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Opinion | Prisons, rural healthcare and gaming need Alabama solutions

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The problems that lay before the Alabama Legislature in the coming 2020 session are complex but not so Byzantine as to be unsolvable.

Of the many tasks before state government is what to do about prisons, how to fix rural health care and how to profit from and regulate gaming.

One of these issues alone would be daunting enough to consume an entire Legislative Session, and yet it appears there is no time left on the clock to punt and hope for a miracle.

Sen. Daniel Patrick Moynihan, D-N.Y., in his book, Miles To Go, warned, “Ideological certainty easily degenerates into an insistence upon ignorance. The great strength of political conservatives at this time (and for a generation) is that they are open to the thought that matters are complex. Liberals have got into a reflexive pattern of denying this.”

Perhaps today, the roles are somewhat reversed.

But Moynihan, in 1993, wasn’t talking about conservatives with a capital letter C but lower case as in an ideology that calls for a slow and reasoned approach to policy based on fact and not feeling leading to evidence-based solutions.


Gov. Kay Ivey has made it abundantly clear that her administration is determined to build three new men’s correctional facilities. Ivey’s move is not without controversy, but after decades of half-measures and inaction, her administration is facing the problem head-on.

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The three new facilities will not solve every crisis within the state’s correctional system, but it is an obvious beginning.

Rulings by federal Judge Myron Thompson is forcing the state to act. Further pressure is coming from the DOJ, which found “reasonable cause to believe that conditions at Alabama’s prisons violate the Eighth Amendment to the Constitution,” which prohibits cruel and unusual punishment.

DOJ is threatening a takeover of the state’s prison system but, for now, is waiting to see if the state will correct the problems on its own.

Ivey’s administration, along with a handful of lawmakers—who understand the severity of the problems— is working with DOJ to stave off a costly federal intervention.

But here you have a handful of lawmakers who don’t believe the federal government is serious and therefore continue to kick against the idea of building new prisons. This denial by certain legislators fits nicely into Moynihan’s description of “insistence upon ignorance.” “Insistence upon ignorance” is also the hobgoblin that haunts those who insist that the state doesn’t need justice reform.

“Today, Alabama’s incarceration rates stand out internationally,” according to the Prison Policy Initiative, a non-profit, non-partisan organization known as a “go-to source for timely, actionable data about our criminal justice system.”

There are only two ways to reduce prison overcrowding, how many people are placed in prison and how many are let out.

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The state cannot continue to build more and more prisons, so it must address who goes in and who is let out.

Building new facilities as Ivey plans to do is the right first step.

Rural healthcare

Another Gordian Knot is how to address rural healthcare. There is a sword called expanding Medicaid that could slice through the problem, but that is not a solution currently being considered by Alabama’s political leaders.

Speaker of the House Mac McCutcheon, R-Monrovia, at a recent gathering of the Alabama County Commissioners Association suggested clinic type care in rural areas to address underserved locations.

Alabama is home to 122 hospitals, with 43 being located in Jefferson, Madison, Morgan, Mobile and Montgomery Counties. Seven rural Alabama counties Cleburne, Coosa, Henry, Lamar, Lowndes, Macon, and Perry, do not have a hospital.

“Rural Hospitals are always on the closure edge,” said State Rep. Tim Wadsworth, who represents a rural portion of the state. Wadsworth, in an Op-Ed published a few weeks ago at APR, suggested some creative solutions, which include rural hospitals exposing new sources of revenue.

“Rural hospitals could increase their revenue by utilizing those beds for nursing homes, rehabilitation centers, dental, eye clinics and rehabilitation clinics,” writes Wadsworth.

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A study by Alabama Arise finds that Medicaid expansion would help more than 340,000 Alabamians get health coverage, stabilize our rural hospitals and jump-start our economy – all for a dime on the dollar. It’s a bargain Alabama can’t afford to pass up.

However, there are still Republican lawmakers who contend that the Affordable Care Act is an abomination that should be repealed and replaced.

“Polling during the course of the midterm elections found the ACA to be popular with a majority of Americans,” according to ACA Times. “A Kaiser Family Foundation Health Tracking Poll conducted the week after the 2018 midterm election, saw the ACA continuing to be viewed favorably by 53 percent of the public. New KFF polling in January saw that favorable view continuing, with 51 percent of the public viewing the ACA favorably.”

To date, 36 states and the District of Columbia have expanded Medicaid, which means some 64 percent of the nation’s population is under ACA.

Alabama politicians say the state simply can’t afford expansion; however, studies have found that the expansion generally pays for itself.

It’s unclear at this time if there are any widely agreed-upon solutions to the rural healthcare situation.


The “Bingo wars” initiated and some believe fabricated by then-Gov. Bob Riley has been a bust for the state but a boom for the Poarch Band of Creek Indians who hold an almost complete monopoly on gambling in the state.

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PCI has become so rich off its gaming operations that it is offering the state one billion dollars for a complete monopoly.

Some lawmakers seem eager to accept the tribe’s offer, but others are not swayed that PCI’s proposal is in the best interest of the state.

Speaker McCutcheon, while addressing the ACCA, said, “I am not a big gambling guy; but if you are going to vote for a lottery, that’s gambling, then don’t be a hypocrite and let’s get the biggest bang for the buck,” McCutcheon said. “Let’s address a lottery, the Poarch Creek Indians, and these counties that want a one-armed gambling. Put them all in a room and hammer out a deal.”

A few years ago, PCI and the counties that operate bingo and dog tracks came together for just the sort of meeting that McCutcheon says is needed. The track owners were ready for a deal, but PCI was not.

PCI, while still confident they hold the winning position, are now more interested in a compact because they have reason to fear the Trump administration who may follow the law more succinctly than previous presidents. According to the law governing tribal gaming, a tribe cannot offer any games that are not legal in the state. If state law holds that electronic bingo is illegal—which it does—then PCI can’t offer the games they currently have at their three Alabama casinos. While the Bush and Obama administrations ignored this fact of law, President Trump may not.

McCutcheon’s idea of a grand bargain that heavily taxes and regulates gaming is an ideal solution.

PCI has made an opening bid. It is outrageous and wholly self-serving, but it’s a start.

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Attorney General Steve Marshall must be commended for showing proper restraint as the Legislature tried to address the bingo issue.

Alabama already has gambling. The question is, how do we best regulate, tax and benefit the state?

Bowing to PCI is not a honest solution but there is a plan that can generate hundreds of millions annually for the state and is fair to all stakeholders.

The vexing questions that face our state are not easily answered, but with rational consideration, wise counsel and a willingness not to be hindered by ideological-emotion, there is a path forward.

Gov. Ivey has shown steady and forward-thinking leadership; her position on prisons is known but her stance on rural healthcare and gaming are not clearly articulated.

For the good of the state, we should hope she offers some “Alabama solutions” to healthcare and gaming, as well.

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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