The amendment was proposed largely because Medicaid was in crisis. Even with the amendment’s passage, it still is. Senate President Pro Tem Del Marsh, R-Anniston, summed up the situation when he said Medicaid was “unsustainable at the growth rates we’ve seen over the past few years. We have to do something.”
He is right, but what is the “something” that the Legislature is willing to do?
Wait and hope Congress passes the act that will allow the state to collect taxes on Internet sales? That would help, but it would not be enough to cover rising Medicaid cost and pay back what was borrowed.
Meanwhile, Alabama’s population gets older, too many of its people remain poor, and the federal stimulus money the state first used to patch the budget has dried up.
Marsh hopes Congress will allow states to take Medicaid funding as a block grant, which could be given to those the state decides are qualified for the program. But who will make that decision? And what criteria will be used to determine who gets help and who doesn’t? Who is comfortable with service-cutting politicians making these critical decisions?
On these questions let’s remember it should not be the cowardly state legislators who outsourced their budget-writing duties to a vote of the people.
Marsh would also like for state Medicaid expenditures to be capped, but once again, there is the question of where to put the cap and what happens to those who are still in need when the money runs out.
Those are serious questions.
Likewise, Medicaid money supports local hospitals and other health-care facilities, as Jim Carnes, communications director for Alabama Arise, has recently pointed out. Cut or cap Medicaid and those institutions would have to reduce services, or even close.
Opponents of the amendment argued, meanwhile, that it was only “kicking the can down the road.”
If Alabama’s senators and representatives do not address these questions during the next legislative session and find ways to bring in new and consistent revenue for the General Fund, they will prove the opponents right.
Every legislative session is important, but next year’s may prove to be the most important in decades.