The program has worked so well that for three years it received federal bonuses for simplifying its enrollment and renewal process — less bureaucracy, better service.
Even though the federal government pays 78 percent of the cost of ALLKids, cash-strapped Alabama is now cutting the program to the bone.
ALLKids is not some government give-away. Except for the poorest of the poor, all those enrolled must pay premiums, meet co-pays and cover at least some of the cost of the drugs a doctor prescribes. However, because the state Legislature allocated $15 million less than was requested to maintain current services, adjustments are being made.
The cost is falling first on the families, but if cutting services and increasing costs is not enough, physicians and other health-care providers may see their reimbursements reduced, as well. When that happens, many doctors will drop out of the program. And other cuts are coming.
Earlier this year, Gov. Robert Bentley tried to reduce costs by changing the eligibility rules and dropping many kids from the program — a simple, efficient and draconian solution. The U.S. Secretary of Health and Human Services Kathleen Sebelius ruled that under the 2010 Affordable Care Act, states could not change eligibility standards. She blocked the governor.
As for Bentley’s view of the state’s role in health care, this is part of his refusal to see the forest for the trees. This week he sent a letter to Washington saying he refuses to implement part of the Affordable Care Act, of which he says he is a “staunch opponent.”
As clearly as it can, the ALLKids controversy reveals how the cost of health insurance is out of control. If a family of four living at or near Alabama’s median income does not have insurance through an employer, it would be hard-pressed to find health insurance it could afford without this program. However, a sick child without insurance could wipe out a family’s savings and drive it into debt.
Through ALLKids, the federal and state governments are helping families, which are the bedrock of our social structure. But these governments are also subsidizing an insurance industry that shows little interest in reducing costs.
This situation also reveals how important it is for the state Legislature to quit talking about how programs such as ALLKids can be cut. Instead, lawmakers should talk about how tax reform can bring in the revenue to keep ALLKids offering the services these families need.
It is about time to realize that we are going about this the wrong way. Let’s try tax reform and insurance reform for a change.