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Love thy neighbor & close the gap. The Medicaid gap. Now.

Cover Alabama Lobby Day in Montgomery

Expanding Medicaid in Alabama is long overdue. Medicaid expansion would ensure that nearly 300,000 low-income adults would have lifesaving health insurance. Medicaid expansion would benefit people in every county, help save our hospitals, and generate savings in the General Fund budget. Medicaid expansion is the single most impactful thing we can do to benefit Alabamians.” - Cover Alabama Coalition

Seven current and one former Calhoun County Democrats were among 50-60 Alabamians who gathered at the Statehouse at 11am on March 21st advocating to expand Medicaid. This was the first Cover Alabama Lobby Day. Cover Alabama is a statewide, nonpartisan coalition of more than 100 organizations seeking to “provide quality, affordable health coverage to its residents and implement a sustainable health care system."

Campaign Director Debbie Smith speaks at the Mar. 21, 2023 rally for Medicaid expansion at the Alabama State House

Several speakers started the event. A hair stylist and a chef told about having jobs that put them in ‘the coverage gap’ and the adverse effects of that situation. The ‘gap’ includes about 220,000 Alabamians who earn too much to qualify for Medicaid now but earn too little to afford private insurance or get subsidized insurance on the federal healthcare exchanges.

Watch the slideshow of photos taken from several sources here:

"Jesse Odland, a 41-year-old from Huntsville, couldn’t walk out of work. He soon learned he had 45 to 50 pounds of fluid in his system. He could not put his shoes on. He was bedridden for about three months. Odland now has insurance, but the bills from that time remain unpaid." (Alander Rocha/Alabama Reflector)

Construction worker Kenneth King told about having been injured in an assault, sending him to the emergency room. There, doctors found a life-threatening condition in his aorta. He survived but came out of the hospital with $150,000 in debt.

"Trent Thomas, a 42-year-old hairstylist from Birmingham, did not have dental insurance and couldn’t keep up with the care he needed. Alabamians in the service industry, Thomas said, have no health insurance because they make too much to qualify for health insurance, and make too little to qualify for subsidized plans on the federal health insurance marketplace." (Alander Rocha/Alabama


Rev. Carolyn Foster is co-chair of the Alabama Poor People’s Campaign and director of Greater Birmingham Ministries. She gave examples of tragic results many people suffer from lacking healthcare. For her, the issue is a moral one: It is immoral to allow these conditions in the richest nation on Earth.

It is immoral to allow these conditions in the richest nation on Earth.

Dr. Marsha Raulerson has been a pediatrician in rural Brewton for more than 45 years. Many people in her area have no insurance and no place to turn. So she still treats many former patients without cost as adults. She talked of the urgency to retain small, rural hospitals with emergency rooms, like the one where she practiced. These places save lives of people with insurance as well as without. For example a person with a life-threatening condition needs to be airlifted but first has to be stabilized. Without that immediate action at the local hospital, the person would likely die.

“The American Rescue Plan Act (ARPA) includes a provision that would allow Alabama to access an estimated $619.4 million in additional federal funds, making Medicaid expansion more affordable and sustainable than it has been in years prior. These additional funds, on top of the generous 90/10 match of federal to state funds, could result in the federal government absorbing $397 million in annual expenses currently paid by the state.” - Cover Alabama Coalition

After the speakers finished, participants entered the Statehouse to meet with their legislators and urge them to act on expanding Medicaid. At that time, almost all legislators were in caucuses. So advocates left packets of information with personal notes.

The case for expanding Medicaid is compelling in several ways. Not least are economic ones. Besides the huge gains in personal wellbeing, Medicaid expansion would be a huge boost to economic development. It would create 20,000+ new jobs. The workforce would grow as many people become healthy enough to return to work.

A January 2022 poll from Cygnal polling firm showed that nearly 72% of Alabamians support Medicaid expansion, including 66% of Republican voters. Over half of voters strongly support expansion.” - Cover Alabama Coalition

Expansion would also greatly strengthen Alabama’s healthcare system. It could help save the one-third of rural hospitals in immediate danger of closing and the half of rural hospitals in danger of closure. Expansion would also greatly reduce racial inequities in healthcare.

Notable are infant and maternal mortality and deaths among people with chronic health conditions.
Medicaid expansion is literally a matter of life and death – for communities as well as people.

The following table shows stark differences among counties in the impact of lacking health insurance for all residents. Notice the extremely high per-capita debt from uncompensated hospital costs for more rural counties. These counties are the ones in immediate danger of losing their hospitals, emergency services, and healthcare providers. Expanding Medicaid would also help many residents being caught in and their families destroyed by an endless burden of medical debt. Lifting that burden helps the local economy, as well as the tax base.

Per Percentage Reduction in

Uncompensated capita in uninsured with

County Population cost ($millions) debt Collection expansion

Shelby 223,000 $11.0 $49.3 15 30

Calhoun 115,000 $2.6 $22.6 22 47

Etowah 103,000 $26.9 $261.2 17 50

St. Clair 91,000 $14.4 $158.2 13 38

Talladega 82,000 $14.5 $176.8 27 55

Randolph 22,000 $14.5 $659.1 22 47

Cleburne 15,000 $14.4 $960.0 21 34

Clay 14,000 $14.4 $1,028.6 18 53

Source of data: Cover Alabama fact sheets, 2020 US Census

Expanding Medicaid isn’t a partisan issue, at least not among voters. In fact, more than half of all voters, regardless of party, favor it.
The time to expand Medicaid is NOW! Call, write, or visit your state representative and senator to move this ball across the goal line.

-- Dr. Jim Williams, Calhoun County Democrat, community leader and activist


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