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AG Marshall moves to strip pre-existing conditions coverage from hundreds of thousands of Alabamians

Bill Britt

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Nearly one million non-elderly adults in Alabama have pre-existing conditions and can’t be denied health insurance coverage under current law. However, Alabama’s appointed Attorney General Steve Marshall is currently engaged in a court battle that would deny those individuals health care coverage.

Marshall, the Republican nominee for attorney general, is part of a federal lawsuit which, if successful, will not only leave a third of Alabamians without health coverage for pre-existing conditions, it would strip over 50 million Americans of the same rights, as well.

The case, Texas, et al. vs. the United States, et al., is currently being heard in The United States District Court for The Northern District of Texas, where 18 Republican attorneys general and two Republican governors are suing to overturn the Affordable Care Act.

Recently, the Trump Administration joined the Texas lawsuit challenging portions of Obamacare that prohibit insurers from rejecting certain individuals or charging more for those with pre-existing conditions.

Polling shows public concerns over keeping coverage for pre-existing conditions is a major issue for voters with a supermajority — 75 percent — saying it’s “very important” to keep ACA’s insurance protections, according to a recent survey by the Kaiser Family Foundation.

The American Medical Association, The American Academy of Family Physicians, The American College of Physicians, The American Academy of Pediatrics and the American Academy of Child and Adolescent Psychiatry have all sought to influence the court filing, an Amici Curiae. These groups argue what Marshall and his fellow litigants would strip health care from tens of millions of Americans, sow chaos in the nation’s health care system​ and would remove protections for Americans with pre-existing health conditions.

Here in Alabama, the state’s Hospital Association is supporting Marshall’s election with nearly $20,000 in contributions to his campaign. A number of other health care related organizations are backing Marshall, including one firm’s founder who represents the Southern Poverty Law Center.

APR reached out to the Alabama Hospital Association’s Danne Howard asking why the organization supported a candidate who would take away medical coverage for Alabamians with pre-existing conditions, but as of publication deadline, Howard failed to answer APR‘s query.

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Protect Our Care Campaign Director Brad Woodhouse sees Marshall’s action as politically motivated and harmful to those he has promised to protect.

“Steve Marshall’s politically inspired effort to get rid of the Affordable Care Act could take health insurance away from 483,500 Alabamians, raise premiums, and end the Medicaid expansion, which has been critical for combating the opioid epidemic and keeping rural hospitals afloat,” said Woodhouse.

Marshall joins another GOP lawsuit challenging Obamacare

Marshall, an Obama-Democrat until 2012, turned to the Republican Party once he was determined to run for attorney general. He was first appointed Marshall County District Attorney by then-Gov. Don Siegelman and later appointed Attorney General by Robert Bentley before he was forced from office.

Marshall faces Joseph Siegelman in November’s general election.

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Alabama small business task force forms subcommittee on reopening state’s economy

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Lieutenant Governor Will Ainsworth on Thursday announced that the Alabama Small Business Commission Emergency Task Force has formed a subcommittee on reopening the state’s economy and plans to present a plan to Gov. Kay Ivey and State Health Officer Dr. Scott Harris by April 17.

“Reopening Alabama’s economy and getting businesses back to work will not be like flipping a light switch, but it will more likely be accomplished in stages once the COVID-19 pandemic begins to ease,” Ainsworth said.  “The purpose of this subcommittee is to provide a roadmap to reopening the economy that balances the public’s health and safety with the need for small business owners and employees to resume operations.”

The subcommittee will consider issues like how to best ease restrictions on restaurant and store capacity guidelines and how to incorporate social distancing needs with increased commerce once officials decree that the worst of the COVID-19 threat has passed.

State Rep. Danny Garrett (R – Trussville) will serve as chairman of the subcommittee, and the other members include:

  • Senator Chris Elliott (R – Fairhope)
  • Senator Garlan Gudger (R – Cullman)
  • Representative Joe Lovvorn (R – Auburn)
  • Rosemary Elebash – National Federation of Independent Business, Alabama State Chair
  • Mindy Hanan – Alabama Restaurant and Hospitality Association, Executive Director
  • Katie Britt – Business Council of Alabama, CEO
  • Rick Brown – Alabama Retail Association, President
  • Tony Cochran of CK Business Solutions in Albertville
  • Stephen McNair of McNair Historic Preservation in Mobile

The 22-member commission is statutorily tasked with formulating “policies encouraging innovation of small businesses in the state” and advising the Department of Commerce in promoting small businesses within Alabama.  The state legislature placed the Alabama Small Business Commission under the authority of the Lieutenant Governor’s Office in 2018.

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Health

Feds seizing needed supplies slowed state’s COVID-19 testing efforts

Chip Brownlee

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Add Alabama to the list of states that have had trouble acquiring needed medical supplies from commercial vendors because the federal government intervened and took the supplies.

The federal government has been quietly seizing orders of medical supplies, protective gear and testing materials across the country, and Alabama has not been immune.

The federal government’s actions, blocking the shipment of those supplies, impeded the state’s ability to roll out widespread testing and added to supply shortages in the state, officials say.

The Alabama Department of Public Health told APR Thursday that several shipments of supplies from commercial vendors have been superseded by the U.S. Department of Health and Human Services since the outset of the coronavirus pandemic in the state.

“It’s been happening all along,” said State Health Officer Scott Harris. “We had orders through about three different vendors, national vendors that we would normally use for medical supplies. They had accepted the orders and given us a ship date.”

But then the vendors called and canceled the orders.

“They say, you know, the inventory was acquired by HHS,” Harris said, referring to the Department of Health and Human Services.

The department and the Federal Emergency Management Agency have not publicly reported these acquisitions, according to the Los Angeles Times, nor has the administration detailed how these supplies are being used, when they decide to seize them and where the supplies are being rerouted to.

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The first time was three weeks ago. The state placed an order for about four thousand nasopharyngeal swabs, the long Q-tip like swabs used to perform COVID-19 tests. The order was accepted, but before it could be shipped, HHS seized the supplies.

“That was one of the things that slowed our rollout of testing around the state because there were no supplies to be had,” Harris said.

Since then, the state and hospitals have been able to acquire supplies from other vendors, but the delays have hampered testing, putting Alabama behind other states like Louisiana. As of Thursday, Louisiana had tested nearly 90,000 people for the virus. The number includes most commercial tests.

The main issue facing the state has not been the so-called “test kits” or even the state lab’s capacity to run tests.

“We’ve had days where we thought we were going to be out of reagent, and we’ve wondered if we were going to have to hold off testing, but we haven’t had to stop,” Harris said. “We’ve had some just-in-time deliveries that we weren’t sure were coming.”

The real issue has been the swabs needed to collect samples. Hospitals and health officials across the state, from Huntsville to Mobile, have at one point or another reported severe shortages of nasopharyngeal swabs.

“We’re bidding against every other state in the country, and in some cases, we’re bidding against health care facilities here in our own state who are doing their own testing,” Harris said of the process of acquiring swabs and other supplies.

ADPH and hospitals have been able to get more of those supplies, and Alabama has slowly ramped up testing as a result. But it has not been easy. “Getting those swabs and viral transport media has really been the rate-limiting step for most of our testing clinics,” Harris said.

As of Thursday, the state has tested about 20,000 people, nearly twice the number reported five days ago on April 4. Testing has been increasing over the past week and a half, Harris said.

More have been tested, but it’s hard to know exactly how many because not all commercial labs are reporting the number of negative tests they conduct. Harris said the state has asked the commercial labs to report those numbers, but some have been slow to do so.

Alabama has also had trouble receiving other types of needed medical supplies like ventilators and personal protective equipment. Some of the shipments seized by the federal government have been personal protective equipment intended to refill dwindling supplies at some of the state’s harder hit hospitals, nursing homes and other providers, according to Dr. Donald Williamson, the president of the Alabama Hospital Association.

Though no hospital has run out of PPE, some have been running low, Williamson said. But hospitals have been forced to take unusual measures to conserve supplies, particularly the N95 masks that offer the most protection to health care workers treating COVID-19 patients.

The city of Montgomery in late March received 28 cases of protective masks from the strategic national stockpile, according to the Montgomery Advertiser. When the city opened the shipment, about 5,800 of the masks had dry rot and an expiration date of 2010.

The difficulties in the supply chain have also affected the state’s ability to acquire new ventilators. Harris told APR on Friday that the state asked the federal government for 500 ventilators, and for 200 of them to be delivered urgently. HHS indicated that it would not fulfill the request anytime soon, and that the state could expect additional ventilators only if a dire need was expected within 72 hours.

So Alabama, like a number of states, is being forced to try to source ventilators on its own through the private market, where thousands of hospitals, all the other states and countries all over the world are trying to do the same, causing prices to skyrocket.

Alabama has placed an order for 250 more ventilators, and that order has been accepted, but it has not shipped yet, Harris said.

“We’re just not sure when they’re going to get here,” Harris said. “But we will need them in the next 14 days.”

In the meantime, Alabama has shipped about a dozen out-of-date ventilators to California for refurbishment. About half of those have been returned and distributed to hospitals based on their need. The state has also added to its ventilator capacity by retrofitting anesthesia machines and veterinary ventilators for use on those infected with the virus. Even though the state has added about two hundred new ventilators into service, the usage rate of ventilators has remained about the same. As of April 8, at least 101 people have required mechanical ventilation in Alabama for COVID-19. The number is expected to rise in the next weeks.

In the meantime, the state has had trouble getting ventilators from private vendors because the components needed to produce them have been redirected by the federal government to Ford and GM, who have been ordered to manufacture ventilators in mass quantities.

“They have had first-choice at these parts,” Harris said. “So the people who normally make ventilators can’t get those parts, which slows down delivery for all of us who’ve gone through the normal channels to get them where we would normally get them.”

Williamson and Harris said the state and its hospitals, which are already facing a cash crunch, have been forced to pay inflated prices for needed supplies because demand is high and supply is short.

“Some of our folks are seeing prices substantially higher than they normally have for PPE, specifically N95 masks. Some of it is supply and demand, and some of it is people taking advantage of an unfortunate situation,” Williamson said.

The state has been able to identify supply to help support hospitals who are sourcing their own, too, but the costs are exorbitant and a majority of the “vendors” offering to supply the state with supplies are counterfeit.

“You know, you would normally pay 60 or 70 cents for a mask,” Harris said. “These offers are typically $5 or $6 per mask now. I’ve seen some are asking for $10 or whatever, which is truly outrageous.”

The governor’s office, the Department of Commerce and the attorney general’s office have been helping the Department of Public Health source needed supplies.

“We’re doing our best to source those any way we can,” Harris said.

Harris and Williamson both said PPE supply and ventilator capacity, at least right now, appear to be in decent shape.

“I’m feeling better about ventilators,” Williamson said. “But it would always be nice to have more. With the surge we’re expecting, we seem to be okay. We’ve only had a couple of instances where we’ve had to try to assist and help move ventilators from one hospital to another hospital, but we’ve been able to do that and no one has gone without a ventilator who needed one.”

But the Department of Public Health expects a rise in hospitalizations over the next two weeks that could add further strain the state’s health care system.

“Let’s see what happens over the next week, but for today, we are much better prepared than we would have been, frankly, a few months ago,” Williamson said.

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Health

400 Alabama health care workers and 155 nursing home staff, residents positive for COVID-19

Chip Brownlee

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Nearly 400 health care workers and 90 long-term care facility employees have tested positive for the novel coronavirus.

The Alabama Department of Public Health said Thursday that at least 393 health care workers, 90 long-term care facility employees and 65 long-term care facility residents have tested positive. Health care workers includes those who work at hospitals or doctor’s offices.

As of 2 p.m. on Thursday, the state had confirmed 2,700 cases of the virus. At least 70 people have died after testing positive for the virus in Alabama, of those 48 have been fully investigated and verified by ADPH epidemiologists.

The number of confirmed cases among health care workers has grown significantly this week. Alabama Gov. Kay Ivey said Friday at a press conference that 200 health care workers in the state had contracted COVID-19. By Tuesday, that number increased to 315.

The number of long-term care facility residents has increased from 51 on Tuesday to 65 now, adding to concerns that the virus is widespread among the state’s nursing homes and long-term care facilities, which are considered extremely vulnerable to the virus.

At least 62.5 percent of the 48 verified deaths have been among those 65 years old or older.

At least 333 people have been hospitalized with the virus in Alabama since March 13, but the number is surely higher because of delays in investigating each case.  Of those who have been hospitalized, 153 have required treatment in an intensive care unit and of those, 101 have required mechanical ventilation.

Nurses, doctors, hospitals and the Alabama Department of Public Health have said that a nationwide shortage of personal protective equipment has not spared Alabama.

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Alabama Hospital Association President Dr. Donald Williamson told APR Tuesday that some hospitals in the state have severe shortages of N95 masks, with some hospitals reporting that they have only a days of supplies left.

So far, he said, no hospitals have run out of supplies yet, but some have had to take serious measures to conserve their masks.

State Health Officer Scott Harris told APR Thursday that the state is being bombarded with fake offers to provide PPE, mainly from foreign companies claiming to be able to supply the state.

Harris said the state has been able to identify supply to help support hospitals who are trying to source their own, too, but the costs are exorbitant.

“You know, you would normally pay 60 or 70 cents for a mask,” Harris said. “These offers are typically $5 or $6 per mask now. I’ve seen some are asking for $10 or whatever, which is truly outrageous.”

 

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Crime

Mobile County jail inmates, officers test positive for COVID-19

Eddie Burkhalter

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The Mobile County Sheriff’s Office says six inmates at the county jail and even more correctional officers have tested positive for COVID-19, according to WKRG, which broke the story on Thursday.

Attempts to reach the sheriff’s office’s public information officer wasn’t immediately successful Thursday, but WKRG reported that the sheriff’s office confirmed that 6 inmates have tested positive for the virus and more than 6 officers also tested positive. The news station reported that the sheriff’s office was working to get an exact number of those who tested positive for the virus.

Two Alabama Department of Corrections employees have tested positive, but no inmates in state prisons had confirmed cases as of Tuesday, the last day ADOC had updated testing numbers.

This story will be updated.

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