Alabama Gov. Kay Ivey pilots a state that’s ranked in the bottom 10 in poverty and has nearly a million residents on Medicaid’s rolls. Many of those recipients are children in low-income families, the embodiment of innocence. What’s more, Alabama’s Medicaid eligibility requirements are already the nation’s strongest.
Medicaid is a significant drain on Alabama’s General Fund, but it also is a life-changing necessity for thousands of the state’s poor residents. Our state mustn’t make it more difficult for poor Alabamians who qualify for Medicaid to get it.
Nevertheless, Ivey has doubled down this week on her support of a Trump-administration proposal that would likely remove Medicaid benefits from as many as 17,000 Alabamians. (It could be worse: In Kentucky, a similar proposal could affect almost 100,000 residents.) If implemented, able-bodied Alabamians in Medicaid’s Parents or Caretaker Relatives group would be required to get jobs to retain their health-care coverage.
The catch is that the jobs most available to these Alabamians — part-time and low-wage — usually don’t offer health-insurance coverage through their employers, and the wages they receive would push them above Alabama’s minuscule threshold for Medicaid eligibility.
That’s the Medicaid “coverage gap,” and it’s cruel. Medicaid says there are roughly 74,000 Alabamians in the Parents or Caretaker Relatives group, which includes people with children or a close relative in their home and an annual income of no more than 18 percent of the federal poverty level — just $2,963 a year for a family of two. About 17,000 of those 74,000 Alabamians would be subject to these work requirements and likely lose their Medicaid benefits because of the coverage gap.
Everything about this proposal is marinated in Republican, cost-cutting policies that devalue government’s role in helping the least among us. Former Gov. Robert Bentley famously refused to expand Medicaid in Alabama under the Obama-era Affordable Care Act, a ridiculously political decision that deprived thousands of Alabamians from receiving adequate health care. Now, Ivey plans to move forward with this proposal, she says, because (a.) it will save money, and (b.) it will “reserve Medicaid services for those that are truly in need of assistance.”
The governor’s belief that financial savings are more important than poor Alabamians’ well-being is appalling.
The Center on Budget and Policy Priorities has harshly criticized this GOP-backed work-requirement plan. Alabama Medicaid Agency officials say 90 percent of the public comments they’ve received on the proposal are against it. Who else opposes it? The Alabama Hospital Association, the Medical Association of the State of Alabama, the Alabama Diabetes Association, the Leukemia and Lymphoma Society, the Epilepsy Foundation of Alabama, and more. And why? Because it’s bad policy and it will endanger Alabamians’ health, pitting humanity against a line-item in the state budget. Alabama voters should take note.