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Report: Medicaid expansion needed during COVID-19 crisis

Eddie Burkhalter



More than 340,000 Alabamians are suffering because the state hasn’t expanded Medicaid, and during the COVID-19 pandemic, the need to do so is all the more critical, according to a report released Wednesday. 

The Montgomery-based nonprofit Alabama Arise’s report, Medicaid Matters: Charting the Course to a Healthier Alabama, details how an expansion of the federal program could impact those living without medical care, and those who are struggling to pay for the coverage they have. 

“We’re facing, as everybody knows, unprecedented immediate challenges and longer-term challenges for the recovery,”  said Jim Carnes, policy director at Alabama Arise, speaking to APR on Friday. “And there’s no bigger step we could take right now to soften the blow over the long haul than to expand Medicaid.” 

Carnes said that if Alabama could leverage $9 in federal money for every $1 in state funds on health coverage for low-income adults “there’s just no better deal in town. We’re ignoring it at our peril.” 

Approximately 223,000 Alabamians earn too little or work at jobs that don’t offer health insurance, or they earn too much to qualify for Medicaid but can’t afford private insurance, according to the report. 

Another 120,000 Alabamians are struggling to pay for health insurance they can’t afford.

The largest segment of workers in the state who’d benefit from an expansion of Medicaid are 28,000 food service workers, followed by 23,000 people who work in retail. 

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About 13,000 veterans and adult family members in Alabama have no military insurance and can’t afford private plans, according to the report, and almost 65,000 rural Alabamians are caught in the coverage gap.

Expanding Medicaid would also bolster the state’s crippled rural hospitals, according to the report, which notes that 88 percent of the state’s rural hospitals operate at a loss.

“We’ve lost eight in a decade,” Carnes said, referring to rural hospital closures in Alabama. 


Among Republicans in Montgomery, however, there’s been little support for expanding Medicaid, many of whom cite the upfront cost to the state of about $250 million a year to do so. 

Gov. Kay Ivey said in a press conference in April that 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 for the matching.” 

“Right now, if you were to ask me if there is an appetite for Medicaid expansion in the Senate among Republicans, my answer would be no,” Senate President Pro Tem Del Marsh, R-Anniston, told Alabama Daily News in April. 

“I’m sorry. That’s so offensive,” Carnes said.  “They’ve not been in the mood. They haven’t had an appetite, as if a major policy advancement like that is simply a whim that they’re choosing to kind of swat away like it’s just a nuisance.” 

Carnes said he respects the state’s leaders, but said statements about a lack of appetite for Medicaid expansion such as the one Marsh made is disappointing.

“It’s disappointing to hear a state leader trivialize such a monumental opportunity,” Carnes said. 

But Carnes believes that the COVID-19 pandemic and its impact on both the health of Alabamians and the state’s economy could change the minds of those in Montgomery who have been unwilling to have serious conversations about expanding Medicaid. 

Carnes believes state leaders will see the opportunity the 90 percent federally-matched Medicaid expansion presents for the most vulnerable among us. 

“I really think we’re going to come around. Alabama is sometimes the ‘make me’ state, but I think all the evidence, all the arrows, are pointing in the same direction,” Carnes said.

Eddie Burkhalter is a reporter at the Alabama Political Reporter. You can email him at [email protected] or reach him via Twitter.



Ivey urges Alabamians to complete census or risk losing federal funding, seat in Congress

Micah Danney



Gov. Kay Ivey urged all Alabama residents to complete the 2020 census before the Sept. 30 deadline in a 30-second video released on Friday.

In the video, Ivey said, “Complete your 2020 Census today. We only have until Sept. 30th. Without you, Alabama stands to lose billions in funding, a seat in Congress and economic development opportunities.

“It only takes minutes to complete. Go to or participate by phone or mail. Be counted – if not for you, for those in Alabama who depend on you for a brighter tomorrow.”

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Governor’s chief of staff self-quarantining after wife tests positive for COVID-19

Eddie Burkhalter



Gov. Kay Ivey's chief of staff Jo Bonner

Gov. Kay Ivey’s chief of staff is self-quarantining after his wife tested positive for COVID-19 earlier this week, but the governor was not exposed this week to either her chief of staff, Jo Bonner, or his wife, Ivey’s office said Friday. 

“After attending a visitation with some friends in Mobile last Friday, Jo Bonner’s wife, Janee, was notified Monday morning that a number of the attendees had tested positive for COVID-19,” said Ivey’s press secretary, Gina Maiola, in a statement to APR on Friday. 

“While asymptomatic and out of an abundance of caution, Janee was tested and received a positive result. Upon hearing this early Monday morning, Jo Bonner immediately self-quarantined and worked from home. He was not with the governor this week, and Janee has not been around the governor in several months. Jo is continuing to work from home and will not be back in the office until the normal CDC protocols for exposure have run,” Maiola said.

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AARP Alabama asks for details on $50 million federal COVID-19 aid to nursing homes

Eddie Burkhalter




The Alabama chapter of AARP is asking the state to ensure federal coronavirus relief funds are spent wisely and in the open. Gov. Kay Ivey on Friday announced $50 million in grants would go to state nursing homes to aid in the fight against COVID-19.

Candi Williams, AARP’s Alabama state director, told APR on Monday that the organization, which advocates for the elderly, wants a better understanding of how that money will be spent and to ensure some is spent for ongoing COVID-19 testing.

A spokesman for the Alabama Nursing Home Association says details on how the money can be spent is already publicly available, however, and Ivey in early June announced the award of $18.27 million in federal CARES Act funds to be spent toward regular nursing home COVID-19 testing.

“What we’re looking for is specifics on how it will be used, and we want those specifics to be made publicly available,” Williams said.

Ivey on Friday said the money is to be administered by the Alabama Nursing Home Association Education Foundation. The Alabama Hospital Association is to administer up to $50 million in grants to state hospitals through another program.

“This allocation of up to $50 million will be for operational costs that are COVID-19 related, such as PPE, cleaning, personnel costs and other costs incurred related to the pandemic,” Ivey’s office said in a press release Friday.

“In partnership with the state of Alabama, the Alabama Nursing Home Association Education Foundation will administer the funds fairly and impartially on behalf of the people of Alabama, for all of Alabama’s nursing home facilities,” the statement goes on to say.

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Williams said the public deserves to know how the federal funds will be used, and said Ivey’s office hasn’t yet signaled whether those details will be made public.

Ivey’s office, through a spokeswoman, declined to comment, and referred a reporter to the Alabama Nursing Home Association.

John Matson, communications director for the Alabama Nursing Home Association, told APR that AARP Alabama need only read the memorandum of understanding published along with Ivey’s announcement about the grants on Friday to see how the money must be spent.


According to the memorandum, the Alabama Nursing Home Association Education Foundation can only disburse the funds to nursing homes “for the purposes of responding to or mitigating the COVID-19 public health emergency” and details what facilities must do to receive the money.

Among the requirements, nursing homes in their applications must provide supporting documentation, which can include invoices, purchase orders, payroll records and financial records, according to the memorandum. The foundation must also provide the Alabama Finance Director’s Office with a detailed report on the 15th of each month noting how the money was spent, according to the document.

“I think it would be helpful for them to read that,” Matson said, referring to AARP Alabama and the memorandum of understanding.

AARP Alabama is also asking that the money be used for ongoing and methodical testing of all residents and staff in the state’s long-term care facilities.

“We’ve seen across the country that testing can be hit or miss, and testing frequency can vary,” Williams said. “We’ve seen in other states where that has helped curb the loss of life and helps protect residents.”

Matson noted that Ivey in early June also announced a separate $18.27 million in federal CARES Act funds to be spent toward regular nursing home COVID-19 testing and “proactive surveillance” through the end of the calendar year, which is also being administered by the Alabama Nursing Home Association Education Foundation.

Alabama’s long-term care ombudsmen, who are tasked with protecting residents’ rights and investigating health and safety concerns, have been largely banned from entering Alabama’s long-term care facilities since early on in the pandemic when the facilities ended visitations to help prevent the spread of the virus.

Williams said AARP would also like to see the safe reentry of ombudsmen into state facilities and for those details to be included in a publicly-released plan.

“We also have been advocating for transparency and real-time data about the COVID cases and death in Alabama nursing homes and long-term care facilities. That continues to be a struggle,” Williams said.

The Centers for Medicare and Medicaid Services is collecting that state data, but it’s weeks old by the time it’s published on the federal agency’s website, Williams said.

“Having that information would help us protect the residents, staff and surrounding communities, but also making sure families have that information,” Williams said.

The Alabama Department of Public Health has declined to release county-level or facility-level details on coronavirus in long-term care facilities and nursing homes, citing privacy concerns. Many other states do release that information, however.

According to CMS, there have been 3,841 confirmed COVID-19 cases and 562 deaths among residents in Alabama nursing homes as of July 26. AARP Alabama said COVID-19 deaths of nursing home residents make up approximately 42 percent of the state’s total coronavirus deaths.

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Governor issues call to action on mask wearing: “We are at war with an invisible enemy”





Gov. Kay Ivey on Friday issued a new call to action for all Alabamians to wear a mask to prevent the spread of the coronavirus.


Today we are at war with an invisible enemy.

Not that long ago, families across Alabama helped America turn the tide in World War II. Some joined the front lines in combat, while others led the fight on the home front.

Those sacrifices helped our nation win the war and go on to define the Greatest Generation. Now, we must answer today’s call. By comparison, our sacrifice is small.

But each of us can do our part. Mask up Alabama!

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