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Alabama Dems renew call for Medicaid expansion amid federal cash infusion from stimulus bill

MONTGOMERY — A bicameral group of Democrats in the Alabama Legislature has renewed calls for the state to expand the number of citizens it covers via Medicaid, arguing a financial incentive in the federal government’s recent stimulus bill will ease the financial burden of the much-debated proposal.

Senator Linda Coleman-Madison (D-Birmingham) hosted a press conference urging expansion on Tuesday in the Alabama State House. She was joined by Senate Minority Leader Bobby Singleton (D-Greensboro), Senators Billy Beasley (D-Clayton) and Rodger Smitherman (D-Birmingham), and Representatives Adline Clarke (D-Mobile) and Mary Moore (D-Birmingham).

The assembled legislators pointed out that a provision of the federal government’s recent $1.9 trillion stimulus bill would pay for 5% of the state’s annual pre-expansion Medicaid cost for two years, an estimated total of $940 million over two years. However, this incentive only applies if Alabama expands Medicaid.

Singleton addressed Governor Kay Ivey directly on Tuesday, asking, “If not now, when?” with regards to Medicaid expansion.

The option to expand the number of people in a state who qualify for Medicaid, with the federal government covering 90% of the cost, was created by the Affordable Care Act in 2010.

Expansion would make Medicaid available to “most low-income adults to 138% of the federal poverty level,” in the words of the Kaiser Family Foundation. In Alabama, that amounts to an individual making up to $17,774 per year. The organization estimates that 204,000 Alabamians would become eligible for Medicaid if the state enacts expansion.

Calls to expand Medicaid in years past have been resisted by Republicans, who point to the high cost of the policy as a reason for expansion not being feasible. However, some Republicans have reduced what was in past years vociferous opposition to even discussing expansion.

When asked on Tuesday what the cost of Medicaid expansion in Alabama would be, Coleman-Madison did not reply with an exact figure. Instead, she answered that, in her view, Medicaid expansion is a moral imperative.

A report from an economist at the University of Alabama in Birmingham in 2019 estimated the initial cost of expanding Medicaid at $168 million, with an average annual appropriation of around $23 million being necessary each year afterward.

A 2020 article from National Public Radio showed several states that expanded Medicaid ended up enrolling more individuals than projected, requiring more state money than expected.

The free-market-focused Alabama Policy Institute frequently argues against expansion, pointing out that Medicaid is already one of Alabama’s largest expenditures.

A number of medical groups from across Alabama have continually urged the state to expand Medicaid. The incoming leader of the Medical Association of the State of Alabama, Dr. Aruna Aurora, said Tuesday that expansion would help health care providers offer more preventative care that could “get Alabama out of last place” in several health metrics.

Coleman-Madison expressed interest in using funds from a lottery to cover the costs of Medicaid expansion. Several bills to create a lottery have been introduced in the Alabama Legislature in the wake of a comprehensive gambling bill’s defeat earlier in March, though none of those proposals currently allocate funds for Medicaid expansion.

A spokesperson for Governor Ivey told multiple media outlets in recent days that the governor is “open to the discussion” on expanding Medicaid but has warned that “the problem has always been how to pay for it.”

Henry Thornton is a staff writer for Yellowhammer News. You can contact him by email: henry@new-yhn.local or on Twitter @HenryThornton95.