EDITORIAL: Alabama Legislature must decide what’s more important: money or people

Feb. 06--Nothing about Alabama's Republican-led refusal to expand Medicaid and take advantage of the federal government's offer to pay for most of that expansion is humane or logical. Let's be blunt. It's political, hateful and short-sighted.

Alabama should expand Medicaid. Alabama must expand Medicaid.

That's been clear since the passage of the Affordable Care Act in 2010, but Alabama has foolishly watched a growing number of states take advantage of this ACA component and held firm to the notion that the state's General Fund can't handle the added fiscal burden.

Thirty-seven states, including the District of Columbia, have expanded Medicaid. You say refusal of Medicaid expansion isn't political? Look at a Medicaid map. The 14 non-expansion states are essentially the old Confederacy -- Alabama, Mississippi, Georgia, Florida, Tennessee, the Carolinas and Texas, along with a few GOP strongholds in the Midwest.

The states that have historically shunned investments into residents' lives -- investments in education, in public health, in prison reform, in adequate housing for the poor, in social safety nets for the abused, the sick, the young and the old -- are essentially the ones squandering this opportunity. It's government that clouds its coldness in a blanket of business-friendly policies that value dollars and re-election bids more than people.

Cracks in the Alabama Legislature's anti-expansion stance may be forming, however. State Sen. Jabo Waggoner, R-Vestavia Hills, told ABC 33/40 this month that lawmakers may be forced to consider expansion. "We've got to find a way to keep these rural hospitals open and Medicaid is probably the answer to it," Waggoner said. "So I think we're going to take a lot closer look at the Medicaid issue this year, expansion of Medicaid, than in times past."

On that, the facts are brutal. Ninety-five rural hospitals have closed in the United States since the ACA passed, according to the Cecil G. Sheps Center for Health Services Research at the University of North Carolina. Five of those closings have been in Alabama; others are in sad fiscal shape. And one of the top benefits of Medicaid expansion is the trickle-down effect for small hospitals in rural communities. More people with health insurance mean more people seeking health treatment, which fuels clinics and hospitals and drives hirings of doctors, nurse practitioners and nurses.

Oh, and the cost of expansion? That's what keeps this from happening, Republicans say. Well, from 2014 to 2016, Washington paid 100 percent of the costs. The federal share drops to 90 percent in 2020. So even if state budgets are tepid -- which Alabama's clearly are -- the motivation to take advantage of this opportunity to boost rural hospitals and improve health-care opportunities for so many Alabamians should be strong.

We're not naive. Money trees don't blossom on the Statehouse grounds. Medicaid already devours a hefty portion of state funds. But we're also not willing to agree with those in state government that Medicaid expansion isn't a worthwhile expense. People matter, too.

___

(c)2019 The Anniston Star (Anniston, Ala.)

Visit The Anniston Star (Anniston, Ala.) at www.annistonstar.com

Distributed by Tribune Content Agency, LLC.