Issue: Health

Arise legislative update: Week of Feb. 24, 2025

By Alabama Arise

Arise’s David Stout shares some good news from the Alabama State House this week. The Senate and House have passed SB 102 and HB 89, respectively, and sent them to the other chamber for consideration. These bills would ensure that women eligible for Medicaid could get health care earlier in their pregnancies. David also discusses the introduction of SB 191, which would improve Medicaid coverage for mothers facing postpartum depression.

David also reviews two concerning bills that would be bad for health coverage in Alabama. HB 177 is a confusing bill that could put Medicaid coverage at risk for tens of thousands of children. And SB 84 would authorize health plans that could deny coverage for essential treatments or for people with preexisting conditions.

Full transcript:

Hello, this is David Stout, Arise legislative director, with some good news about happenings in the legislative session. Two maternal health bills are moving: SB 102 by [Sen. Linda] Coleman-Madison and HB 89 by Rep. [Marilyn] Lands. These bills will provide insurance for Medicaid-eligible mothers earlier in their pregnancy. It’s an important bill that will mean healthier mothers and healthier children in the future in Alabama.

Sen. [Vivian] Figures has introduced SB 191, which would provide Medicaid coverage for mothers suffering from postpartum depression. This bill, if it passes, will allow for counseling and prescription drugs to treat postpartum depression.

A bad bill, we think, has been introduced by Rep. [Ben] Robbins from Sylacauga. It’s HB 177, and the intent of the bill seems to be to move children from Medicaid health coverage to the coverage offered by the mother or father’s place of employment. This is a confusing bill. We don’t know exactly what the intention is or the outcome. Arise’s own executive director, Robyn Hyden, testified against the bill.

SB 84 is scheduled to be up in committee in a couple of weeks. We think this is a bad bill. What it does is allow ALFA to have its own unregulated insurance plan. Even worse, it asks that it not be forced to provide coverage for preexisting conditions. We consider this a junk insurance plan, and it is bad for people who are looking for health care. We will oppose this bill and will continue to keep you updated on it.

Feb. 25 is Cover Alabama’s Advocacy Day for Medicaid expansion. It lasts from 9 a.m. to 3 p.m., and we will, along with many groups, be lobbying the Legislature to expand Medicaid and provide better insurance for the citizens of Alabama.

Arise legislative update: Week of Feb. 17, 2025

By Alabama Arise

Arise’s David Stout brings you the latest after another busy week at the Alabama Legislature. David recaps some good news from last week: Bills increasing access to maternal health care (HB 89) and cracking down on companies that violate child labor laws (SB 22) passed in the House and Senate, respectively. He also shares worse news: The House passed HB 29, which would add more red-tape barriers to unemployment insurance for Alabamians facing joblessness.

David closes by discussing how proposed federal Medicaid and SNAP cuts would hurt Alabama, and by inviting our members to speak out at Cover Alabama Advocacy Day on Feb. 25. Stay engaged all year long by signing up for our action alerts and monitoring our bills of interest at alarise.org.

Full transcript

I’m David Stout, legislative director for Alabama Arise, with our weekly legislative report. Bills related to maternal health care moved in both houses this week. These bills would provide health care for mothers who did not have access to prenatal care. The House bill passed the House and awaits action in the Senate committee, while the Senate bill is out of committee and awaits action on the Senate floor.

Another bill we were interested in relates to clawbacks for industries that violate child labor laws. This bill, SB 22, easily moved out of committee and passed the Senate this week. It provides that if a company violates child labor laws, any incentives given to them by the state of Alabama could be clawed back.

A bill we opposed, related to unemployment compensation, passed the House. It made the standards more rigid and made it more difficult to receive unemployment insurance, requiring more applications to businesses to qualify for benefits. Despite our opposition, it did pass and is now awaiting action in the Senate. An amendment was added that would exempt counties with fewer than 20,000 people, where industry is scarce and transportation is often inadequate.

There are also concerns about potential cuts to many programs in Washington. If proposed cuts to Medicaid are made, they could impact around $8 billion in Alabama. SNAP benefits are also threatened, which would affect at least one in five children in Alabama who rely on the program for healthy food. These developments could have a tremendous negative impact on Alabama, and we need to stay vigilant.

We also want to invite you to Cover Alabama Advocacy Day, an event to promote Medicaid expansion. It will take place on Feb. 25 from 9 a.m. to 3 p.m. We encourage you to visit coveralabama.org and sign up. If you attend, we will make accommodations and provide lunch. It is crucial to raise our voices to both the public and the Legislature regarding Medicaid expansion. I hope to see you there. Thank you.

HB 89 and SB 102 would improve maternal health, save money and save lives in Alabama

By Jennifer Harris

Presumptive eligibility allows doctors and other providers to determine Medicaid eligibility for expectant mothers who are likely to be eligible. This allows women to begin receiving Medicaid coverage in the first trimester without having to wait for the agency’s official eligibility decision.

More than 50% of expectant mothers in Alabama are eligible for Medicaid coverage for prenatal medical care crucial for the health of both mother and child. Yet that care is regularly delayed because Alabama doesn’t have a timely procedure to allow many mothers to get prenatal care.

HB 89 by Rep. Marilyn Lands, D-Huntsville, and SB 102 by Sen. Linda Coleman-Madison, D-Birmingham, would allow expectant mothers to receive Medicaid coverage earlier in the pregnancy, when health care is essential for the mother and child. These bills would expand presumptive eligibility and reduce red-tape barriers to coverage.

Why do we need presumptive eligibility?

The wait for Medicaid’s official eligibility approval can prevent mothers from receiving care earlier in their pregnancy. Areas with a lack of maternal health care access compound this issue, increasing the cost of higher-risk pregnancies and deliveries.

Presumptive eligibility allows up to 60 days of Medicaid coverage for women who have not yet been formally approved for coverage but who submit proof of pregnancy and household income information to their maternity care provider. This would allow mothers to see a doctor, receive pregnancy verification and begin prenatal care while the Medicaid approval process is ongoing.

What are the benefits of presumptive eligibility? 

  • Alabama has some of the nation’s highest rates of infant mortality, maternal death and low birth weight. Maternal mortality is higher among patients with late or no prenatal care. 
  • More than 1 in 4 pregnant women (27%) do not receive prenatal care until the second trimester, according to the March of Dimes. This can lead to costlier care later in pregnancy or postpartum. 
  • Receiving prenatal care in the first trimester can improve outcomes and save millions of dollars by diagnosing and treating conditions that may worsen over time without medical attention, thereby reducing risk for maternal and infant death or severe complications. 
  • The state cost for presumptive eligibility – just $273,700, according to the fiscal note – is small compared to the potential savings, both in dollars and especially in lives.

What can the Legislature do to help?

Vote “yes” on HB 89 and SB 102 to improve maternal health, save money and save lives in Alabama.

Alabama at risk from threatened federal funding cuts

By Chris Sanders

Congress this week likely will begin considering budget resolutions that could set the stage for severe cuts to Medicaid, food assistance 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 Monday in response:

“It’s wrong to hurt people who are struggling to help people who are already doing well. But Congress is expected to vote soon on budget and tax legislation that would do exactly that.

“Congress must decide this year whether to renew the 2017 federal tax cut law, which provided tax breaks that overwhelmingly benefited wealthy households and highly profitable corporations. To offset the cost of these tax giveaways, Congress would have to slash funding in other areas. And many of those proposed service cuts would make life worse for Alabamians who struggle to make ends meet.

“The damage could be severe for hundreds of thousands of people across our state. As many as 1 in 5 Alabamians enrolled in Medicaid could lose their health coverage due to cuts and onerous work reporting requirements. Many more people could see food assistance reduced or eliminated. Other potential targets for cuts include school meals, the Child Tax Credit and tax credits for Affordable Care Act coverage.

“These cuts could cause more economic harm in our state than in most others, because Alabama receives far more federal dollars than we pay in taxes to the federal government. In 2022, Alabamians got a return of $2.01 for every dollar in federal taxes paid per capita. That ranked Alabama as the nation’s seventh-highest beneficiary of federal funds.

“As Alabama Arise and 55 partner organizations wrote last month to Alabama’s congressional delegation, Congress should put the future and well-being of all of us ahead of tax cuts for the wealthy and well-connected. Our lawmakers should reject harmful service cuts for working people and tax giveaways to wealthy households. And they should focus instead on building an economy that works for everyone in Alabama and across our country.”

How federal funding improves the quality of life in Alabama

Alabama receives a wide array of federal funding to support and maintain public infrastructure, programs and services. This funding is administered at the state, regional and local levels. Alabama benefited from more than $14.5 billion in federal funds in fiscal year (FY) 2024. Here are a few key examples:

  • $8.1 billion for health and human services, including Medicaid, the Children’s Health Insurance Program (known as ALL Kids in Alabama), Head Start, child care subsidies, child welfare and child protective services, HIV/AIDS prevention, opioid and substance use disorder treatment programs, and supportive services for older adults and people with disabilities.
  • $2.86 billion for nutrition and agriculture programs, including the Supplemental Nutrition Assistance Program (SNAP), the Special Supplemental Nutrition Program for Women, Infants and Children (WIC), school meal programs, emergency food assistance, cooperative extension services and agricultural research.
  • $1.4 billion for transportation, including funds for highways, railways, airports and bridges.
  • $1.35 billion for education, including Title I programs, Pell Grants, special education programs and 21st Century Community Learning Centers.
  • $318 million for housing and urban development programs, including homeownership programs, Community Development Block Grants and assistance for people facing homelessness.
  • $142.1 million for environmental protection, including grants to support clean water, clean air, pesticide management and enforcement of hazardous waste disposal.
  • $110 million for fish and wildlife programs and other programs supported by the Department of the Interior.
  • $92.4 million for the Tennessee Valley Authority.
  • $82 million for workforce development programs, including jobs programs for veterans, unemployment insurance and Workforce Innovation and Opportunity Act (WIOA) programs.
  • $23.8 million for Department of Justice programs, including sexual assault investigations, supports for crime victims and programs to prevent violence against women.
  • $12.6 million for homeland security.
  • $4.7 million for energy assistance and weatherization programs.
  • $2.1 million from the National Endowment for the Arts.
  • $1 million to support election administration.

More resources

View a full breakdown of federal funds that Alabama received in FY 2024.

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

Arise legislative update: Week of Feb. 3, 2025

By Matt Okarmus

Arise’s David Stout welcomes everyone to the Alabama Legislature’s 2025 regular session. Watch to see what to expect and learn about parental leave, school breakfast and other key issues where we hope to make progress this year.

Remember to sign up for our action alerts. And you can read more about our 2025 legislative priorities.

Full transcript below:

Hello, I’m David Stout, the legislative director for Alabama Arise, and I’m here to give you a brief look at the upcoming 2025 legislative session. The session begins Tuesday, Feb. 4, and the Constitution prescribes that the Legislature must meet over 105 days. There are actually 30 so-called working days where they meet, debate, and vote on bills in a session.

There are many issues that are very important to Arise members, and we need to be aware of them and be able to give our input as this session proceeds. During the first week, the budget presentations before the Legislature will occur on Feb. 5 and Feb. 6. These budget hearings, for the first time, are wrapped into the session and will include presentations by financial directors, state departments, education— a whole variety of departments in state government.

Especially important this year, and critical to making Alabama a better state, are three key issues that Arise will be working on. One is parental leave, which we hope will give parental leave for the first time in Alabama to state employees and educators. Secondly, we will be offering a plan to incentivize schools to provide breakfast for all students in public schools in Alabama. Lastly, we will continue our efforts to see that Alabama joins the majority of other states and expands Medicaid to give health coverage to over 200,000 Alabamians who do not have it.

Arise will also be working on a broad agenda in the Legislature, including criminal justice reform, seeking funds for public transportation, maternal and infant health care, voting rights, death penalty reform, and pushing to take more taxes off groceries.

We will keep you posted as we move through this session. It’s extremely important that you stay engaged, and the way to stay engaged is to be conscious of the Arise action alerts. We hope you participate, we hope you contact your legislators, and we think it’s important that you meet with your legislators personally. It’s going to be a difficult session, but Arise is working, we think, for the betterment of the people of Alabama.

Arise 2025: How we’re working to build a better Alabama

By Alabama Arise

Alabama Arise believes in dignity, equity and justice for all. We believe in an Alabama where everyone’s voice is heard and everyone has the opportunity to reach their full potential. And we believe better public policies are the key to building a brighter future for our state.

Below, we’ll share some details of that vision with you before the Alabama Legislature’s regular session begins Feb. 4. We’ll focus on the crucial legislative priorities on our 2025 roadmap to change.

Graphic listing Alabama Arise's 2025 legislative priorities: Arise's roadmap to a better Alabama. The priorities are untaxing groceries, Medicaid expansion, voting rights, criminal justice reform, maternal and infant health, public transportation and death penalty reform.

It’s time to close Alabama’s health coverage gap

For more than a decade, Alabama has been outside looking in on a good deal. While hundreds of thousands of Alabamians continue to struggle without health insurance, state leaders have failed to expand Medicaid. A few loud voices have politicized an issue that never should have been political. And our state has paid the price in lost dollars, lost jobs and lost lives.

Alabama is one of 10 states that has yet to expand Medicaid. That inaction has left hundreds of thousands of Alabamians in a health coverage gap. We’re advocating to make this the year when our state closes that gap.

READ MORE – An Alabama solution: Closing the health coverage gap

Finish removing the state grocery tax

Alabama’s state sales tax on groceries is a cruel tax on survival, and Arise is committed to eliminating it. We were thrilled to see lawmakers pass legislation in 2023 to cut the state grocery tax in half after decades of persistent advocacy by our members. And we’ll continue advocating to remove the rest of the tax sustainably and responsibly. We’re grateful to serve on a state commission that is studying policy pathways to end the state grocery tax while protecting vital funding for public schools.

WATCH – The path forward in Alabama Arise’s work to untax groceries

Fund public transportation to improve life for all Alabamians

Alabama’s labor force participation rate is among the nation’s lowest. Only 58% of working-age adults reported they were actively working or looking for jobs as of November 2024. Our state also has nearly 100,000 more job openings than workers available to fill them. Yet 31% of Alabama job seekers cite transportation issues as the reason they are unemployed or underemployed, according to a study commissioned by the governor’s office.

Unfortunately, Alabama is one of only three states that has no state funding set aside to support public transportation. Alabama Arise will advocate for that to change during this legislative session.

READ MORE – Fund public transportation to improve life for all Alabamians

Expand voting rights to right past wrongs and safeguard democracy in Alabama

Voting rights are the foundation of our democracy, and we should do everything we can to protect them. However, since the U.S. Supreme Court stripped away federal preclearance of voting law changes in 2013, the Legislature has passed several harmful laws to create unnecessary barriers to voting rights in Alabama. This included 2024’s SB 1, which created a chilling effect for people trying in good faith to help Alabamians with absentee voting. Arise will advocate instead for positive steps to support voting rights, including passage of the Alabama Voting Rights Act, which would protect absentee voting and clarify voting procedures. Additionally, lawmakers will introduce bills to remove barriers to voting rights restoration for citizens released from incarceration.

READ MORE – Expand voting rights to right past wrongs and safeguard democracy in Alabama

It’s time for Alabama to prove we care about mothers and children

Healthy parents and healthy children mean a healthier future for Alabama. Comprehensive maternal and infant health care investments are crucial to ensure the health and safety of both infants and Alabamians of child-bearing age, especially postpartum mothers, pregnant women and future mothers. Lawmakers have numerous policy options to increase the number of health care providers and extend health coverage to more parents.

READ MORE – The Alabama Maternal Health Toolkit

School breakfast for all: What Alabama can do to help feed all of our kids

School breakfast for all would help reduce child hunger in Alabama, and it would go a long way toward the goal of guaranteeing a morning meal for every child in our state. School breakfast’s benefits are wide-ranging: It helps address chronic absenteeism, improves adolescent mental health, alleviates behavioral problems and improves test scores. Alabama Arise is pushing for a $16 million appropriation from the Education Trust Fund to ensure every district can pull down the maximum federal funding, and to give local schools the opportunity to offer no-cost breakfast for all Alabama children.

READ MORE – School breakfast for all: What Alabama can do to help feed all of our kids

Alabama’s death penalty practices remain unjust and unusually cruel

Americans increasingly oppose the death penalty. Gallup found that opposition to the death penalty more than doubled in the past 25 years. This may result from disturbingly high error rates in the system. For every 10 people executed since 1976, one innocent person on death row has been set free.

Alabama took an important step toward death penalty reform in 2017 by banning judicial overrides of juries’ sentencing decisions, and we will aim to work this session to make that ban retroactive. But the state’s death penalty scheme also remains broken in many other ways.

READ MORE – Alabama’s death penalty practices remain unjust and unusually cruel

Alabama’s parole system is still broken. How can we fix it?

The state’s parole system is a failure in both its design and in application of its own rules. We need to increase parole board oversight and eliminate racial disparities in parole. People also deserve to be able to attend their own parole hearings.

Arise’s suggested changes would be an important step in the direction of a more just Alabama, and they would mitigate some of the problems plaguing our state’s prison system overall.

READ MORE – Alabama’s parole system is still broken. How can we fix it?

Paid parental leave improves life for Alabama workers

Like any employer, our state should ensure its workers have jobs that support their ability to care for their families. The teachers, social workers and many other state employees who help look after our children and who build up Alabama for all the families in the state should be able to create and grow their own families without scrambling to pay the bills.

Paid parental leave is a common-sense policy that helps workers care for their families while maintaining their careers and financial well-being. State officials often have said Alabama is pro-family. Ensuring that teachers and state employees have paid parental leave is an important step to prove it.

READ MORE – Paid parental leave improves life for Alabama workers

School breakfast for all: What Alabama can do to help feed all of our kids

By Alabama Arise

By Carol Gundlach, senior policy analyst, and LaTrell Clifford Wood, hunger policy advocate | January 2025

Overview

Alabama can and should do more to equip our children and our schools for success. One big step would be to provide school breakfast for all our children. And our lawmakers can make major progress toward that goal this year with a modest allocation from the Education Trust Fund (ETF) budget.

Alabama Arise is recommending an ETF appropriation of $16 million to support public schools, including public charter schools, that wish to provide breakfast to all their students. 

From this amount, each of the 1,459 Alabama schools participating in the National School Lunch Program would be eligible to receive a $5,000 base grant to upgrade their food service capacities.

The remaining $8.7 million could be distributed to eligible schools to bring their breakfast service reimbursements to the maximum possible federal level.

The benefits of school breakfast

Children who start the day with breakfast learn better, participate more in class and are less likely to skip school than are kids who don’t get breakfast. But tight family budgets, busy mornings and before-daylight bus routes can mean many children arrive at school hungry. School districts across the country have found that breakfast for all children, served after the first bell, reduces hunger and helps kids learn.

It’s time for Alabama’s school districts to join their peers nationwide in feeding breakfast to all of our kids. Here are just a few of the benefits:

School breakfast reduces child hunger across our state. In Alabama, 23% of school-age children are food insecure, meaning they do not always have enough to eat or know when they will get their next meal. That rate is even higher among children of color. School breakfast could guarantee a morning meal for all Alabama children during the school day. School breakfast for all kids also allows schools to experiment with food delivery services like grab-and-go kiosks or breakfast in the classroom that increase participation and make sure kids are ready to start the day.

School breakfast reduces chronic absenteeism. Nearly 1 in 5 Alabama children have been chronically absent from school, and 53% of Alabama schools have high absenteeism rates. Research has shown that students who get breakfast at school have improved attendance and decreased tardiness, according to the Food Research and Action Center. 

School breakfast improves standardized testing and math scores. Alabama ranks 48th in average math ACT scores. Academic achievement improves, especially for math, when breakfast is available for school-age children.

School breakfast reduces behavioral problems. Child hunger contributes to impulsivity, hyperactivity, irritability, aggression, anxiety and substance abuse, according to the National Institutes of Health. Reducing hunger would reduce these behaviors.

How Alabama lawmakers can help feed children

The Alabama Legislature can help schools offer school breakfast for all children.  The Legislature can help feed Alabama’s schoolchildren by appropriating ETF dollars to match federal funds for school breakfast. Schools that choose to offer breakfast to all their children can use these matching funds to give all their students breakfast at the start of the school day. Thirty-five other states are considering similar legislation, and eight states have approved some form of school meals for every child.

How is school breakfast funded now? Many schools already provide breakfast for all children, but other schools need state help. Some Alabama schools offer breakfast to income-eligible children under the traditional federal School Breakfast Program, administered by the Alabama State Department of Education. 

Schools with a significant number of low-income children can receive the maximum federal reimbursement for all meals served. But some Alabama schools can’t make the federal reimbursement rate work for them without additional state or local dollars. And some Alabama schools would like to offer breakfast for all their children but don’t want to deal with federal regulations that might impact their Title 1 distribution to local schools.

Bottom line

Providing school breakfast at all public schools would be an important step to improve child nutrition and student success. An ETF budget appropriation of approximately $16 million would allow Alabama schools to be made whole if they can’t receive the maximum federal reimbursement for these meals. This support for school breakfast for all would help children grow, thrive and learn across Alabama.

‘It shouldn’t be like this’

By Whit Sides
Standing, posed photo of Florence Dutch
(Photo by Whit Sides)

Florence Dortch, 60, of Vredenburgh (Monroe County)

Florence has been uninsured for 22 years. Lately, she’s been receiving care from a rural health clinic in Monroeville, where she pays out of pocket for help with her arthritis, high blood pressure and monitoring her prediabetes. She has trouble affording her medications but is able to continue taking her prescriptions for now with help from her sister. 

“I make it work because I have to. I try not to think about how long I’ve been living like this, because it’s not great. It’ll get you down. I rely on a lot of help from the community, but it shouldn’t be like this, because I’m not the only one.”

Florence has a few more years until she’s eligible for Medicare. Because she works, she doesn’t meet Alabama’s stringent income eligibility requirements for Medicaid.

“If working people could get the coverage they deserve, we wouldn’t even be where we are now. Here in the Black Belt, or anywhere else.”

‘I just want to go to the doctor’

By Whit Sides

Standing, posed photo of Kiana George

Kiana George, 29, of Camden

“I felt like with Medicaid, I got the best care I’ve ever had, and I could afford the copays. I didn’t have to worry about racking up debt just for going to the doctor.”

Kiana is a child care provider working in Camden. She recently lost Medicaid coverage during the state’s “unwinding” period after learning she was “earning too much” at the day care center, leaving her in Alabama’s health coverage gap.

After she sought urgent care for polycystic ovarian syndrome, out-of-pocket bills for diagnostic labs and imaging left her with thousands of dollars in medical debt.

“I get these bills in the mail, and it’s so much stress. I don’t like owing people money. So I just don’t get help even when I’m in pain.”

Kiana visits free clinics offered at local health fairs but says the care is limited. She’s worried about needing care when she’s not close to home, or facing another medical emergency and collecting even more medical debt.

“I really wish Alabama would expand Medicaid. I just want to go to the doctor. I feel like without coverage, by the time I do get to the doctor, it is too late, and everything is way out of hand.”

‘Coverage needs to be affordable for everyone’

By Whit Sides
A standing, posed photo of Valerie Cochran.
(Photo by Whit Sides)

Valerie Cochran, 61, of Camden

“We’re all gonna get sick. That’s life. But coverage needs to be affordable for everyone.”

Valerie is disabled, living without health coverage in rural Wilcox County. After 30 surgeries, she’s got thousands of dollars in medical debt.

During a routine colonoscopy, doctors removed a tumor in Valerie’s stomach. After receiving the hospital bill, she became so worried about the cost of follow-up care at the cancer center that she chose to delay treatment. Valerie hopes to get Medicare coverage through SSDI after she turns 62 later this year. Until then, her options are limited.

“Medicaid expansion would make a world of difference for me, and other people like me. With my issues, I should be taking care of my health, not living in fear of how much it’s going to cost to take care of myself.”