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Alabama leaders consider Medicaid Expansion with new federal incentive

WBMA Birmingham logo WBMA Birmingham 3/24/2021 Lauren Walsh

The leader of the Alabama Hospital Association is urging state leaders to expand Medicaid. This comes after the federal government put up a new financial incentive to states.

“For the patients who are not insured, it’s the right thing to do,” Dr. Don Williamson said. “We will get better health outcomes. We will diagnose diseases earlier. We’ll save lives and that ultimately is the bottom line.”

Governor Kay Ivey’s spokeswoman says she's open to the discussion, adding “our Finance Department and Medicaid Agency will need thoroughly review it before we can fully weigh in on this issue.”

Expanding Medicaid in Alabama could add some 300,000 more Alabamians to the rolls. Many advocates for expansion- call this new financial incentive a game changer.

“I do feel like we’re closer now than we ever have been and like I said, if not now, then when is the question,” said Brian Massey, Chief Advocacy Officer for St. Vincent’s Hospital.

Massey wants the state to take advantage of the federal government’s new offer to help make Medicaid expansion cheaper for Alabama.

“Right now, a lot of people who would fall into the Medicaid gap either delay care or they fall into the most expensive type of care- the emergency room,” Massey said, while adding that Medicaid would give those people access to primary care.

Williamson says expansion would also help keep rural hospitals open.

“Rural hospitals right now, over 85 percent of them have negative operating margins and that’s not sustainable and that’s largely driven by their uncompensated care,” Williamson said.

The new incentive offers states a five percent boost in the federal match for the people already on Alabama’s Medicaid roll. That incentive would last two years.

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Caption: Alabama leaders consider Medicaid Expansion with new federal incentive (

“Five percent on a population of over a million people generates substantial savings on the state’s side that will more than cover the cost of expansion,” Williamson said. “.I think financially for the state it’s a win.”

Sen. Greg Albritton, chairman of the Senate General Fund Committee, says leaders are weighing the pros and cons of expansion.

“There are discussions going on about this program and how and if we can join in but the numbers don’t add up,” Albritton said. “There’s continued arguments if you will, discussion over which numbers are valid and which are not.”

The concern is that the boost will only last two years. Leaders are crunching numbers to see how much expansion would cost the state afterward.

“Whether it’s $200 million or $300 million or 400 million, the state doesn’t have that amount of money in the general fund to put toward this at this point,” Albritton said.

We asked the chances Alabama will expand Medicaid with the new option.

“The pressure’s there,” Albritton replied. “People are pushing.Unless we have a better answer than pay for it for two years and then you got it- unless there’s a different answer, unless there’s a different path we can do, I just don’t believe this path will work for us.”

Right now, 1.1 million Alabamians have Medicaid insurance. That group includes few able bodied adults.

Expansion would allow Medicaid for an individual making around $17,000 a year or a family of three with an annual income of $29,000.


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