Gov. Bentley Responds to Pressure to Expand Alabama Medicaid Program

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HUNTSVILLE, Ala. (WHNT) – For months, Alabama has stood firm behind its decision to opt out of the Medicaid expansion slated to go into effect next year as part of the Affordable Care Act.

“We are improving our present Medicaid program,” said Governor Robert Bentley.

Governor Bentley remains immovable on his position against proposed Medicaid expansion in the state, as he made clear during a visit to nonprofit Phoenix Services in Huntsville on Tuesday.

“We’ve totally redone that program and we’re going to make it a workable program,” Bentley contends.

"Our goal is to create more jobs in the state of Alabama like here at Phoenix or other places and have fewer people on Medicaid - that's our ultimate goal," the governor maintains.

Bentley has repeatedly said the state can’t afford to take on the full amount for the estimated 300,000 new participants once the federal matching funds start dropping in 2017.

But studies have emerged in recent months countering that position, saying the overall economic benefits to the state would outweigh the additional medical costs – by millions of dollars and thousands of jobs – if Alabama changed its stance and expanded Medicaid.

On February 26, 2013, the Alabama Senate Democratic Caucus unveiled Senate Bill 259 during a news conference.  SB-259 is a bill sponsored by state Senator Roger Bedford (D-Russellville) and was cosponsored by all Democratic senators. It will require Medicaid expansion in the state of Alabama.

The members of the Alabama Senate Democratic Caucus believe this bill would expand the Medicaid program to provide assistance to all persons for whom federal matching funds are available to the state under the Patient Protection and Affordable Care Act.

During the news conference there were many references to expanding Medicaid by the members of the Alabama Senate Democratic Caucus as “putting people before politics,” “good for the economy and business,” and the “difference between life and death.”

The expansion of Medicaid in Alabama can happen in one of two ways. Either the governor or the legislature can enact it.

Where the States Stand on Medicaid Expansion (Graph courtesy: The advisory Board Company)

Where the States Stand on Medicaid Expansion (Graph courtesy: The Advisory Board Company)

“We’re calling on the Governor to enact Medicaid expansion so that 300,000 Alabamians will have a better quality of life. But, we are also prepared to pass legislation if the Governor won’t act,” stated Senator Bedford.

"The first three years are 100 percent paid for by the federal government and then the federal government will pay 90 cents on the dollar. It’s a sound investment. We hope Alabama will go for it.”

A study commissioned by the Alabama Hospital Association shows the state could create anywhere from 24,600 to nearly 52,000 jobs between 2014 and 2020 if it takes part in the expansion.

David Bronner, CEO of the Retirement Systems of Alabama, has described Bentley's opposition to the Medicaid expansion as “incredibly short-sighted and incredibly naive.” He mentioned the study AHA commissioned:

“There’s not a company in the history of Alabama that can create that many jobs,” he said.  “And we pay hundreds of millions of dollars (in incentives) for a thousand jobs. (In the expansion), we don’t pay anything, and we get 30,000-plus jobs ... You can’t be anymore naive than to be against that," Bronner added.

RSA’s Bronner said he believes much of the opposition to the expansion stems from a dislike of the Affordable Care Act, in general.  But, he said politics shouldn’t get in the way of doing the right thing for the state’s low-income residents.

“To say you don’t like the program, that’s just crock,” Bronner said.  “Who cares if you like the program or not?  What you’re doing is helping 300,000 people and helping the rest of us who are paying a bill for those 300,000 people."

Of Alabama's population of 4.8 million, about 531,000 would be newly eligible for Medicaid under the proposed expansion.  Of those, 332,000 are currently uninsured according to data compiled by the Birmingham Business Journal from a UAB Study, The Kauffman Foundation and state records.

State officials have said the expansion would push Alabama's Medicaid from $6.3 billion to what they characterize as an unaffordable $13.2 billion by 2020.

The total cost for the expansion for Alabama is estimated at $771 million between 2014 and 2020 according to the preferred scenario in UAB's study.

But under that same scenario, tax revenue would increase by $1.7 billion leading to a potential positive net impact of $935 million on the state budget.

So, is opting out a billion-dollar gamble as characterized by expansion supporters?

"We are not going to expand a system that was totally broken," Gov. Bentley said Tuesday.  "Our job right now is to make sure the system we have works well," he said, "and we're doing that."

With the potential addition of 30,000 jobs in the state according to the Alabama Hospital Association, WHNT News 19 asked Governor Bentley how the state can afford to not to expand Medicaid:

"Well, now let me say this," the governor started, "Do we need a more accessible, affordable healthcare in this state and in this country?  Absolutely.  The problem we have is the Affordable Care Act is not working and it's not a workable situation," Bentley contends.

"Expanding Medicaid is expanding an entitlement program and I can't think of anything worse than expanding an entitlement program - I am totally against that."

Bentley says Alabama will need to make the current situation work.  He says the Patient Protection and Affordable Care Acts don't protect patients.  They are not affordable. "And, it's not healthcare."

But he says his position doesn't mean there will be a neglect for Alabama citizens.  He says state officials will need to come up with ways to expand healthcare in Alabama through primary care physicians, by using physicians extenders like nurse practitioners and physicians assistants.

"And really try to improve the quality of life of the people of this state," Bentley finished. "The most important thing we can do is help them get a job."

Huntsville Hospital CEO David Spillers issued the following response to WHNT News 19:

"We believe without the expansion of Medicaid, hundreds of thousands of people in Alabama will continue to remain uninsured.  This will put a strain on the health care system statewide.  We believe it will also put us at a competitive disadvantage to those states that choose to expand.  We also believe the economic impact of approximately $1.8 billion a year coming into our state would create a significant number of jobs and also improve the health care of thousands of people in Alabama."


  • Wake Up

    The people will have a chance very soon to express how they feel concerning this issue — at the voting places!

  • putter

    Mr. Bronner , Is the CEO for the UNION RETIREMENT SYSTEM of ALABAMA ,He is Not talking about ALL the people of ALABAMA,ONLY UNION people in ALABAMA ,don’t let him tell you other wise!

      • putter

        Robert,you are correct , Bronners UNION is fighting for Obamacare ,like all of Obamas UNION buddys. They all have been ordered to. Obama has already payed the UNIONS off ,now it time for them to do him a favor.

    • thumper

      oh what you really mean is union = citizens …not big business right? when did those citizens become NOT citizens? and when did big business become represented citizens to republican legislators?

    • M. Butler

      You are completely wrong in saying that there is a union for public employees in Alabama. There is no union. There is no collective bargaining, no contract between employees and the state, no elected union reps, etc. You clearly don’t understand what a union is.
      David Bronner is in charge of investing public employee pension money to make it grow. He wants the economy to grow so his investments (for example, the RTG golf trail and various hotels around the state) will make more money. Educate yourself, please.

  • Wake Up

    PutPut, unions benefit everyone around them, not just the union members. First, the fact is that when unions are stronger the economy as a whole does better. Unions restore demand to an economy by raising wages for their members and putting more purchasing power to work, enabling more hiring. On the flip side, when labor is weak and capital unconstrained, corporations hoard, hiring slows, and inequality deepens. Thus we have today both record highs in corporate profits and record lows in wages.

    Second, unions lift wages for non-union members too by creating a higher prevailing wage. Even if you aren’t a member your pay is influenced by the strength or weakness of organized labor. The presence of unions sets off a wage race to the top. Their absence sets off a race to the bottom.

    Read more: The Decline of Unions is Your Problem, Too |

  • Amy

    A democracy cannot exist as a permanent form of government. It can only exist until the majority discovers it can vote itself largess out of the public treasury. After that, the majority always votes for the candidate promising the most benefits with the result the democracy collapses because of the loose fiscal policy ensuing, always to be followed by a dictatorship, then a monarchy.

    Elmer T Peterson

    • Seamus

      Nice quote, Amy, but I have to ask… What happens when the Few votes “itself largess out of the public treasury” and there’s no accountability for the corporate and legislative bunch at the top, when they control the legislatures, the regulators and the justice system? The result is the same… the collapse of the democracy… but the cause and the beneficiaries of its collapse are vastly fewer… and it’s called fascism.

  • Kim

    I’m one of the people that can not afford to be added to my husband’s insurance due to the price increase. Because Alabama’s governor decided not to expand medicaid, I do not qualify for any help through Obama Care with insurance and I do not qualify for medicaid!! I have many health issues that keep me from holding down or keeping a job. I am not on disablity, so what am I suppose to do. I’m still stuck in the same sad situation with NO insurance and yes my quality of life is getting worse over the years due to my inability to seek and get sufficient medical care!!

    • Wake Up

      Kim, your best option is to vote for a governor that will help the ACA succeed rather than one that works to make it fail!

      • Philip

        Obamacare is a complete failure from concept to implementation. We are going to loose doctors and hospitals that will take medicaid patients and it won’t matter if you are covered by it or not. If there are no doctors for you to see, then you are still without healthcare even though you have some type of coverage.

  • george washington

    Unions raise the cost of everything and deny others the right to work. There was a time when Unions had a real purpose. Now they just raise he cost of living and stuff the pockets of the union leaders. Most are corrupt and worry about power – not people!!

    • John Mullins

      Spoken like a person who has no idea what unions really do or has ever been a member of one. I felt the same until I joined one and found out that all the bad things I had ever been told about unions were lies told by ignorant people. The decline of unions has caused the decline of the middle class in our country and is destroying our entire economy.. Both our economy and our people did best when unions were their strongest !

      • Philip

        Paying people more money than they are worth is not a good idea. I work for a company that has unions in the north but not in Huntsville. I can get my work done here a lot faster than I can up there. It takes 2 or 3 days to get a computer moved from one office to the next because we have to have a union worker do it, a task anyone can do. Here I can pick it up and move it right when I need it moved, no delay. So paying someone more than they are worth for a job anyone can do with no threat of being fired equals a bad deal for the rest of us.

  • Yvonne Foater

    To Putter. You do not know anything about this subject or you would know that the union people represented by Dr.Bronner are all already insured. None of the members of the state insurance programs will be affected by the expansion of Medicaid or by Obamacare.

    Dr. Bronner, unlike Gov/Dr Bentley cares about everyone in this state and wants to see Alwbama for once become number one in some area besides football!

    • putter

      Ms. Foater , you are correct Oboma has already carved the UNIONS out of Obamacare, now he needs a little help from his UNION buddys.

  • Seamus

    bentley doesn’t want the ACA to work… doesn’t want healthcare to work for the common person. Why? Because ALL he knows it what his tea party mindset allows him to believe… Just like most GOP these days, for the “doctor” ideology means more than people, ideology means more than math or logic and ideology is all he can spout.

  • John Mullins

    Just the increase in revenue into the state treasury by those extra Medicaid dollars being spent would more than pay for the cost to the state. The Governor shows he has no knowledge of economics or any Christian compassion for the poor. Not only would the expansion be revenue positive for the state but would also help the struggling city and county governments with their revenue shortfalls. It is our tax dollars we paid the federal government we are talking about. Why would anyone not want them returned to the state ? Our Governor is an idiot that is also NOT a Christian no matter what he claims.

    • Wake Up

      John, those that scream the loudest about being Christians are often the least likely to be true Christians!

      • Saul Alinsky

        I love you man !, separate the people as much as you can, and make them want government more, Thanks Wake Up.

  • Ned Crater

    He cannot think of anything worse than expanding the entitlement of Medicaid. He sees no problem giving away millions in tax breaks to companies to create a few poor paying jobs, he sees nothing wrong demonizing the poor as leeches who do not deserve the ability to see a doctor, he does not understand the impact preventative care would have in the State with one of the highest instances of heart disease, diabetes and stroke. He does not comprehend the changes that have been made to the existing medicaid program and the complete destruction his actions will cause the medical industry in this State. He is a shill for the insurance companies, he does not represent the people, unless the people have a whole lot of money. Doctor? I think the man got his license from a crackerjacks box.

  • thumper

    JOBS would be created by AL passing a minimum living wage law and prosperity will increase for all citizens and not just the elite few of already wealthy corporations. Citizens deserve the opportunity of a living wage and the security of health care insurance coverage and the only way for them to have and get that is for PUBLIC servants to represent them in law and regulation and not the “personhoods” of corporations in self-serving actions.

  • andilaw

    Folks with certain serious chronic medical conditions like diabetes, high blood pressure, glaucoma, schizophrenia, etc. will become disabled and unable to work if they are denied access to medical care to manage these conditions. You know this because you or your relatives and friends deal with these issues on a daily basis. When (not if, but when) they are disabled and unable to work because they were unable to afford this care, are you then going to call them worthless blights on society? Dr. Bentley, you know this is true. Everyone needs access to medical care.

    • Wake Up

      Andilaw, for some, it is more important to see President Obama fail than to help people. It is more important for them to sabotage everything even if that means many people will suffer. Let them know what side you are on when you vote next time!

      • Saul Alinsky

        Thank you again, Wake Up, divide the people up, green vs blue ,black vs orange ,white vs pink. make them all haters. just so our socialist government, can take from the producers , and give to our non-producers. again thanks Wake UP for your help.

  • eddie braxton johhnson

    THIS is GOV. BENTLEY WE TALKING BOUT!!!..this is the same guy who said, alabama’s economy would benefit from ELIMININATING all the illegals until people with BETTER sense thought otherwise..Same goes for medicaid!!! ..who is this guy? he’s a typical product of the 50’s!! stuck in the same’ol ways ..times have changed and this man needs to change his tune

  • W.S. landers

    Please, please someone run against this clown. Hopefully they will come from the Republican party since a democrat stands 0 % chance of beating a republican in Alabama.

  • Dan Gordon

    hope governor of Alabama gets hit by a truck, thanks to his ignorant decision not to expand Medicaid I was just informed by the government that I don’t make enough money to qualify for the tax credits and should be getting free health care thru Medicaid but due to our ignorant governors decision that is not an option in this and 16 other republican states, and to top that all off my healthcare plan I have paid for for years has been raised to an amount I can no longer afford

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