A Letter To Governor Ivey On Medicaid Expansion

 TO: Governor Kay Ivey March 15, 2021

Medicaid Expansion to Adults—If Not Now, When?

Two years ago, over a hundred people in Escambia County came together at D. W. McMillan hospital to meet with our state legislators: Sen. Greg Albritton and Rep. Alan Baker. We presented the overwhelming need for Alabama to expand Medicaid to adults. Medicaid funding will increase access to needed health care for our community, support our rural hospital, and provide adequate payment for our physicians who serve our neighbors.

Our elected officials were sympathetic to our needs, but questioned the adequacy of state matching funds. The answer: our Medicaid Agency actually returned part of its budget to the General Fund this year. The Families First Coronavirus Response Act increased the federal match rate (FMAP) for Alabama to 78.57%, decreasing the state match.

Also, Medicaid payments to physicians and hospitals decreased during the pandemic, due to the general public avoiding emergency care, well-child visits and other routine services. But the cost to physicians and hospitals skyrocketed because of the need for PPE, costs for care of the sickest coronavirus patients, and other measures taken to protect patients from the virus.

The new American Rescue Plan Act will increase funding to Alabama by $940 million over the next two years as an incentive to expand Medicaid. (Center on Budget and Policy Priorities). This includes another 5% increase to our FMAP.

Only twelve states have not expanded Medicaid. No state has reversed its decision. Ten years of research shows reductions in annual mortality, improved access to care, increase in smoking cessation, reduction in uncompensated care costs, reduction of families in poverty, lower rates of maternal death, a decrease in rural hospital closures, and gains in employment and the labor market.

Almost 70% of Alabamians now support Medicaid expansion. We are waiting impatiently on our leaders.

Marsha D Raulerson M.Ed. MD FAAP, Pediatrician, Brewton, Alabama