Alabama medicaid expansion moves at a glacial pace

Published 11:21 pm Wednesday, November 11, 2015

The time for waffling on expanding Medicaid for the hundreds of thousands of Alabama residents who lack health insurance is over.
Gov. Robert Bentley, a physician who should understand the importance of making health care available to lower-income Alabamians, has been moving at a glacial pace toward accepting federal Medicaid expansion dollars through the Affordable Care Act.
Last month he took another baby step forward, saying, though he opposed the ACA, it’s time to move past that and “take the resources we have available,” to improve quality of life for the people of Alabama.
That seemed like a breakthrough, but Bentley then hedged his bets, saying while his administration is looking at a potential Medicaid expansion, “we are not at that stage right now.”
Alabama politicians who get state-subsidized health care may not be at that stage, but ordinary folks suffering because of lack of health care certainly are.
About 139,000 are stuck in a health insurance coverage gap because of the state’s failure to implement the Medicaid expansion, according to a new study from the Kaiser Family Foundation.
They’re mostly working Alabamians who don’t earn enough to qualify for ACA insurance subsidies, but make too much to get Medicaid under the state’s miserly income limit restrictions.
Bentley must take a stand in favor of the Medicaid expansion because convincing the ideologically rigid Legislature to implement such a plan will be a monumental task.
It’s true expansion would cost the Legislature more in the short run. Currently the federal government picks up the expansion tab. In 2017 states will be required to contribute a small percentage of the costs, but never more than 10 percent.
Countering that expense, however, would be the undeniable humanitarian and economic benefits from the expansion. They include a healthier, more productive workforce, job growth in health care fields, and aid to Alabama’s imperiled rural hospital network, now flailing to cover the costs of treating the uninsured.
The Kaiser study also showed that states like Alabama that refused to expand Medicaid took a sucker punch. Their Medicaid costs in 2015 increased at a rate that’s twice as high as that for states that opted for expansion – 6.9 percent as opposed to 3.4 percent.
Other red states have seen the light and moved to provide more of their residents with urgently needed health care.
Stop waiting, Governor. Find the courage of your conscience and convictions, advocate strongly to expand Medicaid and give Alabama’s working poor hope of healthier lives.

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