Issue: Medicaid Expansion

Cover Alabama Coalition: Medicaid expansion is essential to state’s recovery

By Chris Sanders

A nonpartisan alliance of more than 60 Alabama organizations has come together to urge Gov. Kay Ivey to say yes to Medicaid expansion. The Cover Alabama Coalition, which launched Wednesday, is calling on Ivey to close the health coverage gap for workers who don’t have employer-based insurance and can’t afford to purchase insurance on their own. Alabama Arise is a founding member of the coalition.

Cover Alabama logo

Cover Alabama is a coalition of advocacy groups, businesses, community organizations, consumer groups, health care providers and religious congregations from across the state. (You can read the full membership list here.) The coalition held a virtual news conference Wednesday to highlight the critical role that Medicaid expansion can play in ensuring access to health care, protecting families against bankruptcy and stabilizing rural hospitals – both during the COVID-19 pandemic and the economic recovery.

“This pandemic only heightens the need for bold, comprehensive action,” said Evey Owen, interim coalition director for Cover Alabama. “The health and economic costs of COVID-19 will be high no matter what. Alabama must maximize the value of every state dollar we spend to protect public health. And the best way to do that is to leverage the 90% federal match for Medicaid expansion.”

The need to expand Medicaid here and now

So far, 36 states – including Arkansas, Kentucky and Louisiana – have expanded Medicaid to cover adults with low incomes. Alabama is one of just 14 states that have not done so. Medicaid expansion would benefit hundreds of thousands of Alabamians who are uninsured or struggling to pay for health coverage. Many of these uninsured people are “front-line workers” at grocery stores, hospitals, pharmacies and other essential businesses during the COVID-19 pandemic.

“It’s great to applaud the brave Alabamians who are keeping food on our tables and keeping hospitals clean during the crisis, but it would be even better to make sure they can get health coverage,” Owen said. “These are the workers most likely to be uninsured, and we should do everything we can to keep them safe and healthy.”

Speakers at Cover Alabama’s news conference Wednesday pointed out that Medicaid expansion would:

  • Help uninsured Alabamians avoid risks of delayed care, like unchecked COVID-19 transmission, poor health outcomes and overwhelming medical debt.
  • Relieve rural health care providers from financial strain, preventing further hospital closures.
  • Bring billions of federal dollars into local and state economies as they struggle to recover from revenue losses of historic proportions.

To elevate and amplify the public conversation about Medicaid expansion at this critical time, Cover Alabama plans to share stories of Alabamians caught in the coverage gap, news about expansion’s impact in other states and an opportunity for more groups to join the campaign.

COVID-19: 7 policy changes that would help protect Alabamians

By Robyn Hyden

The World Health Organization has labeled COVID-19 a global pandemic. And state officials announced the first confirmed case of the disease in Alabama on Friday. As the virus strains our health systems, schools and economy, we must ensure the most vulnerable Alabamians have the medical care, social supports and other protections they need to weather the crisis.

The Alabama Legislature will be on spring break for the next two weeks. We hope our state lawmakers and members of Congress will take time to examine the situation developing in their communities. And we hope they will act quickly and courageously to address these critical public health needs.

Here are seven actions that policymakers should take now to protect the well-being and security of all Alabamians:

1. Gov. Kay Ivey should expand Medicaid.

Medicaid expansion would extend health coverage to more than 223,000 uninsured Alabamians with low incomes. It also would ensure coverage for another 120,000 who struggle to afford the insurance they have.

Expansion would take several months to implement, but it would prepare us for the big challenges ahead. In the short term, Medicaid could take numerous other steps to protect families. Examples include streamlining enrollment, covering new mothers for one year after delivery and increasing our “bare-bones” income limit for parents.

Email Gov. Ivey to ask her to expand Medicaid and help address the coronavirus threat. Or if you’d prefer to reach out by phone, click here to call Gov. Ivey’s office.

2. Lawmakers should increase funding for public health to ensure adequate testing, preparation and prevention.

In addition, state and local agencies should take the lead on proactive policies and procedures to protect those who are most vulnerable to this virus. Read State Health Officer Scott Harris’ report to the Senate Health Committee.

3. Congress should authorize emergency food assistance increases.

Boosting the Supplemental Nutrition Assistance Program (SNAP) would help children get the food they need while they’re out of school. It also would promote food security for seniors, people who lose their jobs and other people at risk of hunger. Read additional recommendations to address critical food security issues from our partners at the Food Research and Action Center.

4. Policymakers should remove barriers to social support services.

Medicaid, SNAP, WIC and Temporary Assistance for Needy Families (TANF) save and improve lives. Red-tape barriers to these services make it harder for struggling families to get the help they need during a crisis. Read Arise’s fact sheet to learn why state lawmakers should abandon efforts to reduce access to safety net programs.

5. State lawmakers should remove the state sales tax on groceries while protecting education funding.

As many people prepare for social distancing by purchasing enough food to last for several weeks, the grocery tax imposes the highest tax burden on the people who can least afford it. It’s yet another illustration of why this cruel tax must end. Click here to urge state legislators to untax groceries and replace the revenue by supporting SB 144.

6. Policymakers should look at options to extend paid medical and family leave to every worker.

States including Washington and Massachusetts have created affordable buy-in plans so that even smaller employers can provide extended medical or family leave. Read how paid family and medical leave was made affordable and available to every worker in the state of Washington. Then read more about federal discussions to provide short-term relief for paid leave.

7. Alabama should expand unemployment protections to mitigate the effects of job losses for individuals and communities.

Closures and layoffs in the coming months will leave many workers without essential income. Public officials must act now to reduce the financial toll on people who struggle to make ends meet. Read recommendations from the National Employment Law Project (NELP) about potential improvements to unemployment insurance coverage.

Looking ahead

The conversation about the best policy and social responses will continue to evolve over the coming days and weeks. And additional needs and solutions are likely to emerge. Throughout this crisis and beyond, Arise will continue to speak out for dignity, equity and justice for all Alabamians.

Arise legislative recap: March 13, 2020

By Matt Okarmus

We’re excited to introduce you this week to Sherrel Wheeler Stewart, Arise’s new story collection coordinator. In this video, Sherrel talks about her new position and explains how you can help her tell the stories of uninsured and underinsured Alabamians who live in the Medicaid coverage gap.

If you’d like to share your story with Sherrel, email her at sherrel@alarise.org or use this brief online form.

Arise legislative recap: March 6, 2020

By Matt Okarmus

Arise’s Jim Carnes discusses how the coronavirus outbreak and the closure of Pickens County Medical Center showcase Alabama’s need for Medicaid expansion. Also, in the wake of the recent execution of Nathaniel Woods, Jim talks about HB 359, which would forbid the death penalty in capital cases where the jury does not agree unanimously to impose it.

Alabama needs to expand Medicaid NOW!

By Alabama Arise

Medicaid is a health lifeline for one in four Alabamians and an economic engine for communities across our state. Extending Medicaid coverage to adults with low incomes would make life better for Alabamians of all races, genders and incomes.

Medicaid expansion would ensure coverage for 340,000 Alabamians, including:

  • People who work low-wage jobs and can’t afford private coverage
  • Workers who are between jobs
  • Adults who are caring for children or older family members at home
  • People who have disabilities and are awaiting SSI determinations
  • Adult college students
  • Uninsured veterans

Medicaid expansion would help more Alabamians have:

  • Regular primary care and preventive checkups
  • Earlier detection and treatment of serious health problems
  • Regular OB/GYN visits without referral
  • Less dependence on costly emergency care
  • Better health and greater financial peace of mind

Medicaid expansion would bring our federal tax dollars home to support:

  • Healthier families, workers and communities
  • Stronger rural hospitals and clinics
  • Stronger community mental health and substance use disorder services
  • A needed boost in jobs and revenue for state and local economies

Bottom line

Medicaid expansion is the single biggest step we can take to move Alabama forward. It’s time to invest in a healthier future for our state and our people. It’s time to #CoverAlabama.

Arise 2020: Our vision for a better Alabama

By Alabama Arise

Alabama Arise members have worked for more than three decades to build a brighter, more inclusive future for our state. And as the Legislature’s 2020 regular session starts Tuesday, we’re proud to renew that commitment.

Below, Arise executive director Robyn Hyden highlights some key goals for the session, including Medicaid expansion and untaxing groceries.

How you can make a difference

Together, we can turn our shared vision for a better Alabama into a reality. Here are three ways you can help:

(1) Become an Arise individual member. Numbers matter. The more members we have, the louder our voice for change is at the State House. If you’re not yet an Arise member, click here to become one today. If you’re already a member, please ask your friends and neighbors to join us as well!

(2) Talk to your legislators. Make sure your lawmakers know where you stand on our issues. Click here to sign up for our action alerts. And if you can, come meet your lawmakers in person at Arise’s annual Legislative Day on Feb. 25 in Montgomery. Click here to pre-register before Feb. 14.

(3) Spread the word about our issue priorities. The more people learn about our movement, the more support we gain. Read more about our 2020 issue priorities and share this information with your friends:

Together, we can make Alabama a place where everyone’s voice is heard and everyone has the opportunity to reach their full potential. Together, we can build a better Alabama!

Arise 2020: Expand Medicaid to save lives and make Alabama healthier

By Jim Carnes

Happy anniversary – not! 2020 marks the 10th year of Medicaid expansion under the Affordable Care Act, but not in Alabama. We’re one of just 14 states that have rejected federal funding to extend affordable health coverage to adults with low incomes. And soon, Kansas may cut that number to 13.

The stakes have only gotten higher as time has passed. Over the last 10 years, Alabama has:

  • Seen 13 hospital closures, including seven rural ones.
  • Given up more than $1 billion a year in federal Medicaid funding.
  • Forfeited a similar amount in related economic activity.
  • Allowed thousands of preventable deaths.
  • Stranded more than 220,000 Alabamians in the coverage gap, unable to qualify for Medicaid or afford private coverage.
  • Left tens of thousands more struggling to pay for health insurance they can barely afford.

After a decade of missed opportunity, Alabama needs to invest in our people and our future. Uninsured working parents, caregivers, veterans, people awaiting disability determinations, adult students and other Alabamians with low wages are putting off needed health care. Nearly 90% of our rural hospitals are operating in the red. People and communities across our state are suffering unnecessarily, and it’s time to do something about it.

What will it take to move Alabama forward? 

This can and should be the year for Medicaid expansion in Alabama. It’s an overdue move that would bring our federal tax dollars home to stabilize our rural hospitals and clinics. It would provide critical investment in local economies. And it would increase economic security for struggling Alabamians.

Success would not require passing a bill. Gov. Kay Ivey could simply request a Medicaid rule change raising the eligibility limit for adults, including those without children. A legislative panel that reviews rule changes could allow Medicaid to seek permission from Washington. If that gets the OK, Medicaid would simply factor expansion costs into its next annual budget.

Arise members have identified Medicaid expansion as a top priority. It’s the single biggest step Alabama could take to make life better for people with low incomes. And we’re working hard to make it happen.

We need you with us as we work to make Medicaid expansion a reality in our state. Please join Alabama Arise or renew your membership today to add your voice to our chorus for change. Together, we can build a better Alabama!

Why Medicaid expansion is a must for prison reform in Alabama

By Jim Carnes

Against a backdrop of human tragedy, Gov. Kay Ivey’s Study Group on Criminal Justice Policy is working toward a January deadline for its recommendations to the Legislature. The U.S. Department of Justice in April issued a sobering overview of the Alabama corrections system’s numerous shortcomings. And the Montgomery Advertiser shed further light on the situation in November, publishing horrific accounts of life inside state prisons.

It’s no secret that Alabama’s prisons are overcrowded, violent and inhumane. Any meaningful solution to this crisis must address two major challenges. First, it must alleviate the abysmal conditions inside Alabama’s prisons. Second, it must help people who are at risk of incarceration or re-incarceration become productive members of their communities. (See the key policy recommendations from Alabamians for Fair Justice below.)

Dena Dickerson, executive director of the Offender Alumni Association, speaks during an Oct. 3 news conference at the State House in Montgomery. Dickerson was one of dozens of supporters of Alabamians for Fair Justice (AFJ) who assembled to show support for reforms to make Alabama’s corrections system more humane and restorative. Alabama Arise is a member of the AFJ coalition.

The missing voices who need to be heard

Alabama Arise has been following the study group’s learning curve on a broad array of criminal justice issues. In four public meetings since July, members have received a flood of statistics from prison administrators, sentencing specialists, law enforcement officers, prosecutors, judges, mental health officials and other experts. They also have toured multiple correctional facilities, becoming eyewitnesses to the shameful conditions they’re charged with improving.

Largely missing from this crash course: the voices of the people Alabama’s criminal justice system affects most. The panel should fill that gap by inviting testimony from inmates’ family members and formerly incarcerated individuals. Many of them have attended the public study group meetings, and the formal recommendations should reflect their lived experiences.

Policy solutions should ease reentry, reduce recidivism

Of the roughly 21,000 people in Alabama’s prisons in a given year, 95% eventually reenter society, according to the Alabama Department of Corrections (DOC). Of those, about 29% wind up back in prison within three years.

Breaking the cycle of recidivism is a challenge that reaches beyond DOC, or even criminal justice policy. It also requires community partnerships to serve people with untreated mental health and addiction problems. These challenges can undermine successful reentry and often contribute to incarceration in the first place.

By targeting recidivism, the study group is highlighting our state’s overburdened community mental health and substance use services network. Medicaid expansion, at a 90% federal match, would allow Alabama to expand these services tenfold for the same state investment. The study group should urge our state to take this essential step forward.

The study group’s measured, highly visible approach to its complicated challenge is not one it can easily shrug off. The panel has set a high bar for meaningful recommendations, and Arise expects them to meet it. Arise and our partners in the Alabamians for Fair Justice alliance will keep up the pressure for comprehensive, lasting reform.

The path to a better corrections system

Alabama’s corrections system must become more humane and restorative. Alabama Arise and our allies in the Alabamians for Fair Justice coalition have proposed numerous changes to put our state on a path toward dignity, equity and justice for all. Here are a few of these recommendations:

  • Expand state investments in mental health care and treatment for substance use disorders.
  • Increase state support for mental health courts, pretrial diversion and reentry programs.
  • Reduce court costs and give people a reasonable amount of time to begin paying fines and restitution after returning from prison.
  • End automatic suspensions of driver’s licenses in cases unrelated to traffic safety.
  • Apply the state’s presumptive sentencing guidelines retroactively.

Visit alabamafairjustice.org/resources to read the coalition’s full list of policy solutions on prison reform in Alabama.

Expand Medicaid to shore up children’s health coverage in Alabama

By Jim Carnes

Children’s health coverage has long been a point of pride for Alabama, and we can’t afford to backslide. But Alabama’s rate of uninsured children has moved in the wrong direction since 2016, according to a recent report from Georgetown University’s Center for Children and Families (CCF).

Our state’s uninsured rate for children (3.5%) remained one of the best in the South in 2018. After years of improvement, though, Alabama’s number of uninsured children ticked up from 32,000 in 2016 to 41,000 in 2018.

That’s a warning sign that our policymakers should heed. Alabama must protect the coverage gains we’ve made through ALL Kids. And we should build on those gains by expanding Medicaid to cover adults with low incomes.

When parents have health insurance, their children are more likely to have coverage as well. Medicaid expansion would boost health security for struggling families across Alabama. That would be good for children, good for communities and good for our entire state.

Check out our news release for more on the Georgetown CCF report. Then urge Gov. Kay Ivey to expand Medicaid so all Alabamians can get the care they need to survive and thrive.