyone, not everything for some.
Christian writer and social activist Jim Wallis said, “The Bible insists that the best test of a nation’s righteousness is how it treats the poorest and most vulnerable in its midst.”
This is the test we face.
Perhaps all that is left is a prayer that compassion will trump greed and thought will temper emotion.