Familiar tune, another General Fund dilemma

Published 11:34 pm Friday, March 18, 2016

Gov. Robert Bentley is threatening a special session if the Legislature doesn’t do his bidding, and legislative leaders are saying “bring it on.”

We’ve certainly heard that tune before out of Montgomery, but the “music” has extra intensity and ramifications this year.

The Senate last month approved a $1.8 billion General Fund budget for Fiscal Year 2017. That’s a nearly 4 percent increase over last year, but it keeps the major state agencies at level funding. That includes the Alabama Medicaid Agency, which devours the most money from the General Fund (nearly 40 percent) to provide the state’s share of services for the million-plus Alabamians who use the program.

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Medicaid officials sought at least a $100 million increase over this year’s $685 million budget, and claim that supposedly level funding will effectively be a $100 million cut.

They say that will mean cuts in services, which will carry additional consequences besides the impact on patients.

Alabama has been working on plans to transition Medicaid to a regional managed-care format, an idea we’ve supported at least trying given its success elsewhere. It’s counting on $700 million in federal funding to implement that plan, which is set to take effect Oct. 1.

However, that help from Washington is contingent on the state maintaining its current Medicaid program. Alabama officials fear the offer might be withdrawn if the program backslides, which could make the entire thing implode.

Bentley asked for $100 million more for Medicaid in his proposed budget. The Senate said “no.” The House will vote Tuesday on a budget that gives Medicaid $15 million more.

The governor says he’ll veto any budget that’s sans the $100 million and bring the Legislature back for a special session. Legislative leaders know he’ll do that — he did it twice last year before a General Fund budget was finalized — but are signaling it will be a waste of time.

They say there is no appetite for taxes or transferring $181 million from the Education Trust Fund to the General Fund (which Bentley’s budget proposed), or for giving Medicaid anything extra beyond the pittance in the House budget.

We’re actually a bit tired of legislative shell games, pulling dollars from one pot to plug leaks in another.

The legislative leaders favor enacting their budget and seeing what happens — seeing what the actual impact on Medicaid is, and whether the efficiencies of managed care might make the funding concerns moot.

Theoretically, that’s not a bad approach. We doubt anyone can say with absolute certainty what’s going to happen.

It’s just hard to view people’s lives and health through a strictly theoretical prism, plus what happens if the feds do get mad and say “no money for you?”

Both sides seem dug in, and while Bentley isn’t totally unarmed and controls Alabama’s “bully pulpit,” the Legislature, if it’s determined, can impose its will on a governor.

So Medicaid might not get that extra $100 million. We just hope those who think “wait and see” is the best approach are right.

It seems as if a genie’s lamp (or some other miracle) will be necessary to fix what’s wrong with Alabama’s General Fund. One thing is for certain, the state’s politicians don’t know how to fix it and while they dither, the gap between costs and revenue just keeps getting wider.

Online- www.gadsdentimes.com