The Alabama legislative season has concluded for the year with new laws going into effect this Saturday. The Parents Right to Know Act and the squatter’s law are among the laws that will be enacted.
However, there are many issues that remain unresolved. Medicaid and healthcare expansion is one of them.
Alabama remains as one of 10 states that has not expanded Medicaid. The lack of expansion for the federal program has left an estimated 300,000 Alabamians without healthcare.
Cover Alabama, a coalition of over 130 organizations across the state, along with over 80 other organizations, wrote a letter to Gov. Kay Ivey earlier this month discussing closing the healthcare gap in the Yellowhammer state.
Debbie Smith, the campaign director for Cover Alabama, said the letter was written to show Gov. Ivey that she has been shown lots of information regarding the benefits of Medicaid expansion.
“We know the Governor has been looking at various options to close the coverage gap over the last few years, but particularly in the last few months. And unfortunately, nothing came out of this legislative session, so we just wanted to take the opportunity to acknowledge that she's been presented with lots of information and many different ways to close the coverage gap,” Smith said.
The organizations, which represent thousands of people across Alabama, wanted to let the Governor know that something needs to be done to close the coverage gap.
“We came together just to let the governor know that there's at least 85 organizations across the state that are interested and seeing her act immediately to close the coverage gap,” Smith explained. “Our 85 organizations represent thousands of people across Alabama. And so we were just letting her see the power numbers that we have of how many organizations we have that are wanting her to do something now to close the coverage gap.”
The letter comes after the Medicaid unwinding process began last year and after legislators in Arkansas and North Carolina stated how healthcare expansion has benefitted their states.
Smith said if Alabama had expanded Medicaid during the unwinding period many Alabamians would still have healthcare coverage.
“More people will be eligible for under the Medicaid expansion population. So a lot of people who are losing their coverage right now wouldn't necessarily lose it, and lose access to the prescriptions and to be able to see a doctor,” she said.
Because of the unwinding Smith said the healthcare coverage gap has most likely widened.
“If anything, it's probably gotten wider because of the unwinding. We had 1.3 million people enrolled, I believe during the public health emergency. And the standard usual amount of people that are enrolled in Alabama is about 1 million,” she explained.
Last year, the Alabama Department of Mental Health reported that Alabama’s infant mortality rate decreased. However, the state infant mortality rate remains higher than the national average. Because of this, Smith said she is concerned with pregnant people without healthcare as well.
“I'm also concerned about the people who are getting pregnant and not having any kind of health coverage. We have one of the worst maternal and infant mortality rates in the country. And a lot of that goes back to the fact that people aren't having they're not healthy before they even get pregnant,” Smith said. “If we were to expand Medicaid, we'd have more people covered under Medicaid already and have their diabetes or high blood pressure, or other things that they can manage before they even get pregnant. So they have a healthy pregnancy and birth.”
According to Smith, the people most affected by the healthcare coverage gap are those who are a part of the working class. She said the coverage gap is also affecting college students.
“A lot of working individuals who just don't have access to health coverage through their job, or make enough money to purchase it on their own. And then there's also people who are, taking care of kids home, taking care of their parents, people in those situations that may be in the coverage gap, as well as college students that don't have access to coverage through their parents,” she explained.
The lack of Medicaid expansion has also negatively affected Alabama’s workforce. Smith said many of the people who are unemployed have cited personal illness or disability as their reason.
“If we expanded Medicaid, those 300,000 people are going to have better quality of life, and it's going to save lives. But in addition to that, it's going to help our workforce. I think that's a big thing that Alabama has been looking at over the last couple of years as our workforce participation rate isn't great,” she continued. “And they did a survey on what are some of the reasons that unemployed or underemployed people are staying out the workforce. And the number three reason listed was ‘my own personal illness or disability.’ So people are citing healthcare as a reason that they're not going to work.”
According to Smith, if Alabama were to expand Medicaid today, it would be a financial gain for the state.
“Because of the incentives that we would get, and because the federal government would pay for 90% of the cost to expand Medicaid, we would actually save money up to [about] $400 million over a couple of years,” she said.
The benefit to expanding healthcare is people having the access to healthcare services they need.
“I don't think we talk about that enough. People who have health coverage are able to go to the doctor, they're able to get the screenings that they need, and catch things like cancer early or, get diagnosed with diabetes and are able to manage that, or high blood pressure and are able to manage that once they actually have access to health coverage,” Smith said.
She said Alabama could afford to pay for Medicaid expansion in the long term and that the program would pay for itself.
“The Public affairs and Research Council of Alabama did a study on the economic impact of Medicaid expansion a couple of years ago, and their study only looked at six years. But for the six years that they study, it would pay for itself during that time,” Smith said.”
Alabama will be putting other laws into effect during June including the Parents Right to Know Act. The Hands-Free Driving law, which was enacted last year, will be enforced beginning in June.
