Bentley says he will veto budget

Published 3:00 am Tuesday, March 22, 2016

MONTGOMERY (AP) — Alabama Gov. Robert Bentley said Monday that he will veto a general fund budget lawmakers are expected to approve this week over what he called an “unacceptable” appropriation for Medicaid.

The Alabama Senate on Tuesday is expected to give final approval to a budget that is $85 million short of the amount Bentley says is needed to adequately fund the state’s Medicaid program.

“Legislators just don’t understand it, and I don’t think they want to,” Bentley said during a press conference in Monroeville to highlight problems with rural broadband and health care access.

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Bentley, a dermatologist who maintains his medical license, called the disconnect between medical providers and legislators “frustrating” and said lawmakers misunderstand the program.

“They (legislators) think there’s a lot of fraud and abuse — I hear that all the time,” Bentley said. “It’s as bare bones as you can possibly get. It’s children, the elderly, pregnant women and the disabled. Able-bodied people don’t get it.”

The budget poised for final passage would steer $700 million to Medicaid. The agency has said it needs $785 million to maintain current services and continue the lawmaker-approved transition to regional managed care.

Sen. Trip Pittman, chairman of the Senate Finance and Taxation General Fund Committee, said Monday that he will seek Senate concurrence with House changes to the budget Tuesday. If senators agree, that will send the spending plan on to Bentley.

Pittman said the additional money for Medicaid is just not there without slashing other agencies. The Montrose Republican said lawmakers will continue the discussions after the budget passage.

“We’ll continue the conversation and see who, if anybody, is willing to come to the table on solutions,” Pittman said.

Although the governor has threatened a veto, lawmakers, if they choose to, could override his objections with relative ease. A majority vote of the elected members of both chambers could enact the spending plan over Bentley’s objections.

Medicaid Commissioner Stephanie Azar has said the agency needs $785 million to continue the transition to regional managed care, a shift that has been three years in the making. The Centers for Medicare and Medicaid approved the state’s waiver application last month.

Instead of the traditional fee-for-service health care delivery model, Alabama plans to contract with 11 regional care organizations to provide care and case management services for patients. The state planned to debut the new system Oct. 1.

The organizations will assign a primary care doctor to each patient and might provide additional services such as transportation to assure that the low-income patients are able to get to appointments. Lawmakers approved the change two years ago in the hopes of tamping down future Medicaid costs.

Monroe County Hospital CEO Jeff Brannon urged doctors to personally contact legislators to express their concerns.

“If they (legislators) let it fall apart, it’s going to be a crisis they don’t want to take up, in my opinion,” Brannon said.