Issue: Medicaid Expansion

Medicaid Expansion Advocacy Day – Feb. 25, 2025

By Alabama Arise

Alabama Arise and Cover Alabama joined with the American Cancer Society Cancer Action Network to host a Medicaid Expansion Advocacy Day on Feb. 25 in Montgomery. Nearly 100 passionate supporters came to the State House to speak out in defense of Medicaid and the urgent need to close Alabama’s health coverage gap.

As federal threats to Medicaid persist, advocates stressed that expansion is essential both to cover more people and to protect against harmful cuts. Many described the devastation of losing Medicaid coverage and falling into the gap – earning too much to qualify for traditional Medicaid but too little to receive tax credits for private coverage.

Camden resident Kiana George and Birmingham resident Angelica McCain told their personal stories of how the coverage gap has affected their lives. Their testimonies, as well as those from faith leaders, business owners and others, highlighted the urgent need for expansion to ensure everyone has access to care. Thank you to everyone who showed up, spoke out and made a difference. Your voices matter, and we are making progress together.

Transcript:

[Voiceover] Alabama Arise and Cover Alabama joined with the American Cancer Society Cancer Action Network to host a Medicaid expansion advocacy day on Tuesday, February 25, in Montgomery. Nearly 100 passionate supporters came to the State House to speak out in defense of Medicaid and the urgent need to close Alabama’s health coverage gap. Several people spoke about the devastating experience of losing Medicaid coverage and falling into the gap — earning too much to qualify for Medicaid but too little to receive federal tax credits to help pay for health coverage. Their testimonies underscored the urgent need for Alabama to expand Medicaid so everyone can get the health care they need to survive and thrive.

[Debbie Smith] I’m here with many advocates from across the state to ask the Legislature and Gov. Ivey to close the coverage gap and expand Medicaid. Right now, around 200,000 of our friends, neighbors and family members are caught in the Medicaid coverage gap. They work hard — taking care of our children, serving our food, stocking our grocery store shelves — but they can’t afford to see a doctor when they’re sick. And when they can’t get the care they need, it doesn’t just hurt them, it hurts all of us. When people don’t have health coverage, they aren’t able to see a doctor for regular checkups or early treatment. That means preventable conditions turn into expensive emergencies.

[Kiana George] Hello, I’m Kiana George from Camden, Alabama, or as they call it, Wilcox County. My story is pretty simple. I lost coverage back in September 2023 when they did the whole [unwinding], and then I’ve been basically fighting for my life ever since. I’ve always had blood pressure issues since around 2015-2016. I called Medicaid, and they told me because I made more than $295 a month, that I didn’t qualify. And then I called the Marketplace, and I don’t make enough money to get an insurance plan. So what am I supposed to do? I started getting bills in the mail, and that discouraged me from going to the doctor because if I’m already in debt, I can’t pay you. If I don’t have the money for insurance, I don’t have the money to pay you for not having insurance. I stopped taking my medicine last year because it was making me sick, but I was too scared to go back to the doctor to get it changed because I thought they were going to make me pay for it. And after that — not a good idea. Because guess who ended up a month after turning 30, in ICU in the hospital with stroke-level blood pressure. I did. As a matter of fact, while Jackson was boycotting outside, I was inside the hospital. In ICU.

And didn’t even know it. I would really, really appreciate all the lawmakers, all the legislators, the governor… anybody. I have a 9-year-old. I want to see my baby grow up. If I don’t have coverage, I’m not going to be able to live. Thank y’all.

[Angelica McCain] I’m Angelica. I came down here from Birmingham. My story starts at birth. I was on Medicaid as a baby. When my parents first moved here, my mom worked three jobs while my dad didn’t work at all. Medicaid was the only way we survived as children. Fast forward 18 years, 19, I get dropped. I start working in the service industry. If you’re familiar with the service industry, they are not legally required to offer health insurance to anyone, so if you make your career in the service industry, you’re not going to get health insurance unless you pay an arm and a leg for it. So, ultimately, I resulted in having to get Medicaid for my daughters as they were born. Medicaid would only cover me while I was pregnant, and that was it. They cover my children now. It’s confusing for me about why they will cover my children to be born but they will not cover me to continue to be healthy, to be alive for them. On top of that, my 9-year-old was diagnosed with a soccer-ball-sized tumor last summer in her right ovary. And thankfully for Medicaid, I didn’t have to pay $200,000 for her to have her surgery. That was a really difficult time, and then also having to fight for that coverage for my children to live… It just doesn’t seem humane in a lot of ways. And a lot of people are having to fight just to provide for their children. We shouldn’t have to fight this hard for it. We’re just hoping Alabama can cover the Medicaid gap and help everybody actually just be able to exist healthily.

[David Silverstein] I’m a businessman from Birmingham. Why am I here? For two reasons. One, because I believe we can do better as a state. I’d love for my children and my children’s children to stay in the state and make it a better place to live, and work, and raise a family. But think of this: If we expanded Medicaid, it would have close to a $2 billion positive economic impact on this state. Think about that. Our rural hospitals would have a chance to survive.

[Smith] Alabama is losing billions of dollars that could have been invested in our health care system. It’s time to stop pointing fingers and start leading. The time for excuses is over. The time for action is now. Let’s expand Medicaid. Let’s save lives. Let’s cover Alabama.

Vote ‘No’ on SB 84 and HB 477: Junk health plans are not the solution for Alabama’s health coverage gap

By Alabama Arise

Junk health plans lack basic consumer protections.

  • SB 84 and HB 477 would allow a “nonprofit agricultural organization” to offer unregulated health plans to its members in Alabama. The bill explicitly says these benefits would “not [be] provided through an insurance policy.”
  • Unlike health insurance sold by other carriers, plans like the ones offered under SB 84 and HB 477 could deny someone health coverage based on previous medical history. If people with preexisting conditions are accepted, they could be charged a higher premium and/or not have coverage for care related to their preexisting conditions.
  • These new plans could put caps on key benefits, and they would not have to limit annual and lifetime out-of-pocket costs for consumers. This could leave patients with massive medical bills or force them to forgo needed treatment.

Junk health plans lack financial oversight.

  • Plans under SB 84 and HB 477 would lack the financial requirements that Marketplace insurance has.
  • The plans could charge whatever prices they want without regulatory oversight, and they would not have to spend a minimum share of the money they collect on medical care.

Junk health plans are not a solution for closing Alabama’s health coverage gap.

  • Alabamians deserve health coverage that delivers stable, high-quality insurance they can afford to use when illness strikes. This coverage should include a full set of benefits to protect people when they become sick, and it should be available regardless of one’s medical history to prevent discrimination.
  • Good health coverage should be properly regulated to ensure that customers’ financial and medical interests are protected.
  • The plans offered under SB 84 and HB 477 would not ensure affordable or adequate health coverage for the nearly 200,000 Alabamians in our state’s coverage gap. Lawmakers should focus instead on boosting our state’s workforce by expanding Medicaid coverage to ensure every Alabamian can get the health care they need to survive and thrive.

Updated March 25, 2025, to add references to HB 477.

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

‘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.”

Las prioridades legislativas de Alabama Arise para 2025

By Alabama Arise

Más de 150 grupos miembros de Alabama Arise y más de 1,500 miembros individuales eligen todos los años nuestras prioridades legislativas. Este proceso garantiza que los habitantes de Alabama más afectados por la pobreza participen de las decisiones. A continuación se enumeran las prioridades que nuestros miembros eligieron para 2025.

Para obtener una versión de este documento en PDF, haga clic aquí o en el botón de “Descargar” (Download) arriba.

Reforma impositiva – Un sistema impositivo más equitativo puede ayudar a la gente con problemas a llegar a fin de mes. Alabama debería quitar el impuesto a los alimentos y asegurar financiación justa y sostenible para servicios esenciales. 

Presupuestos estatales adecuados – Los servicios públicos fuertes amplían las oportunidades para todos. Alabama debe ampliar Medicaid y proteger los fondos para las escuelas públicas. También debe reducir el hambre y las dificultades respaldando el desayuno gratuito universal en las escuelas públicas.

Derecho al voto – Todos merecen su voz en nuestra democracia. Alabama debe aprobar el voto temprano sin excusas y eliminar barreras para la restauración del derecho al voto para quienes no lo tienen. 

Reforma de justicia penal – Nuestro sistema de justicia debe asegurar la justicia y la equidad para todos. Alabama debe mejorar el sistema de libertad condicional, reformar las leyes de sentencias punitivas y reducir la dependencia de multas y tarifas como fuente de ingresos. 

Atención médica maternoinfantil – La salud y seguridad de las familias es de suma importancia. Alabama debe mejorar el acceso a atención médica de alta calidad, asegurar que no se criminalice la atención vital durante el embarazo y extender la licencia prenatal para empleados y maestros en el estado.

Transporte público – La conexión comunitaria es esencial. Alabama debe financiar el Fondo Fiduciario de Transporte Público para que todos puedan llegar al trabajo, la escuela, la atención médica y más.

Reforma de pena de muerte – Todos en Alabama merecen la misma justicia según la ley. Un paso clave en esta dirección sería aplicar la prohibición de Alabama de anulación judicial de veredictos de jurado de manera retroactiva, para aplicarla a personas sentenciadas bajo esta política, ahora ilegal.

Alabama Arise 2025 legislative priorities

By Alabama Arise

More than 150 Alabama Arise member groups and more than 1,500 individual members choose our legislative priorities each year. This process ensures that Alabamians most impacted by poverty have a seat at the table. Below are the priorities that our members selected for 2025.

For a PDF version of this document, click here or click the “Download” button above.

Image of a flyer listing Alabama Arise's 2025 legislative priorities: Our policy roadmap to a better, more equitable Alabama. The priorities are tax reform, adequate state budgets, voting rights, criminal justice reform, maternal and infant health care, public transportation and death penalty reform.

Tax reform – A more equitable tax system can help struggling people make ends meet. Alabama should untax groceries and ensure fair, sustainable funding for vital services.

Adequate state budgets – Strong public services broaden opportunity for all. Alabama must expand Medicaid and protect funding for public schools. Our state also should reduce hunger and hardship by supporting universal free breakfast in public schools.

Voting rights – Everyone deserves a say in our democracy. Alabama should pass no-excuse early voting and lift barriers to voting rights restoration for disenfranchised people.

Criminal justice reform – Our justice system must ensure fairness and justice for all. Alabama should improve its parole system, reform punitive sentencing laws and reduce reliance on fines and fees as a revenue source.

Maternal and infant health – The health and safety of families is paramount. Alabama should improve access to high-quality health care, ensure life-saving pregnancy care is not criminalized and extend paid parental leave for state employees and teachers.

Public transportation – Community connection is vital. Alabama should fund the Public Transportation Trust Fund so everyone can get to work, school, medical care and more.

Death penalty reform – All Alabamians deserve equal justice under the law. A key step in this direction would be to apply Alabama’s ban on judicial overrides of jury sentencing verdicts retroactively to people sentenced under this now-illegal policy.

From a childhood in the cancer ward to a lifetime in Alabama’s coverage gap

By Whit Sides

Lary Brooks is a fighter. 

At just 2 1/2 years old, he was diagnosed with acute lymphocytic leukemia, a bone and blood cancer that nearly took his life. Lary survived thanks to the life-saving treatment he received at St. Jude Children’s Research Hospital in Memphis, Tenn.

“I was a week from dying when they found it,” Lary recalled about his childhood cancer diagnosis. “From 1979 to 1982, I was under treatment — 1,800 units of chemo and radiation.”

Those intense treatments took a severe toll on his body that affected nearly every aspect of his life, even as an adult.

“I’ve had my L4, L5 vertebrae blown out because of so many spinal taps,” he said. Doctors used the painful procedure to monitor his progress throughout childhood.

Lary’s courage in the face of pain earned him the name “OK Kid.” When the doctors at St. Jude asked him how he felt during these intense procedures, he always responded, “I’m OK.”

But from the time he was young, Lary said, he felt like he hadn’t been able to live life to its fullest.

“At one time, I had my left arm in a full cast and my right arm in a half cast,” he said. “I stepped into a hole while playing with my sister and ended up breaking my wrist.”

Front-facing photo of white male with a shirt with a Batman logo.
Lary Brooks of New Hope, Ala., has dealt with health issues stemming from childhood cancer for his entire life. (Photo courtesy of Lary Brooks)

Today, at age 47, Lary lives with his family in New Hope, a small town southeast of Huntsville. He suffers from osteopenia and scoliosis. The lingering effects of his childhood cancer caused a loss of spine density and chronic pain that often leaves him unable to work.

‘I’m ready to go back to work now’

Over the years, Lary has found jobs in construction, as a waiter and as an automotive tech. But each job ended when he was injured or needed care.

Most recently, Lary suffered a fall that required major facial surgery to reconstruct his jaw. The surgery left him with more medical debt and yet another battle to get the care he desperately needed.

Originally, doctors told him he’d be recovering for six to eight weeks. But now it’s looking more like Lary won’t be able to work for six months.

“I’m ready to go back to work now, but I’ve got to get released from the doctors,” Lary said, anxious to return to his life. 

Yet with no health insurance, he can only access emergency care. That means he can’t see the specialists he needs to manage his everyday issues — or the crippling pain that comes from them.

Without access to the prescriptions he needs, Lary is left with few pain management options. They provide little to no relief.

“I don’t have insurance, so I can’t treat my problems as they come up, and everything just deteriorates,” he said. “The only thing I’m able to do … is over-the-counter pain medication, but it doesn’t work.”

Alabama’s failure to expand Medicaid to cover adults with low incomes has left nearly 200,000 residents like Lary in the health coverage gap, unable to afford private insurance but not eligible for Medicaid. Our state is one of only 10 yet to accept federal funds that would offer coverage to folks like Lary.

Without Medicaid expansion, Lary must either rely on expensive emergency room visits for temporary relief or continue to endure debilitating pain every day. As he recovers at home from his most recent surgery, he’s left with few options.

A life in pain

“I walk around with a pain level of 10, 24/7, seven days a week,” Lary said. “The only thing I can think about or stay focused on is my body pain because it’s like my brain will not allow me to focus on anything else.”

Lary said his pain is compounded by the limitations placed on health care providers due to the opioid crisis.

“I ask the doctors if there’s any way that I can get help to where I can still stay at work on a full-time basis,” he said. “But with the opiate crisis, they won’t prescribe chronic pain medication without me being established in a pain clinic. So I’m reduced to going down to part-time at work but struggling with my pain all the time.”

Lary’s mother, Brenda Brooks, said finding payment assistance through local hospitals for Lary’s care has become a part-time job itself. She often digs through past tax returns, prints out the past few months of bank statements and tracks down medical records from different doctors.

Brenda said that even with his extensive medical history, Lary has been denied for disability benefits many times. And it hasn’t been for a lack of his mother trying.

“Last time, the disability doctor told us Lary is able to work, as something like a truck driver? He’s not supposed to lift over 25 pounds. Tell me how that works,” Brenda asked.

A photo with film quality from the 1980's in which a mother is holding her son.
Brenda Brooks holds her son Lary in spring 1980. The picture was taken about six months after Lary was diagnosed with leukemia. (Photo courtesy of Brenda Brooks)

‘I just wait until I can’t stand it anymore’

So for now, Lary keeps trying to find work while not being able to afford coverage or consistent care. He said he manages by spacing out care, or sometimes avoiding it altogether.

“It’s mainly just choosing the right time to go to the doctor,” he said. “I mean, with my pain and everything, and me being a diabetic, I’m usually having to wait probably six months in order to go.”

Ideally, Lary should be able to go to the doctor monthly. But living in the coverage gap forces him to make tough decisions about whether to seek care when he needs it.

“I spread it out and then choose what pain level I’m in before I either go to the ER or I just wait until I can’t stand it anymore,” Lary said.

It’s a piecemeal plan for pain management caused by living in the coverage gap. When things do become unbearable, his mother said, it’s never without a cost.

“We still owe UAB Hospital for surgery, like $11,000,” Brenda said. “That’s not including the doctor visits. That’s just the surgery and the hospital time.”

On top of that, Lary said his debt at Huntsville Hospital, the closest to his home, is nearly $30,000.

A mother turned warrior

Lary said his mother has been his greatest advocate. A substitute teacher, she has taken up the fight to get her son the care he needs.

“I’ve called everyone — local lawmakers, even Gov. Kay Ivey,” Brenda said. “I’ll do whatever it takes to get him the care he deserves.”

Finally, she reached out to Cover Alabama to share her family’s story.

“I want everyone to understand that people in the gap like Lary just need fair coverage. They aren’t looking for a handout. He pays taxes, so I don’t think it should even be looked at that way,” Brenda said.

A tall man with arms crossed stands next to a woman who is a couple feet shorter.
Lary and Brenda Brooks pose inside their home in New Hope, Ala., in October 2024. (Photo by Whit Sides)

Medicaid expansion could help Lary access the specialists he needs without relying on the emergency room for short-term fixes.

“If I could get in to see a good doctor and stay with them, I’d be able to live a normal life,” he said.

For now, Lary’s lack of health coverage affects his freedom and autonomy as an adult, including his relationships.

For Lary, the effects of living without insurance extend beyond his physical health. He recently had to ask his uncle for $3,000 to pay for treatment. He said it was a tough blow mentally.

And romantically, he finds it difficult to find partners or companionship because he feels like “there’s always a catch.”

“I’ve met lots of women, but when I told them exactly what my story was, most of them decided to walk out because they thought it was too much trouble,” he said. “That’s why I’m 47 and still single.”

Hope for a better Alabama

Lary remains hopeful and tries to keep a positive outlook. But he said it’s important to be honest about the isolation he goes through daily.

“It messes with your confidence a little bit,” he said. “I want to be a productive member of society. I don’t want to feel like a burden.”

Medicaid expansion would help Lary live a more fulfilling life, free from the constant worry of mounting medical debt and inadequate care. It would give him and thousands of other Alabamians the chance to work rather than being sidelined by a lack of support.

“You’ve got all these people in this state alone living in the gap,” Lary said. “Imagine how many more in other states like Texas. If we can’t work, our state doesn’t get the tax money.”

For Lary, this is more than a political issue — it’s a matter of survival. As he continues to fight for his health, he holds on to the hope that the system will change one day. In the meantime, Brenda will keep advocating for her son, hoping her calls to lawmakers won’t fall on deaf ears.

“I’ve sent out so many emails and only ever got one response,” Brenda said. “They are supposed to represent people in their area, especially those who need the help. And they’re supposed to push to get what their constituents need, like expanding Medicaid.”

A man hugs a woman.
Lary and Brenda Brooks embrace inside their home in New Hope, Ala., in October 2024. (Photo by Whit Sides)

‘The honest way’

Lary said caring for him as a child and not being able to “fix it” was a traumatic experience for his family. He said that’s his constant motivation now: wanting to fix anything he can for others.

Even while recovering from surgery, Lary still finds time to help others. He’s a member of St. Jude’s alumni program, which allows cancer survivors like him to work with doctors to develop new treatments for kids living with bone cancers similar to the one he fought.

“I’m trying to do things the honest way,” Lary said. “I just wish there were systems to help me keep doing that.”

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.