Groups are calling on Alabama Governor Kay Ivey and the state Legislature to expand Medicaid after President Joe Biden signed into law the latest COVID-19 relief package, which brings federal incentives for states to do so.
Ivey and state lawmakers have said they won’t support a Medicaid expansion because the state couldn’t afford to find a required 10 percent match.
“Certainly we’re concerned about the health and welfare of all of our citizens, wherever they may live,” Ivey said in April 2020. “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.”
The federal government covered the full cost of Medicaid expansion, when it became an option in 2014, but beginning in 2016, funding began dropping from 100 percent, and prior to Biden signing the COVID relief package into law on Thursday, had dwindled to 90 percent.
The American Rescue Plan Act of 2021, signed into law Thursday, gives states for two years a 5-percentage-point increase in federal funding for a state’s traditional Medicaid coverage, which is a larger population than just for an expanded group.
That incentive could mean an additional $940 million for Alabama Medicaid over those two years, according to the Center of Budget Priority and Policies, a Washington D.C.-based progressive nonprofit think tank.
“For more than eight years, Alabama leaders have pointed their fingers elsewhere to explain their lack of action on expanding Medicaid. While they have made excuses, thousands of our neighbors have died and dozens of health providers have closed their doors because patients can’t afford treatment,” said Robyn Hyden, executive director of Alabama Arise, in a statement. “With the passage of the American Rescue Plan Act, Congress has removed any further cause for delay. Alabama can access an additional $940 million to offset the cost of Medicaid expansion ‒ but only if our leaders are willing to step up.”
“The additional federal dollars from this increase would exceed the full state cost of Medicaid expansion for a number of years. Advocates for Medicaid expansion say this is a unique opportunity for the state to expand coverage,” according to a press release from the Cover Alabama Coalition, a group of organizations advocating for Medicaid expansion in the state.
Expanding Medicaid in Alabama would mean approximately 300,000 more people would have access to health care, including more than 5,000 veterans and 8,000 of their family members, according to the coalition.
Nearly 70 percent of Alabamians asked support expanding Medicaid, including 64 percent of Republicans, according to a January poll, conducted by the Montgomery firm Cygnal for Cover Alabama. Support for expansion increased when those polled were asked if they would support expanding Medicaid using federal funding.
“This law is a much-needed step toward closing the health coverage gap in Alabama. The American Rescue Plan Act would provide Alabama with financial incentives to expand Medicaid coverage at last. We have no time to waste. Tens of thousands of people have died in the South ‒ my home ‒ because they couldn’t afford to get the health care they needed,” said Jane Adams, campaign director at Alabama Arise and the Cover Alabama Coalition in a statement.
Dr. Julia Boothe, a primary care physician in Pickens County, said in a statement that the lack of previous Medicaid expansion was a major factor in the closing of the county’s only hospital.
“Since that time, we’ve endured a pandemic without even basic health care available to all citizens of our county, despite many in our community providing such services at their own expense,” Boothe said. “Expanding Medicaid will also allow for the overwhelming majority of our citizens to have primary care services available.”
“I am in a Black Belt county that has continued to see widened health care disparities through this pandemic,” Boothe said. “Despite many in our state leadership touting their hopes and dreams of adequate health care and health outcomes, they continue to shut the door on ‘the least of these.’ Alabama’s Medicaid system is far from perfect, but at least it might be a bridge to some basic services for our citizens.”
“The Medical Association of the State of Alabama commends the work of the Cover Alabama Coalition in its efforts to expand Medicaid,” said Dr. John Meigs Jr., president of the Medical Association of the State of Alabama, in a statement. “Without question, increasing access to quality care improves health outcomes for patients. While this obviously has a positive impact on individuals, the benefits also trickle up through families and communities, ultimately bettering our entire state.”