Jack Bernard is a retired senior vice president for a national healthcare corporation and worked with large hospitals throughout the south, including Alabama. He is the former director of planning for Georgia. More in his blog.
“Whoever is generous to the poor lends to the Lord, and he will repay him for his deed.” Proverbs 19:17
“But if anyone has the world’s goods and sees his brother in need, yet closes his heart against him, how does God’s love abide in him?” 1 John 3:17
A recent column on Southern States and Medicaid expansion in Modern Healthcare magazine, an industry standard bearer, was highly informative
As it pointed out, 8 of the 12 states which have yet to expand Medicaid to cover more of the poor are in the South. They are Alabama, Georgia, Mississippi, Tennessee, South Carolina, North Carolina, Texas, and Florida (Only Florida and Mississippi provide for a referendum on the issue, which will almost certainly pass with a majority in every one of these states).
I find it incredibly hypocritical that the Legislatures and governors in each of these states have not already expanded Medicaid. After all, the South and Southwest are the most religious areas of the nation.
Of the 50 states, here’s how the above states rank in religiosity: Alabama-1, Mississippi-2; Tennessee-3; South Carolina-6; Georgia-8; North Carolina-10; Texas-11; and Florida-22. So, 7 of the 8 states choosing not to expand Medicaid to cover needy low-income people are among the 11 most religious states.
So, what are the numbers of insured here and where does Alabama stand versus other states? Let’s start with some history.
Alabama’s rate of uninsured was at 14% prior to the Affordable Care Act (ACA, Obamacare) over a decade ago, lower than the national average. The rate did fall substantially, as did the uninsured rate in every state. However, the 38 states which chose to expand Medicaid coverage dropped much more than those that did not, including Alabama. Currently, 10% of Alabamians still remain without insurance, whereas the rate for the nation is 9%. These 483,400 white, black and brown uninsured Alabamians reside all over the state, in rural, suburban and urban areas. Many are the working poor, either self-employed or working in small businesses which do not provide coverage.
It has been projected that under Medicaid expansion, the rate of uninsured would drop to 6% and many of the uninsured would be covered. In addition to helping these needy individuals, the Alabama Hospital Association has stated that Medicaid expansion would also stop the closure of more small, rural hospitals, several of which have closed in recent years.
Gov. Kay Ivey has opted to submit a convoluted “Medicaid Waiver” to CMS/DHHS which would include work requirements. Of course, people who are working in well-paying jobs end up not being financially eligible for Medicaid. So, her proposal makes little sense and is still under review by the feds and is unlikely to ever be approved.
In the meantime, instead of simply expanding Medicaid (with 90% paid for by the Federal government) to cover the maximum number allowed under federal law, Governor Ivey and the Alabama legislature have chosen to let $4.8 billion in federal tax money of Alabama residents go to the other 38 states which decided to expand their Medicaid programs.
That makes little financial or moral sense for the state’s residents.
Currently, Alabama is the most religious state and is tied with several other states for the 12th highest rate of uninsured. Although I’m not a religious person myself, I believe in following many of the more compassionate teachings contained in the bible. Obviously, the Alabama governor and legislature… and the legislatures and governors in all of these 8 states…must not.