Jeff Martin

Jeff Martin

Could Medicaid expansion finally be coming to Alabama? Several recent indicators point to the possibility Governor Kay Ivey might reconsider it when the legislative session begins next month. The Governor can make the change with the stroke of a pen, only needing the legislature to budget for the 10 percent of matching dollars.

As the saying goes, better late than never, but it’s something that should have been done five years ago, especially considering at the time there was a doctor occupying the Governor’s mansion.

Alabama is one of only 14 states that have not expanded Medicaid under the Affordable Care Act. It probably doesn’t come as a surprise to learn that of those 14 states, most are Republican controlled southern states.

Gov. Ivey has an opportunity to generate billions of dollars in economic activity and state savings and provide more than 340,000 Alabamians with health insurance coverage, according to two reports released last week regarding Medicaid expansion.

The Alabama Hospital Association launched a campaign to expand Medicaid in September and these new studies are further proof that expansion is the best option available to the state. Alabama’s cost would be $1 billion over four years. But we would see a return of $11 billion in increased economic activity.

How you ask?

According to the studies, the ripple effect of the influx of federal dollars and increased Medicaid enrollees would be tremendous, noting that the number of health care services and employees would increase as would the community services required to support the additional growth and the taxes paid by the newly created jobs. In addition, more than $58 million in current State spending could be replaced with federal funds. And the savings and economic gains would increase over time.

Sounds like a win-win for everyone.

In the last election the Alabama Hospital Association contributed to the campaign of Gov. Ivey, despite her unwillingness at the time to support expansion. Her Democratic opponent, Walt Maddox was on record as a strong supporter of expanding Medicaid, but did not receive the same support. Giving me hope there might be a chance Ivey would have a change of heart after the elections.

Another reason I expect it to garner more legislative attention comes from recent statements by longtime Republican State Senator Jabo Waggoner, who said, “we’ve got to find a way to keep these rural hospitals open and Medicaid is probably the answer to it.”

Speaking to the media last week, Don Williamson, president of the Alabama Hospital Association said, “By failing to expand Medicaid over the next four years, we will leave $11 billion dollars on the table.”

“On a more personal note, we will leave hundreds of thousands of Alabamians without health insurance, with limited access to health care and we will condemn significant numbers of our financially challenged rural hospitals to closure,” Williamson said.

Rural hospitals are shuttering at an alarming rate in the states that have refused Medicaid expansion. Currently almost 90 percent of the state’s rural hospitals are operating in the red. Alabama has seen the closure of 12 hospitals in the last eight years, with the likelihood more will close in the near future without expansion. Already, there are many rural citizens who are further than an hour’s drive to the closest emergency room.

It is an undisputed fact that rural hospital closure rates are higher (about 85 percent) in states that have not expanded.

Currently eight Alabama counties are without a hospital and as a result have higher mortality rates and more than half of the state’s 67 counties don’t deliver babies. Furthermore, the absence of needed medical facilities in rural counties and towns typically result in an economic death spiral. Because let’s face it, who wants to live somewhere that doesn’t provide adequate health care.

Access to health care shouldn’t be a political issue and several red states have recently made the change to expand. While too late to take the lead, Alabama should at least follow. Statistics show that states that have expanded have fewer uninsured residents, better access to care, fewer infant deaths and the earlier detection of cancer.

It’s past time for the Governor and legislature to do what’s right for the state and it’s people, because the consequences of not doing anything will have a tremendous impact on us all.

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