By Kim Chandler, Associated Press
MONTGOMERY, Ala. – Gov. Robert Bentley has said he is open to expanding Alabama’s Medicaid program, but the plan would have to be designed by the state and it would require people to work.
In a speech to legislators Thursday, Bentley reiterated his past opposition to a straight expansion of Alabama’s Medicaid program under the Affordable Care Act. However, the governor, elaborating more than he has previously, said he is willing to consider a state-designed program that uses the federal Medicaid expansion dollars to increase coverage. The Republican governor said a program would have to use the private sector to insure people and also put work and job training requirements on them.
“It needs to be tied to some things. If you are an able-bodied person, it needs to be tied to the fact that they are trying to get a job or they have a job. There are some stipulations there,” Bentley said.
The Affordable Care Act gives states federal funds to help expand Medicaid to cover people at up to 138 percent of the federal poverty level, which is $27,310 for a family of three in 2014. A U.S. Supreme Court ruling made the expansion optional. Bentley has so far refused. Most of the states that have expanded Medicaid under the Affordable Care Act have done so by raising the income eligibility on their existing Medicaid programs.
A few states, including Pennsylvania, Iowa and Arkansas, have gotten waivers to use the federal expansion dollars to buy Medicaid recipients insurance coverage through the marketplace or to create state-tweaked programs.
Proponents of Medicaid expansion reacted cautiously.
“Our goal is to get uninsured people covered. We’re eager to hear from the governor. We certainly prefer movement to a slammed door,” said Jim Carnes, policy director of Alabama Arise, an advocacy group for low-income families.
A study by the University of Alabama at Birmingham estimated 300,000 additional Alabamians would be covered under a Medicaid expansion.
While Bentley discussed a work requirement, the federal government has curtailed what conditions those waiver states could impose on Medicaid recipients. The Republican governor of Pennsylvania initially sought to require recipients to be actively searching for jobs, but later dropped the idea. The state runs a separate program to encourage employment for participants.
“While encouraging work may be a state objective, it is not the purpose of the Medicaid program and, as such, is not part of the Pennsylvania demonstration,” CMS spokesman Aaron Albright said in an email.
Bentley said his office is not working on any proposal.
“We really have not gone into detail. Other states have talked about it, and they may have turned them down, but now they have a Republican Congress, and things may be different,” Bentley said.
The governor has been a harsh critic of the Affordable Care Act. Bentley first announced in 2012 that Alabama would not expand Medicaid or set up an insurance exchange under the federal health care law. However, he has sometimes used qualifiers about not expanding Medicaid in its current form.
“I will not expand Medicaid as it exists under the current structure because it is broken,” Bentley said in 2012.
Expansion became an issue during this November’s election when his opponent, Democrat Parker Griffith, repeatedly criticized Bentley for his refusal to expand Medicaid.
“I hope he does expand Medicaid. I think it will be good, not only for the people of Alabama, but for the hospitals of Alabama,” Griffith said.
Republished with permission of the Associated Press.