3 months ago

Alabama should wait and watch before considering Medicaid expansion

If only Alabama’s leaders had a magical Medicaid “Choose Your Own Adventure” book, so they could flip ahead and see the different outcomes we could expect by expanding the government insurance program that was originally designed for the poor and disabled.

Would it end in a stronger economy, more jobs and a vibrant system of rural hospitals?

“Medicaid expansion remains an economic development opportunity without equal,” said David Becker, an economics professor at UAB, in an AL.com article.

Or would it bankrupt our already cash-strapped state budget and further sink our country into unsustainable levels of national debt?

“When you expand Medicaid, the administrative costs and the cost of expansion will eventually swamp the state,” warned U.S. Rep. Gary Palmer (R-Hoover), during an interview on the Matt & Aunie Show on Talk 99.5 FM in Birmingham. “It has in other states. Illinois is about to go bankrupt.”

Each side makes a strong case, but the truth seems hidden behind a fog of experts, statistics and forecasts that confuse more than clarify.

The Economic Impact

A UAB study conducted by Becker and paid for by the Alabama Hospital Association found that even when Alabama starts paying 10 percent of the expansion’s costs, the move would create thousands of new jobs and generate $2.7 billion a year in economic activity. Becker wrote that the expense would be “almost entirely offset” by new tax revenue and state spending reductions on current Medicaid enrollees and other health programs.

And another study funded by the same association concluded that “state savings and other economic gains from expansion could be reinvested in the health care system in Alabama, including to support expansion and other state priorities.”

But critics say those predictions are extremely unrealistic and point to how widely off the mark such estimates have been elsewhere.

States that expanded Medicaid have signed up more than twice as many “able-bodied adults” than expected and per-person costs have exceeded original estimates by a whopping 76 percent, according to a 2018 report by the Foundation for Government Accountability. This led to cost overruns of 157 percent, the report showed, with Medicaid now accounting for one of every three state budget dollars.

Many expect the same overruns in Alabama, which would exacerbate our already challenging budget.

“We will have to find $250 million more in the state general fund every year, even when revenues decline in recessions,” said Daniel Sutter, an economics professor and director of the Manuel H. Johnson Center for Political Economy at Troy University, in an email. “Alabama’s perennial budget crisis is due largely to having to pay for Medicaid every year. Medicaid expansion makes this pressure worse.”

Hospital Closures

Supporters of Medicaid expansion most often mention that 12 Alabama hospitals have closed this decade, with many being in rural areas possibly leaving residents without critical care nearby. Expanding the program, they contend, may have saved those hospitals, and could still save many that are at risk.

“Those are critical dollars for us as our hospitals currently spend more than $500 million each year in care for which they receive no reimbursement,” said Owen Bailey, chairman of the board of the Alabama Hospital Association and CEO of USA Health, in a press release. “Providing insurance through Medicaid expansion is vital to maintain access to care for everyone.”

While an influx of Medicaid cash would help these hospitals in the short term, it’s unclear if it solves the underlying problems that created their instability in the first place.

Hospitals are losing money and closing for a variety of reasons, according to The New York Times — shrinking rural populations, hospital mergers, consolidated services, regulatory burdens, low reimbursement rates, and a decrease in hospital care due to outpatient services and speedier care that requires less hospital time.

Officials at one Kansas hospital that closed in 2015 told The Times that additional Medicaid funds would have been significant but probably would not have helped them survive in the long run.

Meanwhile, help could come from elsewhere. The federal agency that oversees Medicare recently announced that its “tweaking” the formula used to reimburse hospitals in Alabama, a move that AL.com noted could increase payments to rural hospitals.

A way forward

When economists are arguing vastly different forecasts and outcomes, it’s often helpful to fall back to a few simple yet immutable conservative principles. Chief among them is the principle of prudence, which basically says we shouldn’t rush big decisions – decisions that have long-term consequences and that cannot easily be reversed, if at all.

Medicaid expansion is clearly one of those decisions.

And even without that magical Medicaid “Choose Your Own Adventure” book, there have already been unexpected plot twists, and clear deathtraps, for other states who decided to expand the program.

Alabama should wait and watch to see if the promises, or the fears, are realized.

We should also patiently observe states taking alternate storylines through Medicaid waiverspartial Medicaid expansion requests and block grant plans.

Otherwise, if Alabama takes the bait and expands Medicaid, we might turn the final page only to see that ominous yet sadly predictable word.

Bankrupt.

J. Pepper Bryars is a senior fellow at the Alabama Policy Institute. Follow him on Twitter at @jpepperbryars.

13 hours ago

On this day in Alabama history: Camp McClellan was established in east Alabama

July 18, 1917

Shortly after the United States entered World War I, the War Department established Camp McClellan as a rapid mobilization base and permanent National Guard facility. More than 27,000 men were training at the east Alabama base by the end of 1917. Camp McClellan was originally named in honor of U.S. Army Maj. Gen. George B. McClellan, and was renamed Fort McClellan in 1929. During World War II, nearly 500,000 military personnel trained there. After being put in custodial status following the war, it was reactivated during the Korean War and Cold War era. The focus shifted to chemical weapons training during and after the Vietnam War. The fort survived one round of military base closings during the 1990s, but it was finally shut down in 1999. The site has shifted to private use as well as for Alabama National Guard training.

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Read more at Encyclopedia of Alabama.

For more on Alabama’s Bicentennial, visit Alabama 200.

(Courtesy of Alabama NewsCenter)

13 hours ago

Ainsworth in Huntsville: Alabama is ‘the aerospace capital of the world’

Wednesday, Lt. Governor Will Ainsworth (R-AL) presented Dr. Edwin “Buzz” Aldrin, Jr. with the 2019 Thomas R. Hobson Distinguished Aerospace Service Award for a lifetime of exemplary achievement in the aerospace field.

The award presentation came during the Aerospace States Association’s annual dinner, which was held in Huntsville at the U.S. Space and Rocket Center.

Ainsworth is currently chair of the association, which is a national nonpartisan group composed of lieutenant governors, gubernatorial-appointed delegates and associate members from aerospace organizations and academia.

In remarks shared with Yellowhammer News, Ainsworth honored Alabama’s space legacy, recognizing Apollo 11’s 50th anniversary this week.

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“Throughout each of the past six decades, Alabama and the Marshall Space Flight Center have created the engines that rocketed man into the heavens,” he said. “It’s here that Dr. Wernher Von Braun and his committed team of scientists and engineers birthed the Saturn V rocket that took men to the Moon and allowed them to place a U.S. flag on the lunar surface.”

“For those reasons, it’s altogether appropriate that we gather in this state and this city for the 50th anniversary of the Apollo 11 mission,” he continued. “We are fortunate to have Buzz Aldrin, an original moonwalker and living American legend, join us during this conference.”

The conference is set to last through the rest of the week, with attendees working on publicly policy related to the aerospace industry and advocating for their home states.

“The work we do here this week will bring the stars and planets closer to the earth and ensure that future generations are privy to the same dreams and inspirations that the Mercury, Gemini, Apollo, Skylab, Shuttle, and Space Station eras provid-ed to generations prior,” Ainsworth told the crowd.

Alabama is set to play a big role in ongoing and future space exploration, as Ainsworth emphasized in an interview with WHNT on Wednesday.

“I was just talking with some industry leaders who are here and they are talking about expanding the existing industry,” he the lieutenant governor said. “I think a lot of new industries are looking here. And the reason why is we are the aerospace capital of the world. I think when you look at our tax environment, with the workforce we are training, Alabama is open for business in aerospace, no doubt.”

Speaking with WZDX, Ainsworth referenced the Artemis program, with companies like United Launch Alliance (ULA) in Alabama set to make history in the very near future.

“Today I had an opportunity to tour ULA where they are building rockets that will literally send our next astronauts to the Moon, and when you look at just the president’s commitment to going back to the Moon, and when you look at potentially the future of going to Mars, it’s an exciting and energetic time in the aerospace industry right now,” Ainsworth advised.

RELATED: Aderholt celebrates Apollo 11, calls for SLS to stay on schedule

Sean Ross is a staff writer for Yellowhammer News. You can follow him on Twitter @sean_yhn.

15 hours ago

Apollo 11 is now problematic?

Right now, Alabama, along with the rest of America, is celebrating the 50th anniversary of the Apollo 11 mission. A mission that culminated in man walking on the moon and fulfilled the vision put out by President John F. Kennedy that it would be done before the end of the 1970s.

In normal times, this would be a time for celebration and unity. Americans from all sectors and political parties would drop their swords and join together to consume media of trying times and magnificent accomplishments.

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Unfortunately, this is Trump’s America and because of that, the overarching theme that must pulse through every aspect of American culture, which is dominated by the media and their Democrats, is the simple undeniable and universal belief that America sucks.

It’s racist, stupid, sexist, stupid, homophobic, stupid, Islamaphobic, stupid and stupid.

Our soccer team believes it. Our celebrities believe it. Our politicians believe it.

And the news media is going to feed it to us non-stop.

For example, Werhner Von Braun was a Nazi, therefore his accomplishments on this matter are unworthy.

Another example: The space program had too many men, therefore it was problematic.

Another argument is Soviet Russia had more firsts (or something), so America should have focused less on accomplishing the mission and more on diversity.

Who is this for? What American wanted this? Who is the consumer for this news?

Inhabitants of American newsrooms and their woke superfans online.

This was not one outlet, one reporter, one editor — it is across the board.

These are major American media outlets and they cannot resist the urge to scold their fellow Americans for, in this case, the perceived sins of the past.

This is why people hate the media as a whole.

They aren’t offended, they aren’t going to write a letter, they aren’t going to demand someone be fired.

Your average American is sick of this nonsense. They roll their eyes and go on about their business.

This is why people don’t trust them. This is why they are called things like the “enemy of the people” and people applaud it.

This is how you got Trump.

President Donald Trump is the embodiment of the people who are sick of this crap.

And every time the people who work in these newsrooms and under these “legendary” banners write these articles try to scold Americans for some clearly arbitrary offense of the day, or the past, they might as well drop a dollar into Trump’s reelection campaign.

Dale Jackson is a contributing writer to Yellowhammer News and hosts a talk show from 7-11 am weekdays on WVNN.

15 hours ago

Doug Jones’ approval rating continues to fall

Senator Doug Jones (D-AL) continues to lose popularity as 2020 draws nearer.

Morning Consult on Thursday released its polling numbers for the second quarter of 2019, showing Jones’ net approval rating 20 points lower than the first quarter of 2018 when he entered the U.S. Senate.

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The polling was conducted from April 1 through June 30 and measured registered voters. The results showed 39% of respondents approved of Jones’ job performance, while 37% disapproved and 24% were undecided. The margin of error was 1%.

In contrast, Senator Richard Shelby’s (R-AL) net approval rating is 15 points higher than Jones’, with 46% approving and only 29% disapproving of Alabama’s venerable senior senator.

Jones’ net approval rating has dropped three points since the beginning of the year.

Another poll conducted in April went deeper than Morning Consult’s approval rating surveys, showing that Jones faces nearly insurmountable demographic barriers to reelection.

Sean Ross is a staff writer for Yellowhammer News. You can follow him on Twitter @sean_yhn.

16 hours ago

Alabama couple turns racist graffiti message into opportunity to respond to hate with love

Jeremy and Gina Miller, an interracial husband-and-wife real estate team in the Birmingham metro area, were shocked on Wednesday to discover a racial slur painted on one of their “For Sale” signs at a local property.

ABC 33/40 reported that “NO N***R” was painted on the Local Realty sign in large white letters.

However, the Millers are responding to this hateful incident purely with love, guided by their faith, according to The Trussville Tribune.

“I think that God has been preparing Gina and me for a long time, in ways that we never would have expected, to touch a lot of people,” Jeremy told the newspaper.

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The Millers, who live in Clay, will not be pressing charges on the individual responsible for the racist graffiti, whose identity is at this time unknown.

“We would love to know who did it because if we find them, we will show them mercy,” Jeremy advised. “I don’t think anything good comes from pressing charges. That’s not the message here.”

The couple hopes to use the incident to unite their community and lift others up.

“We just got a message on Facebook yesterday about how God spoke to him through my post and our response,” Jeremy told The Trussville Tribune. “It encouraged him to see us responding through love and not through retaliation.”

“When something like this occurs, you can love back instead. We want to unite people,” he added.

Jeremy also wants people to know the racist incident is not representative of their community.

“This is not indicative of the people in this area,” he emphasized. “It happens everywhere and they don’t always say it to your face.”

Perhaps the toughest part of the incident personally for the Millers has been trying to tell their children what happened.

“Having to explain to them what happened with the sign has been a little frustrating,” Gina noted.

The Millers are also using this incident as a learning opportunity.

“We tell [our children] all the time, hurt people, hurt people,” Jeremy explained. “I tell them that even adults do mean things sometimes. When you’re angry, you’re not nice to other people… We want to respond in love when maybe that person hasn’t received such things.”

Jeremy stressed a constant message of love.

“It (racism) is not dead and it probably won’t die for a very, very long time, but we as a culture and society have to keep perpetuating the message of loving one another,” he remarked. “If someone’s hurting and they lash out at you, you don’t have to respond negatively.”

The defaced sign has been replaced with a fresh one that includes both Jeremy and Gina’s headshots.

Read more here.

Sean Ross is a staff writer for Yellowhammer News. You can follow him on Twitter @sean_yhn