Issue: Health

Virginia wants you to join her in protecting health coverage in Alabama

By Whit Sides
A woman sitting and smiling.
Virginia found a good job and health insurance that meets her needs after moving back to Alabama last year. But Congress is considering legislation that could send health care costs soaring for her and tens of thousands of other Alabamians. (Photo by Whit Sides)

Virginia would say things have been going well since moving back home to Birmingham a year ago – steady even. She said consistency has been key in staying healthy when life takes on unexpected changes.

And Virginia has had to navigate some unexpected changes recently. 

After graduating from Mountain Brook High School and attending the University of Montevallo, she got married and followed her military spouse out of state. Virginia became a federal employee on the base where they were stationed, working in health care administration.

One of the benefits of being in a military family was having health coverage through TRICARE. That allowed her to stay on top of her mental and physical health.

“I’ve been treated for depression, anxiety and ADHD since I was very young, about 14, so it’s important that I regularly go to counseling. It’s important to find medication that works and stick with it,” Virginia said. “The reason I’ve done so well with my mental health is because I’ve had access to great health coverage throughout my life.”

When she and her spouse decided to separate, Virginia moved home. Then she learned she had lost her TRICARE health coverage in November 2024. 

“I knew I had to be in Birmingham. It’s where I know people. It’s where my family is,” she said. “I wasn’t in the best space emotionally, but I knew if I could make it home, I could deal with whatever was next once I got there.”

Reconnecting with the community

Virginia began her job search the day she arrived back in Alabama. She soon started working at a grocery store. The work was brutal, with long hours on her feet and only 10-minute breaks. But she said she was grateful for the support system that helped her earn money and become plugged into her community again.

“When I told my friends I was looking for a job, so many people were incredibly helpful, and that’s how I heard about the navigators at Enroll Alabama,” she said.

Virginia mentioned to her roommate that she was living without insurance. Her roommate then suggested visiting healthcare.gov to explore the Marketplace created under the Affordable Care Act (ACA).

An enrollment navigator walked Virginia through the process. With her recent income and household changes, together they discovered that she was eligible for premium tax credits that reduced the cost of her monthly health insurance premiums.

“I did a lot of research to make sure the plan I chose covered most of what I needed to cover my regular medications and doctors and everything,” she said. “And honestly, it wasn’t the cheapest plan, but I could afford it now with the help.”

Shortly after Virginia enrolled in her new plan, she received more good news: She was offered a job working at a family-owned office downtown.

“I work at a small local office now, and the reason I could accept that job is because I already had insurance,” she said.

The budget debate becomes personal

Since moving back, Virginia said, she feels like starting over in Birmingham was the right decision. She has plugged into several social organizations and is making an effort to become involved in causes she was passionate about locally.

That’s when Virginia found out the U.S. House recently passed a budget reconciliation bill (HR 1) with proposed health care cuts that might affect her directly.

“I follow the news, and I’ve seen everything to do with the budget bill for a while now,” she said. “And understandably, a lot of the discussion focuses on Medicaid and Medicare, which is a really big issue. But sometimes navigating health policy is hard when I’m like, ‘OK, if Medicaid’s getting cut and Medicare is getting cut, does that include funding for the Affordable Care Act?”

A woman standing and smiling.
Virginia became more engaged in health care advocacy after attending a town hall that Alabama Arise co-hosted in Birmingham. She urges Alabamians to contact their lawmakers and tell them how proposed health care cuts would harm their families and communities. (Photo by Whit Sides)

Alabama Arise and Birmingham Indivisible co-hosted a community town hall at East Lake United Methodist Church on May 31 in Birmingham. Panelists discussed proposed federal cuts to food assistance and health coverage.

Virginia was one of the nearly 100 people in attendance that day. She heard Debbie Smith, Arise’s Cover Alabama campaign director, break down what HR 1 could mean for Alabamians who receive subsidies to help pay for their ACA plans. For people like Virginia.

“Someone on the panel said that there would be up to 75% cut of the premium tax credits,” Virginia said. “My heart sank, you know? I put my head in my head in my hands and may have literally gasped, ‘Oh, no!’”

How federal cuts would undermine health care across Alabama

The budget plan now moving through Congress would make health care more expensive and less accessible for people across Alabama and nationwide. One way it would do that is to allow enhanced tax credits for ACA Marketplace coverage to expire.

This expiration would cause out-of-pocket premium payments to increase by more than 75% on average for people enrolled in Marketplace plans, according to KFF. In Alabama, that increase would be 93% on average. And in a dozen other states, people would see their premium payments more than double on average. Most of them, like Alabama, have not expanded Medicaid to cover adults with low incomes.

The most significant Marketplace premium increases likely would hit older adults and enrollees with lower incomes, according to KFF. And those higher costs would play a huge role in driving up Alabama’s uninsured rate.

About 190,000 Alabamians would lose health coverage under the proposed new cuts and barriers to Medicaid and ACA coverage. The cuts also would increase the financial strain on many rural hospitals and clinics and ultimately would drive up health care costs for everyone, no matter what type of coverage they have. And all of the cuts would help finance tax breaks for wealthy households and highly profitable corporations.

For Virginia, the health care cuts would be personal. She said she receives close to $300 a month from the tax credits toward her health coverage costs.

“It’s only $3,100 a year, which is not a lot to these people working on the bill, but like, come on, man,” she said. “You’re going to take that from us, when it’s a 75% difference? That’s such a huge deal.”

Speaking out for herself and others

Virginia said she understands that our country needs a budget from year to year. But she said she hopes Alabama’s elected officials reject health care cuts that would harm so many people, including her.

“I’ve been making calls to lawmakers about other issues since before I even knew I was impacted,” Virginia said. “And so now I just start my day by calling [Sen.] Katie Britt and calling [Sen. Tommy] Tuberville. If I leave a voicemail, I call him ‘Coach,’ but sometimes, people actually answer and I have to work through my social anxiety.”

Virginia encourages anyone who might feel overwhelmed by advocacy to take it one step at a time, and to reach out to their lawmakers with their own story.

“I fundamentally disagree with everyone right now who says that it doesn’t matter if you make a call or show up at a town hall,” she said. “Because if we all say, ‘Nothing I do matters’ and we all sit here and do nothing, then we’re really going to be in trouble.”

About Alabama Arise and Cover Alabama

Whit Sides is the storyteller for Alabama Arise, a statewide, member-led organization advancing public policies to improve the lives of Alabamians who are marginalized by poverty. Arise’s membership includes faith-based, community, nonprofit and civic groups, grassroots leaders and individuals from across Alabama. Email: whit@alarise.org.

Arise is a founding member of the Cover Alabama coalition. Cover Alabama is a nonpartisan alliance of advocacy groups, businesses, community organizations, consumer groups, health care providers and religious congregations advocating for Alabama to provide quality, affordable health coverage to its residents and implement a sustainable health care system.

Federal budget bill threatens health coverage for 190,000 Alabamians

By Debbie Smith

A bill passed by the U.S. House would put the health of thousands of Alabamians — and the state’s fragile health care system — at serious risk.

Here is what’s at stake for Alabama:

190,000 Alabamians could lose coverage

The bill would make cuts to Medicaid and would raise premiums through the Health Insurance Marketplace. As a result, thousands of Alabamians may lose their health insurance, and many would be forced to skip medications, delay care or go to the ER in crisis.

$1.14 billion hit to Alabama’s economy

Raising premiums by letting enhanced Affordable Care Act (ACA) premium subsidies expire would shrink Alabama’s economy by $1.14 billion and cost the state 10,000 jobs in 2026.

Blocks Medicaid expansion funding

The bill would eliminate $619 million in federal funds set aside to help Alabama expand Medicaid. This would deny Alabama the chance to cover at least 200,000 more residents – including veterans, college students, caregivers and more.

Pushes Alabama’s health care system closer to collapse

Alabama’s health care infrastructure is already stretched thin – with at least 20 rural hospitals already at risk of closing. This bill would put more than $400 million per year in state Medicaid provider taxes at risk. As a result, our state lawmakers could be forced to cut coverage or raise new taxes to fill the gap.

Raises health care costs for everyone

When people lose coverage, hospitals and providers still deliver care — but with no reimbursement. That means higher health care costs for everyone — no matter what type of coverage you have.

We’ve improved lives across Alabama!

By Alabama Arise
Alabama Arise executive director Robyn Hyden speaks in support of untaxing groceries during Arise’s annual Legislative Day on March 20, 2025, in Montgomery. (Photo by Julie Bennett)

The 2025 legislative session is officially over, and it was busy and productive. Alabama Arise staff, partners and members worked hard to improve the lives of folks living paycheck to paycheck while also protecting the rights of Alabamians under attack by people with regressive policy agendas.

We made major progress toward a better, more inclusive Alabama. And while we didn’t win every fight, together, we held the line for vulnerable people. Download a one-page handout on Arise’s advocacy successes in 2025 here.

We successfully advocated for new laws that will improve lives. These policies will:

● Make groceries more affordable for all Alabamians by reducing the state grocery tax (again)!

● Increase access to food in schools by securing more funding in our education budget for no-cost school breakfast programs in public schools.

● Make it easier for pregnant Alabamians to get prenatal screenings by removing red tape around Medicaid’s “presumptive eligibility” rule.

● Ensure more parents can care for their new families by securing a new paid parental leave policy for teachers, two-year college workers and state employees.

● Decrease the cost of living for families by ending the state sales tax on essential items like diapers, baby supplies, menstrual hygiene products and maternity clothing.

The fight doesn’t stop here. We must build on this momentum as we head toward the 2026 session. Become an Arise member today to join the fight and make your voice be heard!

Medicaid helped save her daughter’s life. Angelica wants it to be there for other Alabamians, too

By Whit Sides
A woman and her two daughters have a photo shoot near what appears to be a creek. The mother, in a red dress, is bending down to kiss her daughter, in a yellow dress.
Irondale resident Angelica McCain plays with her daughters near the Cahaba River in fall 2024. Years of living in Alabama’s health coverage gap and advocating for her children’s health care needs motivated her to become an advocate for affordable health coverage for every Alabamian. (Photo courtesy of Angelica McCain)

By the time Angelica McCain was 17, she had moved out of her family’s home in St. Clair County, east of Birmingham. Since then, she has worked full time in the service industry, where health coverage never comes easily.

Now a single mother of two living in Irondale in eastern Jefferson County, McCain finds herself in a familiar struggle. She is fighting to ensure her children have access to the same Medicaid coverage that helped her growing up.

“I was on Medicaid with my brothers,” McCain said. “My mom worked three jobs, my dad didn’t work much, and that was the only way we could have health care.”

That early experience shaped her perspective and fueled her advocacy today. Working in the service industry for much of her adult life – where health insurance is rarely offered – Angelica often falls into Alabama’s health coverage gap. People in the gap have incomes too high to qualify for Alabama Medicaid, but too low to afford private coverage.

Angelica had coverage during her pregnancies, only to lose it shortly after giving birth.

“Medicaid would cover me while I was pregnant, then drop me afterward,” she said. “It’d be great if our country cared about parents after the babies are born.”

Alabama lawmakers in 2022 extended the postpartum Medicaid coverage period to one year after childbirth, up from the previous cutoff of just 60 days. It was a step in the right direction – but it wasn’t enough to ensure families can get the health care they need.

The life-saving importance of Medicaid coverage

A woman and her two daughters have a photo shoot near what appears to be a creek. They are holding hands.
Irondale resident Angelica McCain smiles for a photo with her children near the Cahaba River in fall 2024. Medicaid coverage paid for live-saving cancer treatment for her older daughter last year. (Photo courtesy of Angelica McCain)

In February, Angelica was able to obtain health insurance for herself for the first time in her adult life through the Marketplace created under the Affordable Care Act. She said it’s not cheap, but she’s got to take care of herself to be around for her daughters.

A recent health scare demonstrated just how important health insurance is for families like Angelica’s. Medicaid coverage proved life-saving when Angelica’s daughter needed major cancer surgery last year.

“First of all, I thought, ‘Oh my God, is Medicaid even gonna cover this because of how big it is?’” she said. “But it covered everything. They did it all. That saved me from being like $200,000 in debt from five days in the hospital.”

Her daughter, now 10, fully recovered. But Angelica said the experience reaffirmed the critical role that Medicaid plays for Alabama families, especially in rural communities.

Tired of the status quo

Angelica is outspoken about the misconceptions and stigmas that often surround federal programs serving Alabama families. She said that in the past, more than half of her paycheck would be spent on private insurance. She said her sister is still in the same situation, facing the choice between paying for groceries or health care.

“I get very, very tired of the status quo,” Angelica said. “I’ve worked in this state for 17 years, and I still didn’t have health care to show for it. It’s not about laziness. It’s about survival.”

A woman and her two daughters have a photo shoot near what appears to be a creek. They are laughing and playing in the water.
Irondale resident Angelica McCain plays with her children near the Cahaba River in fall 2024. Angelica works full time in the service industry and spent many years living in the health coverage gap, earning too much to qualify for Alabama Medicaid but not enough to afford private insurance. (Photo courtesy of Angelica McCain)

Angelica said she often feels like leaders in Washington, D.C., and Montgomery can’t relate to folks like her. When House Speaker Mike Johnson recently claimed to reporters that many young Americans on Medicaid are just “playing video games all day,” it struck a nerve with Angelica.

“He must be out of his mind,” she said bluntly. “They have no idea what’s happening to working-class folks underneath them.”

‘That emotional weight is crushing’

For Alabamians like Angelica, Medicaid is not just a lifeline. It’s a matter of dignity for working families. But the program faces numerous threats at the federal level.

The U.S. House voted 215-214 in May for a budget bill that would cut $800 billion from Medicaid and Marketplace coverage over the next decade. The bill now awaits Senate consideration. If these cuts are enacted, health coverage could become more expensive or inaccessible for tens of thousands of Alabamians.

The bill also would remove additional federal incentives for states to expand Medicaid to cover adults with low incomes. Alabama is one of 10 states yet to expand Medicaid, leaving nearly 200,000 people in the state’s health coverage gap.

Medicaid is an essential part of Alabama’s health care infrastructure. More than 1 million Alabamians – almost all of whom are children, older adults, or people with disabilities – receive their health coverage through Medicaid.

“Children… that’s my heart,” Angelica said. “And it breaks my heart to think there are kids out there who will potentially die, and then families will go under. That emotional weight is crushing.”

If Medicaid were to face cuts or further restrictions, Angelica said her family’s most basic needs could be jeopardized. When times are already tough, she said she doesn’t know if families like hers can take another hit.

“I’d fear their teeth falling out. I’d fear not being able to get my daughter glasses. And I’d fear going into debt just trying to keep them healthy,” she said.

An empowered advocate gets results

In February, Angelica accepted an invitation to share her story at an advocacy day that Cover Alabama and the American Cancer Society Cancer Action Network co-hosted at the State House in Montgomery. There, she met other Alabamians living in the coverage gap. She also spoke at a news conference, where her message to legislators was simple: Expand Medicaid and stop targeting vulnerable communities who are just trying to get by.

A woman speaks at a podium in a crowded room during a press conference or public event.
Irondale resident Angelica McCain (center, standing behind the lectern) speaks about her experience in Alabama’s health coverage gap during a news conference co-hosted by Cover Alabama and the American Cancer Society Cancer Action Network on Feb. 27 at the State House in Montgomery. Speaking at the event and meeting with lawmakers inspired Angelica to deepen her advocacy for affordable health coverage for every Alabamian. (Photo by Whit Sides)

Angelica met with state lawmakers to discuss how her family and others would suffer under a bill that originally would have removed thousands of children from their Medicaid coverage by placing unaffordable requirements on parents with low incomes. Thanks in part to Angelica’s in-person advocacy, the bill’s sponsor agreed to remove the most concerning language from the plan. The bill ultimately did not pass. (Read more here about Angelica’s crucial role in advocating against this legislation.)

Ever since, Angelica said, she has felt more empowered to share her story and help make a difference for working families and people with low incomes across Alabama.

“There are so many people that benefit from Medicaid who don’t fit the stereotype,” she said. “We live in rural Alabama, and we live in cities. We’re white, Black, it doesn’t matter. They’re people like me, just trying to do our best for our kids.”

About Alabama Arise and Cover Alabama

Whit Sides is the Cover Alabama storyteller for Alabama Arise, a statewide, member-led organization advancing public policies to improve the lives of Alabamians who are marginalized by poverty. Arise’s membership includes faith-based, community, nonprofit and civic groups, grassroots leaders and individuals from across Alabama. Email: whit@alarise.org.

Arise is a founding member of the Cover Alabama coalition. Cover Alabama is a nonpartisan alliance of advocacy groups, businesses, community organizations, consumer groups, health care providers and religious congregations advocating for Alabama to provide quality, affordable health coverage to its residents and implement a sustainable health care system.

Federal funding cuts would increase hunger and hardship across Alabama

By Carol Gundlach

Congress is advancing a cruel proposal to take away food assistance, health coverage and other vital services from millions of Americans who struggle to afford basic needs.

Why? To give huge tax cuts to the wealthiest people in the country. The bill’s proposed $1.1 trillion of cuts to food assistance and health care over the next decade would be equal to the amount of tax cuts it would provide for the wealthiest 2% of households, according to the Center on Budget and Policy Priorities.

Congressional leaders are pushing the bill through budget reconciliation, a process that bypasses the Senate filibuster and allows legislation to pass with a simple majority vote. That process is ongoing and fluid. The U.S. House voted 215-214 for the bill in late May. By the time you read this, the Senate may have made many changes, some for the better and others for the worse.

The specifics may change, but the bill’s brutal core will remain the same. It will increase suffering for millions of Americans with low incomes to finance tax breaks for wealthy households and highly profitable corporations.

An existential threat to SNAP in Alabama

Alabama likely would feel the worst effects from proposed cuts to food assistance under the Supplemental Nutrition Assistance Program (SNAP). SNAP helps more than 42 million people nationwide and nearly 800,000 Alabamians put food on the table.

Now, Congress and the White House are threatening those families’ meals in an effort to reduce taxes for billionaires. Three major proposed SNAP changes would have devastating effects on Alabama.

(1) The bill likely would require Alabama to pay hundreds of millions of dollars more for SNAP benefits and administrative costs. The federal government has funded 100% of SNAP benefits for decades. Under the new cost shift, Alabama would become responsible for a projected $258 million or more in direct benefit costs annually, plus an additional $35 million a year in administrative costs.

The General Fund is already facing increasing costs and often stagnant revenues. There is real reason to be concerned that the Legislature can’t, or wouldn’t, commit this money. In that case, Alabama would be forced to cut SNAP benefits significantly – or even eliminate the program altogether.

(2) Congress also is considering expanding SNAP current time limits and work verification red tape for an additional 165,000 Alabamians, including parents with children over age 7. A change of this magnitude would create additional burdens for Alabama’s already stretched child care and child welfare systems. And it could leave thousands of Alabama children and families without food.

(3) Congress is considering limiting future growth in the value of SNAP benefits. Over time, this would reduce benefits for nearly 800,000 SNAP participants in Alabama, including more than 300,000 children, even as food costs continue to grow.

The economic devastation of SNAP cuts

SNAP cuts not only would hurt Alabama’s people. They also would damage Alabama’s economy. More than 5,000 Alabama stores are authorized to accept SNAP payments, and for many, it’s a large part of their business. This is particularly true in small towns and rural communities where retail is a major source of jobs and tax revenue.

Every $1 in SNAP benefits can generate $1.50 in economic activity in local communities, the USDA estimates. Deep SNAP cuts could force layoffs or closures at grocery stores and other retailers across our state. A reduction or loss of SNAP benefits is a threat to our economy and the local communities where we all live and shop.

Threats to Medicaid and ACA coverage

The bill also would make health care inaccessible or less affordable for tens of millions of Americans, including tens of thousands of Alabamians. It would allow enhanced Affordable Care Act (ACA) subsidies to expire, increasing premium costs for marketplace plans.

In addition, the bill would create new barriers that would limit Alabama’s ability to manage its own Medicaid program in the future. For example, the legislation would eliminate the federal incentives set aside to help states like Alabama cover the first two years of Medicaid expansion.

Alabama is one of 10 states yet to expand Medicaid to cover adults with low incomes. As a result, nearly 200,000 Alabamians are in the health coverage gap, earning too much to qualify for Medicaid but too little to afford private insurance.

The bill also would freeze provider taxes at current levels. This would ban Alabama from increasing fees on nursing homes, ambulance providers and others to fund Medicaid costs – even if legislators find that move necessary to sustain the program or expand coverage later.

Now is the time to speak out

It is not too late for us, as Alabamians and Alabama Arise members, to raise our voices against this dreadful bill. Congress is hearing the opposition from people back home, and that pressure continues to grow. The bill’s margin for passage is tight, and only a few votes can make a difference.

Please call on your U.S. representative and senators to say “no” to deep cuts to food assistance and health care. Ask them to focus instead on legislation that advances tax equity and meets essential health and nutrition needs in our communities.

HB 177: A case study in Alabama Arise advocacy

By Whitney Washington

 

Text for this infographic is in text of post.

Alabama Arise successfully leaped into action this year to defend health coverage for thousands of children. In February 2025, Rep. Ben Robbins, R-Sylacauga, introduced HB 177, which would have required that a child covered by Medicaid be placed on a non-custodial parent’s employer-provided health insurance when available, regardless of whether the parent could afford it. The bill also would have required Alabama Medicaid to sue parents who did not do so for payments made on the child’s behalf. Arise went into action.

Policy analysis: Looking for the devil in the details

After reading HB 177’s worrisome language, Arise senior policy analyst Carol Gundlach and other staff got to work on assessing its repercussions. As written, HB 177 would have:

  • Required Alabama Medicaid to sue many parents.
  • Put many parents who were already struggling into medical debt.
  • Forced some victims of domestic violence into contact with their abusers.

Lawmakers turn to Arise for answers

On Feb. 19, the House Ways and Means General Fund Committee debated HB 177. Arise’s Robyn Hyden spoke in opposition. 

“One example … is a friend [whose] take-home pay is $600 a week. … So she could opt in to pay for health insurance through her employer, [but] it would take more than one-third of her paycheck,” she said. 

Many committee members raised questions about the bill’s potential harms. Acting committee chair Rep. Chris Blackshear, R-Phenix City, urged the sponsor to collaborate with Arise regarding our concerns.

Our members take action

At Cover Alabama’s advocacy day, Irondale resident Angelica McCain – equipped and encouraged by Arise – shared her story of being a single mother in the health coverage gap.

“There are so many people that benefit from Medicaid who don’t fit the stereotype,” McCain said. “We live in rural Alabama, and we live in cities. We’re white, Black, it doesn’t matter. They’re people like me, just trying to do our best for our kids.”

Later that day, she spoke directly to Robbins to explain how HB 177 would harm her family. In all, nearly 100 of our advocates visited their lawmakers that day.

Harm mitigation: Advocating for amendments

Arise continued speaking with legislators about HB 177. Robbins ultimately proposed a substitute version that removed some of the bill’s most harmful impacts. The substitute added an affordability test and clarified that the insurance requirements would not apply to custodial parents.

A quiet but mighty win

Sometimes a legislative win is obvious: A good bill is enacted into law. Other times, it looks more like stopping a bad bill or mitigating the harm it would cause. In the case of HB 177, Arise identified a bill that would have hurt vulnerable Alabamians. Then we successfully advocated to make it less harmful – and ultimately, the bill died.

This is just one example of the kind of critical legislative victories that Arise regularly secures for families across Alabama. Your advocacy and support of our work makes it all possible!

U.S. House budget bill would hammer struggling Alabama families

By Chris Sanders

The U.S. House voted 215-214 Thursday for a budget bill that would make basic needs like food and health care more expensive for millions of families through severe cuts to food assistance, Medicaid and other human services. These funding cuts would finance efforts to renew or expand tax cuts for wealthy people and highly profitable corporations.

Alabama Arise executive director Robyn Hyden issued the following statement Friday in response:

“It’s wrong to hurt people who are struggling to help people who are already doing well. But the U.S. House just voted for a budget bill that would do exactly that.

“This cruel budget plan would take away food assistance, health coverage and other vital services from hundreds of thousands of Alabamians who struggle to afford basic needs. And it would make those cuts in service of slashing taxes for billionaires and highly profitable corporations. The bill’s $1.1 trillion of cuts to food assistance and health care over the next decade would be equal to the amount of tax breaks it would provide for the wealthiest 2% of households.

Text at the top: Alabama Arise news release: U.S. House budget bill would hammer struggling Alabama families. In the image below, a mother looks at a long receipt in the foreground. In the background, a father opens grocery bags on a kitchen table while their two young children stand to either side of him.

Threats to nutrition, health care

“Alabama likely would feel the worst effects from cuts to the Supplemental Nutrition Assistance Program. SNAP benefits have been fully federally funded for decades, but this bill would change that. As a result of this cost shift to states, Alabama would be on the hook to pay nearly $300 million a year in direct benefits and additional administrative costs.

“There is real reason to worry that the Legislature can’t or wouldn’t provide this additional funding. In that case, Alabama would be forced to cut SNAP benefits significantly – or even eliminate the program altogether for nearly 800,000 participants statewide. These cuts would send hunger soaring and devastate the economy in local communities across Alabama.

“The House bill also would make health care inaccessible or less affordable for hundreds of thousands of Alabamians. It would allow enhanced Affordable Care Act subsidies to expire, increasing premium costs for marketplace plans. It also would take away the additional federal incentives for the first two years of Medicaid expansion that Alabama left on the table, increasing the chances that hundreds of thousands of our neighbors will remain stuck in the health coverage gap with no options to afford life-saving care.

“The Senate should put the future and well-being of all of us ahead of tax cuts for the wealthy and well-connected. That means rejecting the House bill’s harmful service cuts for working people and tax giveaways to wealthy households. Our senators should focus instead on building an economy that works for everyone in Alabama and across our country.”

More resources

Read the February letter from Alabama Arise and 111 partner organizations urging Alabama’s congressional delegation to oppose harmful cuts to Medicaid and SNAP.

Read the January letter from Alabama Arise and 55 partner organizations urging Alabama’s congressional delegation to oppose further tax cuts for wealthy people.

Alabama Arise praises new maternal health, paid parental leave laws

By Chris Sanders
Gov. Kay Ivey sits behind a wooden desk with her nameplate on it and U.S. and Alabama flags in the background. Smiling people stand behind and to both sides of her. Behind her is wooden paneling and walls with a gray and white pattern. The patterned carpet is dark red and orange.
Alabama Arise executive director Robyn Hyden (fifth from right) and worker policy advocate Dev Wakeley (sixth from right) participated in Gov. Kay Ivey’s bill signing ceremony for SB 199 on May 1, 2025, at the State Capitol in Montgomery. SB 199 will ensure paid parental leave for teachers, two-year college workers and state employees. (Photo courtesy of Office of the Governor)

Tens of thousands of Alabama families will benefit from two new laws removing barriers to health coverage and increasing the availability of paid parental leave. Gov. Kay Ivey held a ceremonial bill signing Thursday at the State Capitol in Montgomery for both bills: SB 102, sponsored by Sen. Linda Coleman-Madison, D-Birmingham, and SB 199, sponsored by Sen. Vivian Figures, D-Mobile. The governor officially signed both bills into law last month.

Alabama Arise staff were proud to participate in the ceremonies for both bills. Improving health care access and ensuring paid parental leave are two key legislative priorities that Arise members advocated for during the Legislature’s 2025 regular session.

Official event photos from the Governor’s Office are available here.

Presumptive eligibility will reduce red-tape barriers to Medicaid coverage

SB 102, sponsored by Sen. Linda Coleman-Madison, D-Birmingham, will expand health care access for thousands of expectant mothers by allowing them to receive Medicaid coverage earlier in their pregnancy. The law will take effect Oct. 1.

The new law will expand presumptive eligibility, which allows doctors and other providers to determine Medicaid eligibility for expectant mothers who are likely to be eligible. This process allows women to begin receiving Medicaid coverage and prenatal medical care in the first trimester without having to wait for the agency’s official eligibility decision.

Gov. Kay Ivey sits behind a wooden desk with her nameplate on it and U.S. and Alabama flags in the background. Smiling people stand behind and to both sides of her. Behind her is wooden paneling and walls with a gray and white pattern. The patterned carpet is dark red and orange.
Alabama Arise senior health policy advocate Jennifer Harris (fifth from right) and executive director Robyn Hyden (seventh from right) participated in Gov. Kay Ivey’s bill signing ceremony for SB 102 on May 1, 2025, at the State Capitol in Montgomery. SB 102 will expand Medicaid presumptive eligibility and allow thousands of expectant mothers in Alabama to receive health care earlier in their pregnancy. (Photo by Matt Okarmus)

“This law will save lives and money for families across Alabama,” said Robyn Hyden, executive director of Alabama Arise. “For too long, Alabama mothers have faced needless barriers to early prenatal care – care that can mean the difference between hope and heartbreak. SB 102 will lift some of those red-tape barriers at last.

“The passage of this act is a life-changing victory for moms and babies in every part of Alabama. Alabama Arise thanks Sen. Linda Coleman-Madison and Rep. Marilyn Lands for their determination and visionary leadership on this legislation. We thank every Arise member who advocated for this bill and every lawmaker who voted for it. And we thank Gov. Kay Ivey for signing it into law.”

Paid parental leave law will help families, boost worker retention

SB 199, sponsored by Sen. Vivian Figures, D-Mobile, will ensure paid parental leave for new parents who work as teachers, two-year college employees or state employees. The law will take effect July 1.

The new law will provide eight weeks of paid leave to mothers after childbirth, adoption of a child aged 3 or younger, stillbirth or miscarriage. Fathers will receive two weeks of paid leave in those circumstances.

Gov. Kay Ivey sits behind a wooden desk with her nameplate on it and U.S. and Alabama flags in the background. Smiling people stand behind and to both sides of her. Behind her is wooden paneling and walls with a gray and white pattern. The patterned carpet is dark red and orange.
Alabama Arise executive director Robyn Hyden (fifth from right) and worker policy advocate Dev Wakeley (sixth from right) participated in Gov. Kay Ivey’s bill signing ceremony for SB 199 on May 1, 2025, at the State Capitol in Montgomery. (Photo by Matt Okarmus)

“Paid parental leave helps workers create and grow their families while maintaining their financial well-being,” Hyden said. “Alabama’s new law guaranteeing paid parental leave for teachers and state employees makes our state a leader in the Southeast. And it is important progress toward ensuring every parent can care for their families without scrambling to pay the bills.

“This new law will enhance the quality of life for families across Alabama. Paid leave will help improve health for babies and families, and it will ease economic stress for new parents. This policy also will improve employee retention for schools and state agencies, and it will help mothers in particular to remain in the workforce.

“Paid parental leave is a common-sense, pro-family policy that will result in a better, healthier future for everyone in our state. Alabama Arise appreciates the leadership from the legislative champions on this issue, Sen. Vivian Figures and Rep. Ginny Shaver. We appreciate Gov. Kay Ivey for highlighting paid leave as a priority in her State of the State address and for signing this bill into law. And we appreciate every legislator who voted for this law and every Arise member who advocated in support of this important investment in healthier families in Alabama.”

Arise legislative update: Week of April 21, 2025

By Alabama Arise

Arise’s Whitney Washington breaks down why HB 477, a bill to allow junk health plans, is not a solution for Alabama’s health coverage gap. HB 477 would authorize non-insurance health plans that aren’t regulated by the Alabama Department of Insurance and that could cap benefits and discriminate against people with preexisting conditions.

This bill is unfortunately gaining traction in the Legislature, and time is running short to stop it. Please contact your legislator today and tell them to vote against this harmful legislation: https://votervoice.net/CoverAlabama/Campaigns/124108/Respond

Full transcript below:

Hi, I’m Whitney Washington, communications associate with Alabama Arise. You’ve probably heard a lot from us about HB 477, the junk health plan bill. If enacted, this bill would allow farm bureaus to sell health plans to their members. While this might sound like a good thing, we disagree.

These plans are not insurance. They are not regulated by the Alabama Department of Insurance.

They can discriminate based on preexisting additions, and there is no limit on out-of-pocket costs. These plans can end up hurting the people that need them the most. HB 477, unfortunately, already passed out of the House with a disappointing 98-1 vote.

This week, it’s up in the Senate Banking and Insurance Committee. If it passes out there, it goes to the full Senate, so this is one of the last opportunities we have to stop this devastating bill. Please show your support and, tell your senator to vote no on HB 477.

Please consider joining Arise. If you’re already a member, tell your friends, and be sure to follow us on YouTube, X, Facebook, Instagram and BlueSky.

Kit de herramientas de salud materna de Alabama

By Alabama Arise

“Para mejorar la salud materna, debemos concentrarnos en mejorar la salud y el acceso a la atención de todas las mujeres; no solo durante el trabajo de parto y el nacimiento, sino también antes y después del embarazo, y durante toda nuestra vida”. – Dra. Leana S. Wen

Descargue aquí una copia completa en PDF del Kit de herramientas de salud materna de Alabama. También puede acceder al PDF haciendo click en el botón “Descargar” (Download) en la parte superior de la página.

Table of contents

Introducción

¡Le damos la bienvenida al Kit de herramientas de salud materna de Alabama! Alabama Arise creó este recurso con una meta principal: darle apoyo y empoderarle para orientarse en las complejidades de la atención de salud materna en Alabama. Ya sea usted una mamá nueva, una embarazada o un/a defensor/a de intereses de salud, este kit de herramientas está diseñado para brindarle información esencial sobre salud materna, cobertura de Medicaid, acceso a la atención médica y recursos comunitarios.

Esperamos que esta guía le ayude a entender las opciones disponibles de atención médica y le dé la confianza que necesita para tomar los próximos pasos en asegurar y mantener la atención necesaria. Tenemos el compromiso de mejorar los resultados de salud materna y apoyar a las familias en todo el estado. Estamos aquí para guiarle en cada paso del proceso.

Le animamos a compartir este kit de herramientas con otros a quienes pueda beneficiar. Juntos, podemos construir un futuro más sano para las madres de Alabama y sus familias.

Trasfondo

La salud materna en Alabama enfrenta grandes desafíos. Alabama tiene una de las tasas más altas de mortalidad materna y nacimientos pretérmino en Estados Unidos. El acceso limitado a atención médica integral empeora estas disparidades, en especial para mujeres en comunidades desatendidas y rurales. Medicaid tiene un papel crucial para tratar estas brechas al cubrir más de la mitad de los nacimientos en Alabama. Sin embargo, a muchas mujeres les sigue faltando la atención continuada que necesitan.

Estadísticas clave

  • Alabama tiene la tercera tasa más alta de mortalidad materna en la nación.
  • Medicaid cubre uno de cada dos nacimientos en Alabama.
  • Las mujeres negras tienen el triple de probabilidades de morir por complicaciones de embarazo.

Acceso a la salud materna en Alabama

Alabama tiene una de las tasas más altas de desiertos de atención de maternidad en Estados Unidos. Estas son zonas donde el acceso a la atención materna es limitado o nulo. Así, muchas mujeres en zonas rurales no tienen acceso a los servicios de obstetricia necesarios. El continuo cierre de alas de maternidad, de modo específico en zonas rurales, limita aún más el acceso a atención prenatal, partos seguros y servicios de posparto.

 

Estadísticas

  • 16 de los 55 condados de Alabama considerados rurales tienen hoy hospitales que brindan servicios de obstetricia, en comparación con 45 de los 55 condados en 1980.
  • Las mujeres de Alabama viajan, en promedio, 17.4 millas y 23.5 minutos a su hospital de nacimientos más cercano.
  • Los hospitales cierran o reducen servicios debido a dificultades financieras. Esta situación es peor por la falta de expansión de Medicaid de Alabama.
  • 8.9% de los nacimientos en todo Alabama ocurren en desiertos de atención de maternidad.

Beneficios y cobertura de Medicaid

Medicaid ofrece una gama integral de servicios para apoyar la salud materna antes de la concepción, durante el embarazo y en el periodo de posparto.

Antes de la concepción

Programa Plan First

El programa Plan First de Medicaid ofrece servicios de planificación familiar a mujeres de 19 a 55 años en Alabama. Para las mujeres, el programa incluye cobertura para pruebas esenciales, métodos anticonceptivos y ayuda para planificar.

SERVICIOS CUBIERTOS POR PLAN FIRST DE MEDICAID

  • Examen anual de planificación familiar 
  • Acceso a métodos anticonceptivos (entre otros, píldoras, DIUs, diafragmas, inyecciones e implantes)
  • Ligadura de trompas (y vasectomías para hombres)
  • Análisis de laboratorio para embarazos
  • Pruebas para infecciones de transmisión sexual
  • Ayuda para planificar cuándo tener un bebé
  • Cesación de tabaquismo

Embarazo

La cobertura de salud durante el embarazo asegura el acceso a atención prenatal, que es crucial para monitorear la salud tanto de la madre como del bebé.

SERVICIOS CUBIERTOS POR MEDICAID

  • Chequeos prenatales habituales
  • Vitaminas prenatales
  • Pruebas de diagnóstico, como ultrasonidos
  • Educación de salud (como clases de preparación para el parto)
  • Servicios dentales
  • Nurse-Family Partnership (NFP) (Consulte la página 13 para más información)
  • Servicios de coordinación de atención de Alabama Coordinated Health Network (ACHN) (Las pacientes deben registrarse en una ACHN antes de programar su primera cita prenatal)

Posparto

La atención posparto es esencial tanto para la madre como para el bebé. Una cobertura extendida después del nacimiento ayuda a asegurar una buena recuperación, apoyo de salud mental y acceso a la atención infantil necesaria. La cobertura posparto está disponible durante un año entero después del nacimiento o la pérdida del embarazo.

SERVICIOS CUBIERTOS POR MEDICAID

  • Chequeos posparto
  • Asesoría de salud mental para tratar la depresión posparto y otros problemas
  • Servicios de planificación familiar para ayudar a espaciar los nacimientos
  • Servicios dentales (hasta los 60 días después del nacimiento)
  • Atención infantil, que incluye vacunas, chequeos habituales y pruebas de desarrollo

Inscripción en Maternidad de Medicaid

No hay un periodo de inscripción abierta para Maternidad de Medicaid. Se puede solicitar e inscribirse en cualquier momento.

La cobertura de Medicaid se puede usar junto con la cobertura de un seguro privado. Si una mujer tiene un plan de seguro privado que no es del Marketplace, también puede inscribirse en Maternidad de Medicaid si cumple con los criterios de ingresos y elegibilidad.  Un  niño que nace de una mujer inscripta en Medicaid al momento del nacimiento es elegible para lo que se conoce como “cobertura considerada de recién nacido”. Se trata de cobertura que comienza con el nacimiento y dura un año, sin importar los cambios en el ingreso del hogar durante ese tiempo.

¿Cómo pueden recibir cobertura las mamás de Alabama?

Medicaid es un recurso vital para las mujeres embarazadas y nuevas madres en Alabama. Entender cómo cumplir los requisitos e inscribirse en Medicaid es esencial para asegurar acceso a atención médica durante el embarazo y después del nacimiento.

Criterios de elegibilidad

  1. Edad
    • Las mujeres embarazadas de Alabama de cualquier edad pueden recibir cobertura completa de Medicaid si cumplen con todos los requisitos. Las mujeres embarazadas menores de 19 años también pueden recibir cobertura completa si se tiene en cuenta el ingreso de sus padres y si cumplen con las pautas de ingreso como niña.
  2. Ingresos
    • El límite de ingresos del hogar para mujeres embarazadas es el 146 % del nivel federal de pobreza (sigla en inglés, FPL). Más información en la página 10.
  3. Ciudadanía
    • Las mujeres embarazadas deben ser ciudadanas de Estados Unidos o tener un estado inmigratorio satisfactorio para poder inscribirse.
  4. Residencia
    • Las mujeres embarazadas deben residir en Alabama para recibir beneficios de Medicaid de Alabama.

Ayuda con la elegibilidad

Pautas de ingreso de 2024

El tamaño del hogar incluye a la mujer embarazada y al niño por nacer. También puede incluir al esposo, padre y/u otros niños menores de 19 años. Esto depende de quién viva en el hogar y cómo se haga la declaración de impuestos.

Elegibilidad económica

La elegibilidad económica de Medicaid se basa en el ingreso bruto ajustado modificado (sigla en inglés MAGI), que comienza con el ingreso bruto ajustado (sigla en inglés, AGI) de una persona. El AGI es el ingreso total que se obtiene en un año después de ciertas deducciones como contribuciones de jubilación o interés de préstamos universitarios. Para determinar el MAGI, la solicitante debe agregar al AGI ingreso extranjero sin impuestos, beneficios exentos de impuestos de Seguridad Social o interés exento de impuestos (si hay). Para muchas solicitantes, el AGI y el MAGI son iguales. Para Medicaid, los ingresos del hogar se calculan sumando el MAGI de cada persona en el hogar, ya sea que presenten o no una declaración de impuestos.

Ejemplos de documentación

  • Verificación de ingresos
    • Talones recientes de pago
    • Declaraciones de impuestos
    • Estados de cuenta de seguro por desempleo o beneficios de Seguridad Social
  • Prueba de identidad y ciudadanía
    • Licencia de conducir o identificación emitida por el estado
    • Certificado de nacimiento o pasaporte de Estados Unidos
    • Tarjeta de residencia permanente (Tarjeta verde o “Green Card”)
  • Confirmación del embarazo
    • Nota del médico/a o verificación de un profesional médico/a
    • Informe de ultrasonido
  • Proof of Alabama residency
    • Cuenta de servicios (electricidad, agua, gas)
    • Contrato de alquiler o hipoteca
    • Tarjeta de registro de votante

Pasos para inscribirse

Verificar elegibilidad

Asegúrese de que sus ingresos cumplan con los requisitos para el tamaño de su hogar (que incluye a usted, sus dependientes y su niño por nacer). Repase la lista de verificación de elegibilidad y la tabla de límites de ingresos en este kit de herramientas para confirmar la elegibilidad.

Reunir la documentación necesaria

Antes de presentar la solicitud, reúna la documentación necesaria:

  • Verificación de ingresos
  • Confirmación de embarazo
  • Prueba de identidad y ciudadanía
  • Prueba de residencia en Alabama

Presentar la solicitud

En línea

Solicite cobertura en línea en insurealabama.adph.state.al.us

Por correo

Descargue, llene y envíe por correo la solicitud de Medicaid a:

Medicaid, P.O. Box 5624

Montgomery, AL 36103-5624

Confirme y espere

Después de presentar la solicitud, debe recibir una carta de confirmación a las pocas semanas. Asegúrese de que toda su información sea correcta. Si no tiene noticias, haga seguimiento con la oficina de Medicaid para controlar el estado de su solicitud.

¿Necesita ayuda?

Llame a la línea de ayuda de Medicaid si necesita ayuda con el proceso de solicitud o para renovar su cobertura.

Línea de ayuda de Medicaid: 888-362-1504

Lunes a viernes de 8 a.m. a 4:30 p.m.

Cómo Alabama está mejorando los resultados

A pesar de las dificultades, numerosos programas e iniciativas en todo Alabama trabajan para mejorar los resultados de salud materna. Estos son algunos.

ALABAMA 211 CONNECTS

Alabama 211 es una línea de ayuda de todo el estado que conecta a los residentes con atención médica esencial, salud materna y servicios sociales. Sirve como recurso central para orientarse entre las opciones de apoyo local durante el embarazo y el periodo de posparto. Se puede llamar simplemente al 2-1-1 para acceder a una amplia gama de servicios.

ALABAMA MARCH OF DIMES

March of Dimes es una organización no lucrativa que respalda investigación, defensa de intereses y programas para mejorar la salud maternoinfantil. En Alabama, se centra en la prevención de defectos congénitos, nacimientos prematuros y disparidades de salud materna. Esta organización ofrece educación prenatal y apoyo para embarazadas, especialmente en comunidades vulnerables.

ALABAMA MATERNAL HEALTH TASK FORCE

La Alabama Maternal Health Task Force (ALMHTF) trabaja para abordar las dificultades estatales de salud materna al coordinar esfuerzos de varias partes interesadas. Tiene como meta mejorar los resultados de salud mediante la reducción de la mortalidad y morbilidad maternas a través de iniciativas de desarrollo de políticas, colaboración y mejora de la calidad de atención médica.

ALABAMA MATERNAL MORTALITY REVIEW COMMITTEE

El Alabama Maternal Mortality Review Committee (MMRC) investiga las muertes maternas en todo el estado para identificar la causa y determinar factores evitables. Al revisar estos casos, el comité da recomendaciones a profesionales médicos/as y creadores/as de políticas para mejorar la atención médica materna y reducir las tasas de mortalidad materna.

ALABAMA PERINATAL QUALITY COLLABORATIVE

La Alabama Perinatal Quality Collaborative (ALPQC) es una iniciativa de todo el estado que reúne a profesionales médicos/as, hospitales y expertos/as en salud pública para mejorar la calidad de la atención perinatal. Se centra en la reducción de la mortalidad infantil y las complicaciones de salud materna mediante la implementación de las mejores prácticas en atención médica.

BIRMINGHAM HEALTHY START PLUS

Birmingham Healthy Start Plus brinda servicios con base en la comunidad para reducir la mortalidad infantil y mejorar la salud materna en los vecindarios más desatendidos de Birmingham. El programa ofrece apoyo prenatal y posparto, educación y recursos para asegurar embarazos sanos y partos seguros para familias vulnerables.

BIRTHWELL PARTNERS

Birthwell Partners es una organización no lucrativa que capacita y brinda doulas para ayudar a mujeres, en particular en zonas desatendidas y rurales de Alabama. Sus servicios ayudan a mejorar los resultados de los nacimientos al ofrecer apoyo emocional, físico y de información durante todo el embarazo, el parto y la recuperación posparto.

COVER ALABAMA

La coalición Cover Alabama hace activismo para la expansión de la cobertura de Medicaid para asegurar que más residentes de Alabama, sobre todo las mujeres embarazadas y las familias, tengan acceso a atención médica asequible. La coalición busca reducir las tasas de mortalidad materna y mejorar la salud materno infantil en general presionando para cerrar la brecha de cobertura en Alabama.

GIFT OF LIFE FOUNDATION

La Gift of Life Foundation respalda la salud maternoinfantil ofreciendo educación prenatal, acceso a atención médica y servicios de intervención temprana. Sus programas están diseñados para reducir la mortalidad infantil y asegurar que las madres reciban atención integral durante y después del embarazo.

NURSE-FAMILY PARTNERSHIP

La Nurse-Family Partnership (NFP) es un programa nacional que se implementa en Alabama para mejorar la salud maternoinfantil mediante la conexión de madres primerizas de bajos ingresos con enfermeros/as especialmente capacitados. Estos enfermeros/as brindan visitas a domicilio durante el embarazo y los primeros dos años de la vida del niño/a. Se centran en salud, destrezas de paternidad/maternidad y autosuficiencia económica.

PREGNANCY RISK ASSESSMENT MONITORING PROGRAM

Pregnancy Risk Assessment Monitoring Program (PRAMS) es una iniciativa de los CDC en colaboración con el Departamento de Salud Pública de Alabama que busca recolectar datos sobre las actitudes y experiencias maternas antes, durante y después del embarazo. Esta información ayuda a dar forma a políticas y programas diseñados para mejorar los resultados de salud maternoinfantil en todo el estado.

Expansión de Medicaid

Alabama es uno de solo 10 estados que sigue sin expandir Medicaid. Esto deja a decenas de miles de mujeres en la brecha de cobertura. La expansión de Medicaid ayudaría a asegurar que más mujeres reciban atención médica antes, durante y después del embarazo, lo cual conduciría a bajar las tasas de mortalidad maternoinfantil.

Estadísticas

  • 10 estados no han expandido Medicaid.
  • Casi 200,000 residentes de Alabama quedan dentro de la brecha de cobertura.
  • Los estados que sí han expandido Medicaid han visto menos muertes maternoinfantiles en comparación con estados sin expansión.
  • La expansión de Medicaid podría evitar más cierres de hospitales y aumentar el acceso a la atención materna en zonas rurales.

Estados

  • Alabama
  • Florida
  • Georgia
  • Kansas
  • Mississippi
  • Carolina del Sur
  • Tennessee
  • Texas
  • Wisconsin
  • Wyoming

Conclusión

Asegurar una mejor salud materna en Alabama es una tarea colectiva que requiere apoyo, acceso a atención y decisiones informadas de manera continua. El Kit de herramientas de salud materna de Alabama es un recurso diseñado para informar y guiar a mujeres, familias y profesionales médicos/as en el acceso a los recursos disponibles a través de Medicaid y otros programas de salud materna. Al asegurar que todas las madres tengan acceso a atención esencial prenatal, de parto y de posparto, podemos trabajar hacia la reducción de la mortalidad materna, abordando disparidades y mejorando la salud tanto de madres como de bebés en todo nuestro estado. Juntos, podemos dar a luz mejores resultados para las familias de todo Alabama.

 

Alabama Arise es una organización no lucrativa de todo el estado conducida por sus miembros. Se dedica a promover políticas públicas para mejorar la vida de los residentes de Alabama que están marginalizados por la pobreza. Entre los miembros de Arise se cuentan grupos religiosos, comunitarios, no lucrativos y cívicos, líderes de activismo de base y personas de todo el estado. Conozca más sobre Arise en alarise.org. Siga a @AlabamaArise en Facebook, Instagram y Twitter/X.