By Brandon Moseley
Alabama Political Reporter
Wednesday the Senate Health Committee voted to indefinitely carry over legislation that would have completely repealed 2012 legislation that would have, if implemented, created regional care organizations (RCOs) to manage Alabama Medicaid.
Senate Bill 351 was sponsored by State Senator Paul Sanford, R-Huntsville.
Senator Sanford said that we spent over tens of millions of dollars to get the RCOs started but ultimately could not get them up and running because of the lack of provider participation. Now there is a change of direction at the federal level. This bill would remove all of the language from the act authorizing the state to create the RCOs.
The Senate Health Committee is chaired by State Senator Jim McClendon, R-Springville.
Chairman McClendon asked, “Would you like to carry this over until we can meet on this?”
Sanford replied, “My hope is that we can vote on it.” I am will to sit down with the original sponsor. It is something that we are not utilizing but “If there are components that we need to leave in place I can look at it. We spent between $20 million and $40 million on the front end. My fear is that if we leave this on the books and get a new administration at the federal level and the state level somebody might start this agains and put another $20 million to $40 million in it.
McClendon said, “My preference would be to work on it and present it to the Health Committee next week.”
The original RCO legislation was authored by McClendon (then the chair of the House Health Committee) and current Senate Majority Leader Greg Reed, R-Jasper, who chaired the Senate Health Committee then.
Majority Reed said, “I never want to be in conflict with my colleague and good buddy from Huntsville, but this piece of legislation at one time had many merits and broad support across the political spectrum.”
“At the moment the Affordable care act is still the law of the land,” Reed said but at the federal level now they are looking at work requirements and potential co-pay requirements. “It would have gotten the job done.”
Reed said that the RCOs failed because, “The hospitals were not going to assume full fiscal responsibility for these patients.” Reed said that there were two initiatives in that legislation, the integrated care networks for nursing home care and the RCO program. The long term care portion is moving forward and will be a savings allowing more seniors to stay in their homes rather than having to go to nursing homes. The regional care organization part is dormant at the moment. My preference is that we leave the legislation in place. It provides more options for the governor.
Sen. Sanford said, “It would still be in archives so if the climate changes.” To just leave things on the books that we know are not being used. “My fear is that the same outcome would happen again.”
Sanford said that when the RCO legislation was originally proposed, “I supported the idea and I supported finding funding for it and we couldn’t.”
Senator Linda Coleman Madison, D-Birmingham, said again this is one of those unintended consequences I think we should leave it in place right now. While I live in Jefferson County where there is plenty of healthcare; people from other parts of the state have to travel long distances for care there. The regional care organizations have the potential to provide care to areas of the state that are currently underserved without them having to travel long distances.
Sen. Coleman said that at the federal level, “I think the pendulum has swung as far away in one direction that it can go and has to come back to the middle. I would like to keep it alive.”
The Health Committee voted to indefinitely carryover SB351.