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Study shows many thousands died without Medicaid expansion

Eddie Burkhalter

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Around 15,600 Americans died over a five-year period because they lived in states that chose not to expand Medicaid, according to a recent study. 

Between 2012 and 2017, those 15,600 or so Americans died because they didn’t have the same access to care as those living in states that expanded Medicaid, according to the study by the University of Michigan, published Monday by the National Bureau of Economic Research. 

Alabama is one of 13 states that hasn’t approved Medicaid expansion. Doing so would provide coverage for around 340,000  Alabamians, according to a separate study in January 2019 by the University of Alabama at Birmingham’s School of Public Health. 

Sarah Miller, the study’s lead author and assistant professor of business economics and public policy at the University of Michigan’s Ross School of Business, told APR Tuesday that while it might seem obvious that expanded healthcare improves health outcomes this study was the first to dig deep into specific demographic data and to show the real impact of Medicaid expansion. 

There have been studies that used death certificates to determine health outcomes for states that expanded Medicaid, but those studies used much smaller sample sizes weren’t able to look at demographics data, which shows a person’s income and whether they had health insurance, Miller said. 

“So that’s been a data challenge for researchers,” Miller said. 

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Miller said they used U.S. Census Bureau survey data coupled with records from the Social Security Administration to better narrow the study’s focus to those who were eligible for Medicaid but who did not receive it. 

Researchers found that before the Affordable Care Act allowed for Medicaid expansion states tracked similarly, but after ACA, the mortality rates started changing. 

“At that point, we see mortality rates going down in the people in the states that opted to expand relative to the not expanding,” Miller said. 

The study noted a .13 percentage point decline in annual mortality, a 9.3 percent reduction over the sample mean, associated with Medicaid expansion.

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Miller said previous studies have shown that expanded Medicaid leads to increases in the use of prescription drugs for things like diabetes and heart disease and increased cancer screenings and hospital visits, which improved health outcomes, but this study was the first to look at the entire U.S. population and dig deep into the data to determine those mortality rates. 

The Affordable Care Act, known as Obamacare, adopted in 2011 allowed states to expand Medicaid programs to low-income uninsured adults and children. 

Expanding Medicaid in Alabama would cost the state an estimated $168 million in the first year and $25 million every year thereafter, but the Alabama Hospital Association estimates that over four years the expansion would add $11.4 billion to the state’s economy, more than paying for its cost. 

Attempts to reach Alabama Hospital Association’s chief policy officer weren’t immediately successful Tuesday afternoon, but the association is also concerned over the closure of rural hospitals as a result of the state’s decision not to expand Medicaid. 

The association estimates that hospitals are about 84 percent more likely to close in states that do not expand Medicaid. In Alabama 13 hospitals, seven located in rural areas, have closed within the last eight years, according to the association. 

Anniston-based RMC Health System in 2018 closed the 104-bed acute care hospital RMC Jacksonville, citing financial troubles. The hospital opened as Jacksonville Medical Center in 1976. 

No bills were introduced during the last state legislative session aimed at expanding Medicaid.

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Corruption

Former State Sen. David Burkette pleads guilty, avoids jail

Josh Moon

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Former Alabama Sen. David Burkette

Former State Sen. David Burkette will avoid jail time and be sentenced to a 30-day suspended sentence as part of a plea deal reached on Monday. 

Burkette, who pleaded guilty to one count of violating the Fair Campaign Practices Act, will also have to pay a $3,000 fine and serve 12 months of probation as part of the deal. He was sentenced in Montgomery Circuit Court on Monday after being charged two weeks ago with failing to deposit more than $3,600 in contributions into campaign accounts — a misdemeanor.

He also resigned his seat in the Alabama Senate as part of the plea deal. 

“I’m just happy to still be here,” Burkette told the court following his sentencing, according to multiple media reports. 

The former senator suffered a stroke in 2018 and has been confined to a wheelchair since. His current health status played a role in his sentence considerations. 

The charges against Burkette stem from a series of complaints filed against him with the Alabama Ethics Commission — all of them related to various issues during his time on the Montgomery City Council. The charge for which he pleaded guilty occurred in 2015.

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The Ethics Commission referred numerous charges to the Alabama attorney general’s office, according to sources familiar with the investigation of Burkette, but the attorney general’s office elected to charge Burkette with only the misdemeanor as part of the deal that saw him resign. 

“Candidates for public office at the state, county and municipal levels must comply with the State’s Fair Campaign Practices Act,” said Attorney General Steve Marshall. “Personally profiting from campaign funds erodes public confidence in the system and will not be tolerated.”

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Legislature

Former state senator arrested on charges of violating campaign finance laws

Josh Moon

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Former State Sen. David Burkette

David Burkette has been officially arrested. The former state senator from Montgomery, who resigned on Tuesday as part of a plea deal with the Alabama Attorney General’s Office, was formally charged on Thursday with a single misdemeanor count of violating the Fair Campaign Practices Act. 

According to a press release from the AG’s office, Burkette’s charge stems from him depositing campaign donations into his personal account instead of into his campaign accounts, as required by the FCPA. The alleged crimes occurred in 2015 and 2016 when Burkette was serving on the Montgomery City Council. 

The complaint alleged that, in 2015 and 2016 while running for the Montgomery City Council, Burkette intentionally failed to deposit $3,625.00 in campaign contributions into his campaign checking account, and instead, deposited or cashed those contributions into or against his personal bank account,” the AG’s release stated. 

The single misdemeanor charge is surprising given the lengthy list of allegations against Burkette submitted to the Alabama Ethics Commission. APR obtained a copy of the original report, which was submitted in October 2018. 

In addition to more than $40,000 in allegedly improperly spent council discretionary funds that were flagged by auditors for the city of Montgomery, Burkette was also accused of inappropriately donating tens of thousands more to suspect charities and two sororities, including his wife’s.

The Ethics Commission referred Burkette’s case to the AG’s Office in October 2019.

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Legislature

Pro-Growth Conference kicks off with Doug Jones, discussions on COVID impact and a living wage

Josh Moon

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Sen. Doug Jones speaks on the floor of the U.S. Senate. (VIA CSPAN)

What happens if you just give impoverished citizens $500 per month — no strings attached? Good things, it turns out. The people use that income to buy food, medicine and basic necessities for life. They take a day off work if they’re sick and actually get treatment. They quit a second, hourly-wage job that they are overqualified for and instead work towards obtaining a better, higher-paying primary job. 

These are things that the city of Stockton, California, has learned in its year-long living wage program.

The program, while limited in size — only 125 people — has proven to be a larger success than city officials had hoped, and it has opened their eyes to a new, more proactive style of governance, Stockton Mayor Michael Tubbs told Alabama elected officials. 

Tubbs was the featured speaker on Tuesday at the first day of the Pro-Growth Policy Conference, a three-day forum for Alabama elected leaders with guest speakers from around the country offering tips and best practices. 

The first day of the conference began with an opening talk from Sen. Doug Jones, who pressed the need for Medicaid expansion and how expansion has aided other red states. Jones also highlighted the need for broadband expansion and talked about a bill he has in the Senate that would create a broadband main office and dish out about $20 million in money for affordable access.

“Now (with COVID), we know how needed it really is,” Jones said. “We see the homework gap that we have. We know there’s a need for more telemedicine. My bill would consolidate in one office all of the monies for broadband … and provide affordable access.”

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Jones said the current COVID pandemic has highlighted just how badly we need better access to broadband in Alabama, and a major area of concern right now is healthcare. 

Highlighting that point, Brandon Garrett, the chief operating officer of the National Minority Quality Forum, and Dr. LaTasha Lee, the vice-president of social and clinical research, demonstrated the many ways in which inequality in health care and health care options is harming impoverished communities. 

A number of factors play into that inequality, but a lack of access to updated means of communication and tools is one of the biggest. 

“(Dr. Martin Luther King Jr.) said that, ‘Of all the forms of inequality, injustice in health care is the most shocking and inhumane because it results in physical death,’” Lee said. “That’s what we’re seeing currently with COVID-19 and sickle cell disease. These two diseases are affecting the minority community and causing death, and they make a great argument that such health care disparities really are a social justice issue.”

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Correcting such issues was one of the goals of Stockton’s living wage experiment. Now, Tubbs said, a working person can afford to stay home or get tested if they’re feeling symptomatic, whereas before that person — scared of missing a paycheck or losing the job altogether — might come to work with the virus and infect an entire workplace. 

That alone, Tubbs said, has restored dignity to a number of residents. 

“This is not easy, especially with budgets the way they are,” Tubbs said. “But I don’t know how we continue to live with the status quo as it is.

“I think part of being a leader, as we are, is having the courage to do something about what we’re seeing. We have to be able to do that.”

The Pro-Growth Policy Conference will run both Wednesday and Thursday, 10 a.m. until 2 p.m. Wednesday’s round of conferences will focus on state grants, economic development around the state and what the 2021 legislative session might look like. 

On Thursday, the event will wrap up with talks by the Equal Justice Initiative’s Bryan Stevenson and Alabama Congresswoman Terri Sewell.

 

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Elections

Russell Bedsole wins Republican runoff in HD49

Brandon Moseley

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House District 49 Republican nominee Russell Bedsole

As of press time, it appears that Russell Bedsole has won a narrow victory over Mimi Penhale in the special Republican primary runoff election in Alabama House District 49.

At press time, Bedsole had a 166-vote lead in unofficial results on the secretary of state’s website.

“We won,” Bedsole declared on social media.

Bedsole is an Alabaster city councilman and a Shelby County Sheriff’s Department captain.

“Sadly, tonight did not turn out in my favor. Despite the loss, I feel like God truly used this opportunity to help me grow in my walk with Him, and gave me the opportunity to increase my testimony,” Penhale said. “I feel so incredibly blessed by the people I have met on this campaign and the experiences I have had. I am disappointed in the outcome, but what an honor it is to have the confidence of 1,183 people across House District 49! Thank you!!”

Russell Bedsole had 1,249 votes, or 51.36 percent, to Mimi Penhale’s 1,183, or 48.64 percent, to win the House District 49 Republican primary runoff.

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There were just 2,432 votes cast in the special primary runoff election. Shelby County was the decisive factor in the election. Bedsole won Shelby County with 762 votes, or 71.42 percent, to Penale’s 305 votes.

Penhale carried Chilton and Bibb Counties, but could not overcome Bedsole’s strong performance in Shelby County.

The provisional ballots will be counted on Sept. 8, 2020, and certification of votes will occur on Sept. 16, 2020.

Bedsole will face Democratic nominee Sheryl Patton in the special general election on Tuesday, Nov. 17, 2020.

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The vacancy in House District 49 was created when State Rep. April Weaver announced her resignation to accept a presidential appointment as a regional director in the Department of Health and Human Services.

In a statement, the Alabama Republican Party thanked “each of the candidates that qualified for offering themselves up for service in the Alabama State House of Representatives.”

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