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Governor: It would be “irresponsible” for Alabama to expand Medicaid right now

Chip Brownlee | The Trace

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Gov. Kay Ivey on Tuesday tamped down discussion about expanding Medicaid in Alabama, saying it would be financially irresponsible to expand the program, which provides health insurance to low-income people, during the COVID-19 pandemic.

“Certainly we’re concerned about the health and welfare of all of our citizens, wherever they may live,” Ivey said. “But at the same time, it would be irresponsible to think about expanding Medicaid just for the sake of expanding Medicaid without having a complete and honest discussion about the source of stable funding to pay the match.”

When Medicaid expansion became an option in 2014, the federal government covered the full cost. Beginning in 2016, funding began dropping from 100 percent. By this year, the federal match rate will level out at 90 percent.

“There is a lot of exploring that has to be done on how you pay for it,” Ivey said. “Right now, we’re focused on keeping everybody healthy and figuring out how we can get our people back to work.”

Federal funding covers most of the costs for those who become newly insured through expansion, but Republican state legislators fear the larger costs would cripple an already tight state budget. Alabama’s constitution has a balanced-budget provision that does not let the state run a budget deficit.

Expanding the program allows states to provide healthcare coverage for all individuals up to 138 percent of the federal poverty rate, which is about $28,000 for a family of three. Proponents have argued that expanding the program would pay for itself through new tax revenues without having to raise any additional taxes.

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If Alabama, for example, were to expand Medicaid this year, it would start with a 90 percent reimbursement rate. Several studies estimate that more than 300,000 people would be newly eligible for the health insurance program for lower-income individuals.

Sen. Doug Jones, who has repeatedly urged the state to immediately expand Medicaid to expand health coverage to low-income people, has sponsored bills to up the federal match rate for states that have been late to expand the program.

“A lot of federal dollars are coming into states right now,” Jones said during a press conference Friday. “Alabama is missing out on a lot of those dollars we would otherwise get because we did not expand Medicaid back six or seven years ago when we had the opportunity.”

Jones pointed to the state’s cash-strapped hospitals as a reason to expand the program. The Alabama Hospital Association has, for years, been lobbying the state government to expand the program.

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“We could give our population better health outcomes, but we could also have more federal dollars,” Jones said.

One of Congress’s coronavirus stimulus bills includes billions in aid for hospitals, but hospitals fear it may not be enough.

Rural hospitals across the country, particularly in non-expansion states, are closing at an alarmingly high rate — largely because the Affordable Care Act intended for an influx of money from more people covered by Medicaid. The new money was intended to offset cuts to Medicare reimbursements built into the Affordable Care Act.

About 52 percent of the state’s hospitals had negative total margins before COVID-19, and 75 percent of them had negative operating margins, according to Alabama Hospital Association President Donald Williamson. Canceling elective procedures to prevent the spread of the virus has crippled hospitals’ cash flows, especially the rural hospitals.

“Our hospitals are losing money rapidly because they’re not doing the elective procedures — even hospitals that are not seeing a surge in COVID patients are still operating by not doing elective procedures that make them money,” Jones said. “Expanding Medicaid would help them right now immediately if we could get that plan in place.”

Jones said Friday he is working in the Senate to pass a bill that would give states the incentive to expand the program right now.

“We’ve got to change some things in the state and across this country so that everybody has access to affordable health care,” Jones said. “Medicaid expansion is a big piece of what I’m looking at.”

The discussion around Medicaid expansion has been ongoing since Alabama refused to expand the program in 2014, but it has taken on a new sense of urgency as COVID-19 continues to disproportionately impact vulnerable people in the state. As of April 12, about 53 percent of the state’s verified COVID-19 deaths have been among black people, who make up only about 27 percent of the state’s population.

Black people also more likely to go uninsured and suffer from chronic health problems.

“This is a disease that has worse outcomes in people that already have other social determinants like chronic health problems or issues just related to education and income,” State Health Officer Scott Harris said Tuesday. “So this is a big concern for us in public health. We want to make sure our most vulnerable citizens are the ones that we are protecting, and we’re committed to continue to do that.”

 

Chip Brownlee is a former political reporter, online content manager and webmaster at the Alabama Political Reporter. He is now a reporter at The Trace, a non-profit newsroom covering guns in America.

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Longtime State Rep. Alvin Holmes has died

Montgomery Fire and Rescue responded to a call at Holmes’ residence on Saturday afternoon, and they found the 81-year-old unresponsive. 

Josh Moon

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State Rep. Alvin Holmes

Alvin Holmes, a 44-year veteran of the Alabama Legislature and one of the state’s most outspoken proponents for racial inclusion, has died. Montgomery Fire and Rescue responded to a call at Holmes’ residence on Saturday afternoon, and they found the 81-year-old unresponsive. 

Over a four-decade-plus career in the Alabama House of Representatives, Holmes was a lightning rod for criticism from his fellow white lawmakers and the white voters who elected them, as he repeatedly challenged the status quo and went headlong at biases and racism that prevented more Black Alabamians from serving in positions of power in the state. 

Holmes was a foot soldier in the Civil Rights Movement in Montgomery and led the charge on getting the Confederate battle flag removed from Alabama’s Capitol building. Holmes fought many of his battles, especially the early ones, by himself, and while to his friends he would admit that standing alone wasn’t always pleasant, he never showed such hesitation outwardly, seeming to revel in the hateful words and personal attacks from other lawmakers and the public. 

Many of the fights Holmes began were later finished in federal courtrooms, and they most often led to further advancements for Black Alabamians.

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Alabama Legislative Black Caucus holds meetings on racism in wake of George Floyd death

Eddie Burkhalter

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State Sen. Vivian Figures, D-Mobile, is the chair of the Alabama Legislative Black Caucus.

Members of the Alabama Legislative Black Caucus in recent months have been meeting with Gov. Kay Ivey, state law enforcement officials and others to voice their concern over systemic racism in Alabama, the group said in a statement Friday. 

Alabama Legislative Black Caucus members in June met with Ivey, and in follow-up meetings with other state officials and leaders of higher education, members discussed what they believe needs changing to battle racism in Alabama, according to the press release. 

“We are very appreciative of Governor Ivey and all of the officials with whom we have met thus far,” said State Sen. Vivian Figures, D-Mobile, chairwoman of the ALBC, in a statement. “Our dialogues have been very substantive and productive as the Caucus presented our concerns and recommendations. Our goal is to get to the root of and eradicate racism and anything that communicates hatred, bigotry or divisiveness within the State of Alabama. The tragic and senseless death of George Floyd caused us all to take a closer look at the systemic racism at work here in Alabama.”

ALBC members met with officials from Alabama Law Enforcement Agency, the Alabama Sheriffs Association, the Alabama Association of Police Chiefs and Katie Britt, president and CEO of the Business Council of Alabama along with BCA’s Executive Leadership Committee.

Members also met with The University of Alabama System Chancellor Finis St. John, and Jay Gogue, president of Auburn University. 

In the statement, ALBC members applauded the University of Alabama’s Board of Trustees for voting unanimously to rename Nott Hall — named for Josiah Nott, a doctor who believed in white superiority — Honors Hall. 

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“The University of Alabama had already started this endeavor before our meeting with them this past Tuesday,” said State Rep. A.J. McCampbell, D-Gallion, vice chairman of ALBC, in a statement. “That was a great first step and strong leadership was shown. We are looking forward to the other institutions of higher learning in Alabama to do the same as well. The Caucus also hopes that all members of the Alabama Legislature have been inspired to adopt and make meaningful changes in legislation that governs our state.”

Figures said the group of elected senators and representatives are holding these talks, with plans for others, “so that people will stop focusing on Alabama’s sordid past, and instead see a beautiful Alabama present, and the makings of a bright future for all Alabamians.” 

“During each of these meetings, our members have had the opportunity to voice what we feel the necessary changes should be. I just hope this openness to positive change continues throughout the upcoming 2021 Alabama Legislative Session,” said State Senate Minority Leader Bobby Singleton, D-Greensboro, in a statement. 

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State senator calls for Rep. Dismukes to resign over celebration of former Klan leader

“Since first being elected in 1996, I’ve had a policy of not publicly criticizing other elected officials, but at this time I am making an exception since Rep. Dismukes is MY state representative,” Chambliss wrote in a tweet. “He does not represent my views or the views of the vast majority of people in District 88.” 

Eddie Burkhalter

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State Sen Clyde Chambliss, R-Prattville, on Monday called for the resignation of Rep. Will Dismukes, R-Prattville.

State Sen Clyde Chambliss, R-Prattville, on Monday called for the resignation of Rep. Will Dismukes, R-Prattville, after posting to social media about attending a birthday celebration for Nathanial Bedford Forrest, a Confederate general and first Grand Wizard of the Ku Klux Klan.

Dismukes posted a photo of himself on Sunday speaking at Fort Dixie outside of Selma on Saturday, the same day that late Congressman and Civil Rights hero Rep. John Lewis, was honored in Selma. 

“Since first being elected in 1996, I’ve had a policy of not publicly criticizing other elected officials, but at this time I am making an exception since Rep. Dismukes is MY state representative,” Chambliss wrote in a tweet. “He does not represent my views or the views of the vast majority of people in District 88.” 

“The post is bad enough, the timing is even worse, but the real problem is that an elected official in 2020 would attend a celebration of the life of someone that led a group that terrorized and killed other human beings,” Chambliss continued in the tweet. “He has had 24 hours to understand why people are so upset, but his interview on WSFA a few moments ago confirms that he is lacking in understanding and judgment — he should resign immediately.” 

Dismukes in the WSFA interview told a reporter that he hadn’t thought about the memorial for Rep. Lewis and connected it to his attendance at the celebration for the Klan leader. 

Dismukes told WSFA that he won’t apologize for his family’s service in the “war between the states” that he said wasn’t primarily fought over slavery, that he’s not a racist but that he doesn’t see the need for the current racial reconciliation. 

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“We no longer drink from separate water fountains, and we no longer have segregated schools,” Dismukes told WSFA. “You know there’s abundant work opportunities for all colors, there’s abundant scholarship opportunities for all colors. So what are you asking that needs to be racially reconciled?”

Chambliss may be the first Republican lawmaker in Alabama to call for Dismukes’ resignation, but others have expressed concern over his social media post and attendance at the event. 

Alabama Republican Party Chairman Terry Lathan issued a statement addressing the post, and said he believes voters should decide whether Dismukes keeps his office. 

“While Rep. Dismukes has released a statement attempting to clarify his actions as a private citizen attending a celebration of the first Grand Wizard of the Klu Klux Klan, Alabamians hold their elected officials to a high standard of actions. So does the Republican Party,” Lathan said in the statement. 

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“Rep. Dismukes offered no explanation for why he participated in a birthday celebration of Nathan Bedford Forrest. Additionally, I find his statement to be shallow in understanding why his activities are deeply offensive to so many Alabamians. His constituents will be the final decision-makers of his political future.”

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Republicans are concerned by Rep. Dismukes’ Confederate social media posts

Brandon Moseley

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Rep. Will Dismukes, R-Prattville, is facing criticism for attending a birthday celebration for the first Grand Wizard of the Ku Klux Klan.

House Majority Leader Nathaniel Ledbetter, R-Rainsville, on Monday released a statement in response to a recent social media post by State Rep. Will Dismukes, R-Prattville, who was in Selma Saturday celebrating Confederate General and Ku Klux Klan leader Gen. Nathan Bedford Forest’s birthday over the weekend. This was while much of the rest of the state was celebrating the life of Alabama native and Civil Rights Movement legend Congressman John Lewis.

“The Alabama Republican Caucus is comprised of 75 men and women, each of whom have their own beliefs and principles that guide their lives,” Ledbetter said. “The personal beliefs expressed by any one member do not reflect the beliefs of the others, and their activities outside the Legislature should be considered their own, as well.”

“Several of our Republican Caucus members have reached out to me with concerns about the content and timing of a recent social media post by State Rep. Will Dismukes, and I, as a House member, share those concerns,” Ledbetter continued. “We live in a nation that guarantees each citizen the right to express the ideas they wish to share, and in the case of a public official, voters will ultimately decide if they agree with those ideas.”

Speaker of the House Mac McCutcheon, R-Monrovia, also released a statement regarding the controversial social media post.

“The Alabama House cannot police the beliefs, statements, and activities of its members outside the Legislature as that is a job best assigned to voters in each House district across the state,” McCutcheon said. “It is important to note, however, that I and many other members of the House devoted our weekend toward honoring an Alabama native and civil rights icon who dedicated his life to securing freedom, liberty, and equality for all Americans.”

“While Rep. Dismukes has released a statement attempting to clarify his actions as a private citizen attending a celebration of the first Grand Wizard of the Klu Klux Klan, Alabamians hold their elected officials to a high standard of actions. So does the Republican Party,” said Alabama Republican Party Chairman Terry Lathan. “Rep. Dismukes offered no explanation for why he participated in a birthday celebration of Nathan Bedford Forrest. Additionally, I find his statement to be shallow in understanding why his activities are deeply offensive to so many Alabamians. His constituents will be the final decision-makers of his political future.”

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“The Alabama of today was on full, honorable display as we paid humble tribute this weekend to the life of Congressman John Lewis,” Lathan continued. “That is the Alabama that we are proud of — showing the nation and world that we are one in the common goals of equality for all of our citizens.”

“It is one thing to honor one’s Southern heritage, however, it is completely another issue to specifically commemorate the leader of an organization with an indisputable history of unconscionable actions and atrocities toward African-Americans,” Lathan concluded. “I strongly urge his constituents to contact Rep. Dismukes to articulate and share with him their thoughts on his personal actions.”

On Sunday, Dismukes shared several pictures from the celebration of Gen. Forest’s birthday, with the caption: “Had a great time at Fort Dixie speaking and giving the invocation for Nathan Bedford Forrest annual birthday celebration. Always a great time and some sure enough good eating!!”

After the comments became a social media firestorm that has garnered press attention, Dismukes attempted to explain his position.

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“First and foremost, my post yesterday was in no way related to disrespecting the passing of Rep. John Lewis,” Dismukes said. “That wasn’t even a thought in my mind. That is not who I am as a person. I am a transparent person. To the point that as a public official I lay it all there for the people to see for better or for worse at times. My post yesterday was as usual me sharing a previous days events. The post was in no way intended to seem as if I was glorifying the Klan or any party thereof. The very atrocities and actions they committed are a disgrace to our country.”

“Also, we are all individual members that make up our legislature. I made a post independent of my colleagues,” Dismukes continued. “I made a post independent of my colleagues. My regret is that I have allowed them to be put in a negative light. If you disagree with me and my beliefs do not hold them under the same umbrella. I can live with a dislike for me, but not fellow members, or members of my own personal family. Our body as a whole is made up of some of the finest people I have ever had the honor of knowing and working with, both Democrat and Republican. I close by reiterating that my post was in no way glorifying the Klan or disrespecting the late Rep. John Lewis.”

The Alabama Democratic Party had already come out and demanded that Dismukes resign months ago when it became known that he, a minister, was chaplain for a Sons of the Confederacy chapter in central Alabama.

Dismukes is serving in his first term in the Alabama House. He briefly was a congressional candidate in Alabama’s 2nd District but dropped out of the race before the Republican Primary.

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