MEDICAID EXPANSION: LAWMAKERS DEBATE IF NOW IS THE TIME
WVUA 23 is part of a joint COVID-19 journalism unit with Alabama Public Radio and the University of Alabama’s Center for Public Television. This is Part 2 in our series on a potential Medicaid expansion.
Alabama lawmakers are looking at short- and long-term plans on keeping Alabamians safe as COVID-19 plagues the state.
One option? Expanding Medicaid.
“I think it’s time that people really speak up and demand that the state of Alabama invest in people’s health care coverage,” said U.S. Sen. Doug Jones.
Jones has been calling for a Medicaid expansion in the state since 2017. That’s when he ran for a seat in the U.S. Senate. The move would give health insurance benefits to more than 300,000 Alabamians who don’t have coverage.
Jones said he acknowledges it wouldn’t come cheap, but the COVID-19 crisis means an expansion is becoming crucial.
“I think this crisis gives us the perfect opportunity to try and expand Medicaid,” he said. “So that we can not only get the money coming in, but we can get some health insurance for folks who are wondering what they’ll do if they get sick.”
But some Alabama lawmakers like Republican State Sen. Cam Ward said expanding Medicaid right now isn’t realistic.
There are several issues regarding a potential expansion, Ward said.
One: Lawmakers have to meet to get anything done.
Two: With the budget uncertainty and businesses closing, coming up with the $155 million the state needs for the first year of expansion is not feasible.
But Jones is pushing back against critics, and said lawmakers have been dragging their feet far too long.
“They could get this done,” Jones said. “The governor could to it by executive order, too, if she had the blessing of the legislature or the leadership in Alabama.”
So what would Medicaid expansion look like, and how quickly would a plan be put into place if Gov. Kay Ivey and the Alabama Legislature agreed?
“Part of it depends on the length of time the Centers for Medicare and Medicaid Services take to approve new plan amendments from the state,” said Institute Fellow in the Health Policy Center at the Urban Institute Linda Blumberg.
CMS can move quick when it’s necessary, she said, so depending on the capacity of the state and the ability to modify certain systems an overhaul could happen in a matter of months.
Some states like Alabama who haven’t yet ethat haven’t expanded can wind up their their lawmakers caught up in the dollars and cents, Blumberg said.
“Right now under current law, Alabama would need to cover 10% of the costs associated with the expansion,” she said. “In the first three years of the implementation of the ACA, states could expand and have it fully paid for by the federal government. And then over a number of years, the cost phased up to 10%. Right now, if you expand as a late-expanding state, you’re expected to start paying 10% of the total cost immediately.”
Critics of expansion like Ward claim Alabama can’t come up with the funds required to get the job done. But Jones said the benefits far outweigh the upfront costs.
One possible benefit is the billions of dollars being pumped into the state’s economy.
Blumberg said it could take up to three months to see the effects of Medicaid expansion in Alabama, but Jones said he thinks lawmakers could make it happen sooner.