Following the recent closure of a rural hospital, health care advocates are renewing calls for Gov. Kay Ivey to expand Medicaid access in Alabama but the governor still says her worry is how to pay for the expansion long-term.
“Ensuring Alabamians all across the state have access to quality health care is important to the governor,” said Gina Maiola, Communications Director for the governor. “However, on the question of expanding Medicaid, she remains concerned for how the state would pay for it long-term.”
The American Cancer Society Cancer Action Network of Alabama and Alabama Arise have called on Ivey to expand Medicaid access following the closure of Thomasville Regional Medical Center in Clarke County and worsening health care issues. Jane Adams, Government Relations Director for ACSCAN, said Ivey’s refusal to expand Medicaid would threaten more hospital closures and suffering for Alabamians especially in rural areas.
“Rural Alabamians who need immediate care will face potentially grave consequences of this predictable outcome. This is a result of the healthcare issues long present in Alabama, which Gov. Kay Ivey can easily change with one stroke of her pen. It is time for Gov. Ivey to allow Alabama to join 40 other states and enact Medicaid expansion,” Adams said in a statement.
Arise said “we are in a health care crisis,” while referencing the closure of four labor and delivery units in Alabama since last October.
AL.com reported that rural areas have been losing pediatricians and part of the problem is because of issues with Medicaid. Alabama Hospital Association officials said expanding Medicaid could help boost rural hospitals financially.
In an interview, Adams told AL.com that Ivey citing concern for long-term costs as the reason for not expanding Medicaid yet is a “lie.”
“That’s a lie,” Adams said.
“We have plans that we’ve showed her administration that pay for Medicaid expansion for 10 years, the amount in federal funding that we receive is equal to the amount we got during the covid stimulus.
“If we expanded Medicaid, we would get that equal amount of money just to invest into health insurance. There are plenty of ways to expand Medicaid and be fiscally responsible. 40 other states have figured it out, including Republican states…So, this lie of how we are going to pay for it long term is an excuse.”
Alabama is one of only 10 states that has not expanded Medicaid access offered by the Affordable Care Act or Obamacare.
Republican lawmakers have historically been reluctant to support the expansion because it is tied to Obamacare. However, during a meeting in April Alabama legislators expressed openness to the idea after being briefed by lawmakers from North Carolina and Arkansas on the benefits of Medicaid expansion.
But Medicaid expansion was not approved during the 2024 legislative session despite Republican House Speaker Rep. Nathaniel Ledbetter, R-Jasper, stating support for a private-public option. Despite legislative action Adams stated that Ivey did not have to wait for the legislature and could enact Medicaid expansion herself through executive action but refuses.
The idea that partisan politics is why thousands of Alabamians are left without health insurance upsets Martha Raulerson, a pediatrician and former president of The Medical Association of the state of Alabama. According to data from the Kaiser Family Foundation, 174,000 individuals would gain coverage through Medicaid expansion.
Raulerson said that if it was called “Trumpcare instead of Obamacare” Medicaid expansion would have already occurred. Raulerson also lives in Escambia County where concerns for the hospitals are growing following the closure of TRMC. The Escambia County Commission is exploring the possibility of an ad valorem tax to generate an addition $1.6 million for the hospital system.
Raulerson said that expanding Medicaid is the “number one thing” that would help healthcare crises many areas are facing while benefitting the state overall.
“Our citizens are suffering because of that [no Medicaid expansion],” Raulerson said. “It would actually bring more money into the state. It would also give us a healthier population.”
