MONTGOMERY, Ala. — In a speech to a group in Montgomery, Alabama Governor Robert Bentley (R) teased attendees with a proposal he says will reform healthcare in rural Alabama, including the government healthcare program for low-income citizens Medicaid.
“There are some programs that I will be announcing by my State of the State that are going to be exciting for rural Alabama and that all of y’all are going to really like,” Bentley told the Montgomery Lions Club last week, according to a report by al.com.
During the majority of his first term, Governor Bentley maintained he would not embrace the Medicaid expansion portion of ObamaCare, but has softened significantly in recent months.
Medicaid expansion would require the state to accept into the program Alabamians making up to 133 percent of the federal poverty level, or $32,253 a year for a family of 4. The federal government would pay for the newly-incurred costs for the first 3 years, phasing down to 90 percent of costs by 2020.
Medicaid currently comprises 37 percent of the state’s ailing General Fund budget, the largest portion. According to the Alabama Policy Institute, the state’s Medicaid expenditures increased by 53% between 2001 and 2013, and as the state’s senior population increases, costs are expected to grow even further.
The Governor has continued to say he will not be signing on to the Obama administration’s plan, he has strongly hinted that he is working on a compromise with Obama’s Dept. of Health and Human Services for a public-private option similar to that of Arkansas.
In the past, Bentley has used the occasion of the annual State of the State address, given on the first day of that year’s legislative session, to announce his priorities for the upcoming year.
In 2014, his fourth address since being inaugurated in 2011, the governor firmly rejected expanding what he termed as the “broken” and “flawed” Medicaid program.
The federal government has said they will give us money to expand. But how can we believe the federal government will keep its word? The anything but Affordable Care Act has done nothing to gain our trust.
First, they told us we could keep our doctor – that turned out not to be true. Next, they told us we could keep our policy – that’s not true. Then they told us our premiums would not go up – nothing could be further from the truth. Now they are telling us we’ll get free money to expand Medicaid.
Ladies and Gentlemen, nothing is free. The money the federal government is spending with wild abandon is not federal dollars – those are your dollars, your hard-earned tax dollars. There is no difference between federal money and your money.
Our great nation is 17.2 trillion dollars in debt and it increases by 2-billion dollars every single day.
That is why I cannot expand Medicaid in Alabama. We will not bring hundreds of thousands into a system that is broken and buckling.
But after being reelected to a second term, Gov. Bentley began hinting at a “compromise,” establishing a task force including many pro-expansion advocates.
In this year’s State of the State, Bentley struck a starkly different tone, saying instead that he would not allow the “flaws” of ObamaCare to keep the state from expanding taxpayer-funded healthcare for the “poorest and most vulnerable.” He also said that some hospitals are “dependent on Medicaid to survive,” further signaling that an expansion of the program may be imminent.
In his address to the Lions Club last week, Bentley said he’s made it a point not to call the Affordable Care Act “ObamaCare,” because his historical opposition to it has nothing to do with its author.
“It’s not about a person, it’s about a philosophy,” Bentley explained. “And I was opposed to the government telling me how to practice medicine when I was a doctor. I’m opposed to Blue Cross telling me how to practice medicine. Or anybody else. I’m opposed to anybody getting between me and the patient.”
The compromise Bentley is alluding to would most likely come in the form of using the Medicaid reforms Alabama passed in 2013, which allow Regional Care Organizations (RCOs) to contract with Medicaid in a system where health care providers will be given a set dollar amount to treat each patient in their care.
The Bentley administration is reportedly now in negotiations with Centers for Medicare and Medicaid Services and Health and Human Services Sylvia Burwell to obtain a waiver allowing the state to embrace the expansion, but in the form of providing higher enrollment and funding to the RCOs.
“We’ve got to first make sure Medicaid works in Alabama, and we’ve got to make sure it works right, and we’re doing that,” said Bentley.
“Then when we go on down the road, then we will look at other options. And we’re going to do that.”
