TO SOME HEALTH SCHOLARS, MEDICAID EXPANSION MAY BE BEST FOR ALABAMA DURING PANDEMIC

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. As part of that effort, here’s a look at the call to expand Medicaid in Alabama, due to the COVID-19 outbreak.


State leaders are doing what they can to keep Alabamians safe as coronavirus cases and deaths climb in our state. But, some say there is more that lawmakers can be doing right now.

Linda Blumberg is an institute fellow in the Health Policy Center at The Urban Institute. She believes Medicaid expansion is the best move for the state as it deals with the COVID-19 outbreak. With the deadly coronavirus plaguing Alabama, there’s a renewed push to do just that.

“It’s a reminder of the vulnerability of our healthcare financing system, and the vulnerability of people when they’re at their worst moment with regard to both their health and incomes,” she said.

David Becker is an associate professor in the Department of Health Care Organization and Policy in the UAB school of public health. He’s advocated for the expansion of Medicaid since 2012. But now, some people see the COVID-19 outbreak as a chance to get the ball rolling on legislation that’s long overdue.

“Not to sound opportunistic, but a lot of policy decisions we make come out of crisis,” Becker said. “That’s really the story of America. Freedom came from a bloody civil war. The creation of social security came out of the depression.”

The 2010 passage of the Affordable Care Act extended Medicaid benefits. The insurance safety net went to all households earning up to 138% of the poverty line. But in 2014 when Medicaid expansion took hold, Alabama opted out.

That year, then-Gov. Robert Bentley argued it would burden taxpayers and foster a “dependency on government.” Advocates like Blumberg said an increase in unemployment is just one major issue hitting Alabama hard as a result of the coronavirus pandemic.

“For a lot of them, they are losing their health insurance,” Blumberg said. “So if they have health insurance through their own employment or through their spouse or parent, and that main worker loses that job, everybody loses their health insurance.”

Blumberg said in states that haven’t expanded like Alabama, there are people who are eligible for coverage if their incomes are 100% to 400% above of the poverty line. Medicaid expansion will pay for part of their insurance through the marketplace healthcare.gov. But, Blumberg said this current setup could be an added burden as we’re faced with troubling times with COVID-19.

“So you could end up in a non-expansion state with a lot of folks losing income, and not be eligible for any health insurance coverage at all when they need it most in the midst of a pandemic,” she said.

State health leaders are telling Alabamians who experience coronavirus symptoms to call their health care providers for screening and to see if there’s a need to set up a COVID-19 test. But with some in the state losing their job, which is leading to a loss of insurance coverage, they don’t have a provider to turn to.

“The situation is such that you don’t want to be in a position where people who are infected aren’t getting tested because they are afraid of the cost or they don’t think they can get the treatment anyway,” Blumberg said. “And that you now have more people moving around in populations that could be affecting others in addition to harming their own health and potential for recovery.”

The Seattle-based Institute for Health Metrics and Evaluation predicts coronavirus cases in Alabama will peak in April. A decline isn’t expected until this summer.

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