The U.S. Supreme Court last summer left most of the Affordable Care Act untouched but gave states the choice of expanding Medicaid to low-income adults (as the law originally required) or leaving it to serve mainly their children, the elderly and low-income people with disabilities. A year into the option, Alabama has taken no steps to accept the offer. The expansion would go into effect Jan. 1, 2014, so time is running out for Bentley to change his mind for Year 1.
It’s not just the uninsured who stand to benefit in profound ways. We talked to a restaurant worker in southwest Alabama who’s held the same minimum-wage job for 22 years. Her employer makes a group health plan available but doesn’t pick up any of the cost. Every two weeks, the worker sees half of her paycheck go toward health insurance. At minimum wage, she would be eligible for Medicaid under the expansion. If Bentley said the word, her take-home pay would double.
Last week at the clinic event, a reporter asked the governor if the bill he signed to restructure Alabama Medicaid opens the door for expanding the program. “I want to create more jobs,” Bentley said, “so we can get more people off of Medicaid.”
Alabama Arise thinks that’s a great idea. Jobs that provide health insurance or pay workers enough to afford their own would bolster families and the economy. The number of children covered by Alabama Medicaid would plummet as their parents gained good incomes. In fact, the governor has before him a jobs-creation opportunity that could set this win-win scenario in motion.
It’s called Medicaid expansion.
Study after study, by national research institutions and our own UAB, has shown that expanding Medicaid would bring Alabama billions of dollars in both federal funding and private-sector growth, creating thousands of new jobs and replenishing our state tax coffers. As Rep. Greg Wren, R-Montgomery, told an Arise conference audience in February, if a corporation with the same prospects for economic growth proposed locating in Alabama, “We’d have a special session tonight to make it happen.”
Those dollars would come on top of the gains that hard-working parents would experience from having their own health coverage. Health security means economic security, not having to scrimp on groceries to buy medicine, not ignoring an infection until you lose your leg.
It all adds up to a giant step forward: New coverage for the uninsured, new jobs in health care and the broader economy, bigger paychecks for low-income workers who have struggled to pay for insurance. Just what the doctor ordered.
The drumbeat for expansion is getting louder. As more studies illustrate its benefits and new polls show nearly two-thirds of Alabamians favor it, more editorial pages urge the governor on. With a Republican primary looming one year down the road, Bentley might consider the huge advantage this opportunity affords him. What better way to start a campaign than by jumpstarting the economy and implementing policies that mean peace of mind — and money in the pocket — for Alabama families?
Alabama Arise applauds Dr. Bentley’s determination to treat what ails Alabama by creating more jobs. Expanding Medicaid is the shortest available path to that goal. If he makes the bold decision to grow the economy and provide health security for hard-working Alabamians at the same time, he can secure his place in history as just the doctor we needed.
Jim Carnes is policy team leader at Alabama Arise, a nonprofit, nonpartisan coalition of 145 congregations and organizations that promote public policies to improve the lives of low-income Alabamians.