Most of the elected leadership in Alabama state government, dominated by Republicans, have outright rejected Medicaid expansion. They have argued such a move to expand Medicaid roles would be too much of a burden on state finances.
The same will likely be true, even more so as lawmakers will be dealing with a significantly altered set of circumstances when they return to Montgomery and reconvene the 2020 legislative session. Tax revenues are likely to take a hit given the near-shutdown of the economy, which will present challenges the remainder of the fiscal year and fiscal years yet to come.
This scenario does not bode well for those pushing for Medicaid expansion in Montgomery, which is primarily Democrats. However, Sen. Doug Jones (D-Mountain Brook) insists there are things the federal government could do to make the lift significantly easier.
During an appearance on Huntsville radio’s WVNN on Thursday, Jones told “The Jeff Poor Show” he continues to undertake efforts to make Medicaid expansion a possibility but acknowledges there will be headwinds.
“There is a way, but it’s also going to take some political will from Congress,” Jones said. “I’ve got a bill pending right now that would give states that expand Medicaid now the same opportunity they had would they expanded six and seven and eight years ago. And that is, for the first three years for this expanded population, you get 100% federal reimbursement. And then you step it down from 95%-5% to 90%-10%, where it is now. I think that is a way for the state of Alabama. We’ve got to give some incentives, I believe. I’m trying to do that.”
“Regardless, I think the state ought to bite the bullet and expand Medicaid,” he said. “We’ve got 340,000 of our citizens who need that health care – and as I said a minute ago, I think people realize now that their neighbor’s health care helps their own health care. We are dependent on each other and our health care, and our health care and our health outcome. And so, I would really like to see the state of Alabama do that.”
Jones acknowledged politics present hurdles. However, he insisted embracing that element of the 2010 Affordable Care Act, also known as Obamacare, would be a net positive for Alabama.
“But make no mistake – I am trying to work with colleagues in the Congress to try to see if there are ways that we can give states like Alabama, who have not done it in the past, the incentives and that will hopefully be more federal match,” he said. “I’m just going to be candid about this – it’s a tough lift because anytime you want to tweak anything with the health care system – you know, our health care system has become so political these days that there is a tug-of-war and there’s a resistance.”
“I’m hoping that what we’re seeing now, especially when we look around the state and the country, and we’re seeing so many people afflicted and dying from this virus from the African-American community, we’re seeing an uptick in rural America – they’re the ones, rural America, our underserved communities would benefit most from Medicaid expansion, not to mention the money that would come in,” Jones continued. “We’re having to cover so much now with federal dollars, anyway. All of this is going to be covered by federal dollars. Every one of our hospitals are going to be losing millions and millions and millions of dollars because they’re not doing the elective procedures. If we can direct some of our federal dollars for the expansion of Medicaid in the short-run and in the long-term, it would be so much better for the health of the state of Alabama, and the health of the state and our individual region.”
When asked about the challenges the Alabama legislature faces in just trying to meet its current obligations and taking on potential shortfalls for future budgets, Jones suggested that given the federal government’s expanded role in the U.S. economy in the wake of the coronavirus pandemic, there could be an opportunity for Alabama to expand Medicaid with minimal harm to state coffers.
“Keep this in mind – the federal government is backfilling a lot of that,” he said. “I mean right now … it’s well over $2 billion of the first package we did the other day that the state of Alabama is going to get. That’s in addition to the health care money, the $133 billion total package that goes to health care. The state is going to get an additional $2 billion or more to help backfill and make up for some of the differences and some of the extra expenses.”
“I think you’re going to see in the next package that there’s going to be more of an effort to help state and local government with their lack of revenue and the loss of revenue,” Jones continued. “When you’ve got people like me and the congressional delegation and the president and others saying ‘stay at home, ‘social distance’ – we can’t say that on the one hand and expect our state and local governments to continue to provide the essential services that they provide with no revenue. The fact of the matter is, for at least a little bit of a period of time, the federal government is going to be the primary and dominant factor in our economy. We’ve got to do it. We’ve got to do it to stabilize it.”
“So, I think there is in an opportunity if folks will look at it – there’s more federal match money, he added. “We’ve upped the federal match coming already to Medicaid in this package. We’ve got money coming into the state. I think there’s a way you can do this and be good stewards of the money and use this in a way that will expand Medicaid and get the health care to folks that they need. And, we’ll have the long-term benefit. We’ve just got to be smart about it and think about it.”
@Jeff_Poor is a graduate of Auburn University and the University of South Alabama, the editor of Breitbart TV, a columnist for Mobile’s Lagniappe Weekly and host of Huntsville’s “The Jeff Poor Show” from 2-5 p.m. on WVNN.
