It’s no secret that Alabama’s healthcare system has been in crisis. But over the last year, it’s gotten worse—a lot worse. And it’s no secret why. Federal cuts and the expiration of Affordable Care Act subsidies are resulting in skyrocketing premiums and pushing access to care further and further out of reach.
Since first being elected in 2005 to represent the people of Lee and Macon Counties in the Alabama Legislature, I have focused on addressing the lack of access to affordable physical and mental health services throughout Alabama, particularly in poor and rural areas.
We have over 25 rural hospitals in the red or on the brink of permanent closure. In addition, more than 350,000 Alabamians don’t have health insurance. That isn’t saving us money. Instead, it’s putting more financial pressure on healthcare providers and, ultimately, taxpayers.
And it’s holding us back. I have and will continue to fight for educational opportunity, career training, family-sustaining jobs, and community revitalization in my district and throughout Alabama. But health truly is wealth. The lack of access to affordable care hinders economic growth, especially in rural communities. After all, why would a company invest millions to build a new factory in an area that has no local emergency care or mental health services for its employees?
No, it’s not making us healthier, or wealthier, or happier. Alabama continues to rank at the very bottom of the list when it comes to mental health care. We’re last in availability of mental health providers and 49th for access to mental health services, according to a recent study by the 2025 Alabama Kids Count Data Book. Of course, that’s no secret, either—not for children, parents, or families who have to navigate long waitlists, complex insurance issues, and long car rides to providers. And for rural Alabamians facing a behavioral health crisis, options are few and far between.
Alabama’s healthcare system is on life support. But the diagnosis is not terminal. And now we have a chance to begin making it better. Recently, I was appointed by Governor Ivey to the Alabama Rural Health Transformation Program, a five-year federal program, to develop and implement plans for rural health and mental health initiatives. In the first year, Alabama was awarded $203 million, a vital investment that we can use to prevent more rural hospitals from closing, to expand medical and mental health services, and to recruit more medical and mental health professionals to rural communities.
It’s a step in the right direction, but it’s only a first step and a temporary one. To enact long-term solutions, we’ll need sustainable investments. And the hard truth is, many small communities simply don’t have the local tax base or revenue to support or maintain them. Why there’s currently no twenty-four-hour emergency care facility in Macon County—the closest one is in Tallassee.
But one step we can take—and it won’t cost a dime—is to change the way we view mental and behavioral health and wellness. Mental health and physical health are interdependent and inseparable. That’s no secret, it’s biology. Positive mental health can lead to better physical well-being and vice versa. Unfortunately, that connection isn’t reflected in our policies or investments. I hope we can use this funding to change that. Let’s expand access to mental health services instead of continuing to use our jails as warehouses for people with substance abuse and mental health disorders.
Alabama’s healthcare system is on life support. It’s not going to get better on its own. The good news is we have an opportunity to help. It’s not a cure-all, but we can use this temporary federal funding to triage our needs, stabilize the system, and chart a course for a comprehensive, sustainable statewide model. We can recover—and we can do it by beginning to close the coverage gap, keeping our hospitals open, prioritizing behavioral health and preventive care, and expanding healthcare services into areas where they are needed most.
