Governor Robert Bentley hopes the incoming Trump administration will allow states to charge Medicaid premiums and set enrollment requirements. The Republican governor wrote House Majority Leader Kevin McCarthy the day before Trump's inauguration, as Congress works on a repeal and possible replacement for the Affordable Care Act. Bentley says states need flexibility to set Medicaid enrollment requirements, reduce benefits and impose premiums on recipients. Bentley cautioned repealing the Affordable Care Act without a "clear replacement" could cause some insurers to withdraw from the market. The governor also urged Congress to maintain indigent care payments to hospitals. The payments are scheduled to drop as the uninsured people shift to Medicaid. However, Alabama did not expand its Medicaid program.