WVUA 23 News is part of a joint COVID-19 journalism unit with Alabama Public Radio and the University of Alabama’s Center for Public Television. As part of continuing coverage, we’re taking a look at why some state lawmakers say expanding Medicaid isn’t a good move for Alabama.

Thousands of Alabamians are out of a job because of coronavirus and the business closures that followed the virus’ spread. Most of those residents are also finding themselves without health insurance.

While some of Alabama’s lawmakers are suggesting a Medicaid expansion is in order, others are calling on an overarching health care overhaul.

“I think it’s time to go back and take another look at this,” said Alabama Sen. Gerald Allen. “It needs to start in Washington. Give some guidelines, some basic rules for the states to develop their program.”

Allen is one of several GOP state lawmakers pushing back against expanding Medicaid under the Affordable Care Act put in place by former U.S. President Barack Obama. The reason? Allen is calling for a health care overhaul instead, and he wants President Donald Trump leading the way.

“It’s a national issue, not just for Alabama,” Allen said. “It’s a national issue to make sure that everyone gets adequate health care. So the debate needs to start in Washington.”

But other leaders disagree, including U.S. Rep Terri Sewell. A Medicaid expansion is the best thing Alabama can do right now as workers and businesses grapple with the economic devastation from COVID-19, said Sewell, who is a Democrat. She’s calling on Alabama lawmakers to act now.

“There’s still more that Gov. Kay Ivey and the State Legislature can do to help us during this crisis,” Sewell said. “They need to expand Medicaid. Uninsured Alabamians who have lost their job shouldn’t have to choose between getting tested and seeking care for the community.”

An expansion would offer health care coverage to more than 360,000 uninsured Alabamians, Democrats said.

But GOP lawmakers are caught up in the cost, which could run the state $155 million to $170 million during the first year of expansion.

Sewell is sponsoring the Medicaid Expansion Now Act, which would help lower state costs if lawmakers agreed to an expansion.

“Our bill would give a 100% federal match for the first three years regardless from when a state expands Medicaid,” Sewell said. “It’s critical to get that 100% match.”

If Alabama were to expand Medicaid right now, the federal government would only be matching 90%. That’s because Alabama did not expand Medicaid within the first five years of the ACA when a 100% match was offered.

While state and federal leaders hash out health care policies, one doctor is raising concerns about what could happen after the pandemic is no longer a threat.

A Keiser Health study shows 1.5 million Alabamians have health conditions like diabetes or hypertension that can result in worse outcomes for patients who contract COVID-19.

Dr. Lea Yerby with University Medical Center in Tuscaloosa said there’s also concerns over a potential second wave of health issues that may come after the current COVID-19 caseload is over.

People stuck indoors are liable to not take proper care of themselves or keep up with their health, Yerby said. Mental health is also a huge concern with so many people out of work.

Yerby is in favor of expanding Medicaid, and said Alabama leaders need to start looking at what long-term plans will help keep the health care system afloat after the pandemic is no longer a threat.

“We need to make sure we continue to have hospitals and a health care system to take care of us through this and after this,” Yerby said. “The expansion of Medicaid would get people who need care the most the care they need, and give our hospitals more of an opportunity to take care of our population.”

Democratic leaders and health care workers aren’t the only ones pushing for a Medicaid expansion.

In an open letter to Ivey published on, several pastors and reverends across the state are urging the Republican governor to be a leader in the fight against coronavirus and expand Medicaid.

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