Alabama Hospital Association begins campaign for Medicaid expansion
With one in every 10 patients walking into state hospitals without insurance, the Alabama Hospital Association on Thursday launched a campaign to push for expansion of the state’s Medicaid program. Politicians in the Deep South have often opposed expansion, but the Alabama Hospital Association is urging citizens and policy makers to think of expansion as they would any other economic development investment, arguing it would benefit communities and the entire state health care system in addition to the estimated 300,000 people who would gain health care coverage “Health care is part of the state’s infrastructure,” Danne Howard, executive vice president and chief policy officer of the Alabama Hospital Association, said. Twelve Alabama hospitals have closed since 2011 and Howard said 75 percent of Alabama’s hospitals are operating in the red. She said expanding Medicaid would be a “significant investment in the state’s fragile health care infrastructure and would help maintain access to care for everyone.” “One in every 10 people who walk into a hospital doesn’t have insurance. At some point those providers, those hospitals, are not going to be able to maintain operation. They are not going to be there, either closing their doors or cutting back services. At that point, it really doesn’t matter what insurance card you have in your pocket. If the provider is not there, the care is not there,” Howard said. Alabama is one of 14 states that have taken no action toward expanding Medicaid eligibility under the Affordable Care Act, according to the Henry J. Kaiser Family Foundation. Thirty-three states and the District of Columbia have approved raising income limits for Medicaid coverage under the Affordable Care Act and another three will vote this fall in ballot measures. The Urban Institute estimated that Medicaid expansion would add 314,000 people to Alabama’s Medicaid rolls. Under the Affordable Care Act, states would put up 10 percent of the cost of covering the additional Medicaid patients and the federal government would pick up the rest. Estimates on what it would cost the state have varied. Gov. Robert Bentley in 2015 estimated that expansion would cost the state $710 million dollars over six years. Other estimates have pegged the cost higher. Alabama Gov. Kay Ivey said last week that she is not opposed to Medicaid expansion, but questioned how the state would pay for it. “Medicaid expansion is desirable perhaps, but how are you going to pay for it? That’s not an issue we can tackle at this point,” the Republican told reporters. Democratic gubernatorial nominee Walt Maddox has proposed striking a gambling compact with the Poarch Creek Indians and using the state’s share of revenue to pay for the state’s cost of Medicaid expansion. At Vaughan Regional Medical Center in Selma, 10-12 percent of patients are uninsured, and 40 percent of patients are on Medicaid, said CEO David McCormack. Looming over hospitals are possible cuts to the federal Disproportionate Share Hospital program for treating a disproportionate share of the indigent. Scheduled reductions were delayed several times, but McCormack said they will have a devastating impact if they go through in 2020 as planned. McCormack said expanding Medicaid would help keep hospitals open and providing services. “I don’t want to give you a dollar, if you give me ten dollars?” McCormack said questioning the argument that the state can’t afford expansion. “First of all, why would we not want billions of dollars coming into the state?” Republished with permission from the Associated Press.
Alabama community health centers receive $4M in critical opioid treatment grants
Community health centers across the state are receiving federal grants to support increased treatment and prevention for opioid and substance abuse. Sen. Richard Shelby made the announcement Thursday that 15 centers would receive a total of $4,038,000 in federal grant funding from the U.S. Department of Health and Human Services (HHS). “It is of the utmost importance that we work to fund the fight against the national opioid crisis,” said Shelby. “Nearly every county in Alabama is affected by this growing problem. These HHS grants will allow community health centers across the state to provide treatment to patients with opioid and substance abuse and support addiction prevention programs, helping our communities tackle this widespread epidemic.” These grants will impact community health centers in the following areas of the state: Bayou La Batre, Birmingham, Centreville, Gadsden, Huntsville, Mobile, Montgomery, Parrish, Selma, Scottsboro, Troy, and Tuscaloosa. On September 19, HHS awarded nearly $352 million to 1,232 community health centers across the nation, including the 15 in Alabama, through the Expanding Access to Quality Substance Use Disorder and Mental Health Services (SUD-MH) awards. The SUD-MH awards support health centers in implementing and advancing evidence-based strategies that best meet the substance use disorder and mental health needs of the populations they serve. The following 15 community health centers in Alabama will receive $4,038,000 in grant funding: Bayou La Batre Area Health Development Board, Inc., Bayou La Batre – $285,000 Christ Health Center, Inc., Birmingham – $285,000 Alabama Regional Medical Services, Birmingham – $285,000 Aletheia House, Inc., Birmingham – $201,750 Cahaba Medical Care Foundation, Centreville – $296,000 Quality of Life Services, Inc., Gadsden – $293,000 Central North Alabama Health, Huntsville – $285,000 Health Services, Inc., Montgomery – $285,000 Franklin Primary Health Center, Inc., Mobile – $285,000 Mobile County Health Department, Mobile – $285,000 Capstone Rural Health Center, Parrish – $287,250 Rural Health Medical Program, Inc., Selma – $285,000 Northeast Alabama Health Services, Inc., Scottsboro – $110,000 S.E. Alabama Rural Health Associates, Troy – $285,000 Whatley Health Services, Inc., Tuscaloosa – $285,000
Montgomery City Council votes against teen curfew
The
Mac McCutcheon weighs-in: Kay Ivey ‘doesn’t really need to debate’ Walt Maddox
There’s been much discussion this year about Republican Gov. Kay Ivey avoiding her Democratic opponent Walt Maddox on the debate stage. Now Alabama House Speaker Mac McCutcheon is offering his opinion on the entire situation, saying Ivey “doesn’t really need to debate” Maddox for the November 6 election. “When it comes to debates, in a campaign, every campaign is different,” McCutcheon told WHNT. “The candidates of those campaigns, they need to look at the polling, they need to look at the issues, they need to look at the opportunity they have.” For months, Ivey has side-stepped Maddox, just as she did with her Republican primary challengers. Earlier this month Ivey went on record saying she has no plans to debate her Democratic challenger as she seeks a full term in office. “Alabamians know my record” and “know what I stand for,” Ivey said. “There are only two people that ever bring up the subject. Y’all in the media and my opponent,” Ivey said in response to a question about debating from a reporter in July. McCutcheon agrees with Ivey, and thinks if Alabamians do have questions they can easily find the answers online. “If they’re listening to social media, if they’re looking at her job performance, if they’re looking at the issues and really digging deep into the issues, I think the answers are there for the public,” McCutcheon added.
Moon Jae-In to carry private message from Kim Jong Un to Donald Trump
A beaming South Korean President Moon Jae-in, freshly returned home Thursday from a whirlwind three-day summit with Kim Jong Un, said the North Korean leader wants the U.S. secretary of state to visit Pyongyang soon for nuclear talks, and also hopes for a quick follow-up to his June summit with President Donald Trump. Only hours after standing with Kim on the peak of a volcano that’s at the heart of Kim dynasty propaganda, Moon told reporters in Seoul that he will be carrying a private message from Kim to Trump about the nuclear standoff when he meets the U.S. president in New York next week on the sidelines of the U.N. General Assembly session. Both Trump, who has repeatedly spoken of his good relationship with Kim, and the North Korean leader have expressed a desire to follow up on the June meeting in Singapore that was meant to settle an impasse that seemed to be edging toward war last year. But there are worries among observers about whether Kim is as committed to denuclearization as he claims. Moon faces increasing pressure from Washington to find a path forward in efforts to get Kim to completely — and unilaterally — abandon his nuclear arsenal, which is thought to be closing in on the ability to accurately target any part of the continental United States. “There are things that the United States wants us to convey to North Korea, and on the other side there are also things that North Korea wants us to convey to the United States,” Moon said at a press center in Seoul where reporters had watched parts of his summit with Kim on huge video screens that occasionally showed live streams from Pyongyang. “I will faithfully serve that role when I meet President Trump to facilitate dialogue between North Korea and the United States.” Moon, who set up the Singapore summit and is eager for another to happen, also told reporters that he’ll convey to Trump his and Kim’s desire to get a declaration on ending the Korean War by the end of this year. The war still technically continues because it ended in 1953 with a cease-fire, not a peace treaty. An end-of-war declaration would be the first step toward an eventual formal peace treaty, but the United States is wary about signing off on something that could result in Kim pushing for the removal of U.S. troops stationed in South Korea to deter the North. Earlier Thursday, Kim and Moon took to the road for the final day of their summit, hiking to the peak of Mount Paektu, which is considered sacred in the North, their hands clasped and raised in a pose of triumph. Their trip to the mountain on the North Korean-Chinese border, and the striking photo-op that will resonate in both Koreas, followed the announcement of wide-ranging agreements on Wednesday that they trumpeted as a major step toward peace. However, their premier accord on the issue that most worries the world — the North’s pursuit of nuclear-tipped missiles — contained a big condition: Kim stated that he would permanently dismantle North Korea’s main nuclear facility only if the United States takes unspecified corresponding measures. “Chairman Kim Jong Un has again and again affirmed his commitment to denuclearization,” Moon said after returning to Seoul. “He expressed his wish to finish a complete denuclearization as soon as possible and focus on economic development.” Moon said North Korea’s agreement to allow international experts to observe a “permanent” dismantling of a missile engine test site and launch pad was the same thing as a commitment to “verifiably and irreversibly” demolish those facilities. Moon says such steps, combined with North Korea’s unilateral but unverified dismantling of a nuclear testing ground earlier this year, would prevent the North from advancing its weaponry through further nuclear and missile tests. Experts say the destruction of the missile engine test site and launch pad wouldn’t represent a material step in the denuclearization of North Korea, which declared its nuclear force complete last year and has designed its most powerful missiles to be fired from vehicles. Moon also said that Kim hoped to visit Seoul soon. “I wish there would be an opportunity for my fellow citizens to see Chairman Kim Jong Un for themselves and hear him talking about the denuclearization of the Korean Peninsula, peace and prosperity with his own voice,” the South Korean president said. Earlier in the day, the leaders smiled broadly as they posed at the summit of Paektu, their wives grinning at their sides, a brilliant blue sky and the deep crater lake that tops the volcano in the background. They also toured the shores of the lake, where Moon and his wife filled bottles with its water and a South Korean pop singer delivered for the leaders a rendition of a beloved Korean folk song, “Arirang,” which is used in both Koreas as an unofficial anthem for peace. The mountain is important to the Kim family, members of which are referred to as sharing the “Paektu bloodline,” and the volcano is emblazoned on North Korea’s national emblem and lends its name to everything from rockets to power stations. Many South Koreans also feel drawn to the volcano, which, according to Korean mythology, was the birthplace of Dangun, the founder of the first ancient Korean kingdom, and has long been considered one of the most beautiful places on the peninsula. Not everyone was pleased, though. About 100 anti-North Korea protesters rallied in central Seoul to express anger about the summit and displayed slogans that read, “No to SK-NK summit that benefits Kim Jong Un.” The leaders are basking in the glow of the joint statement they signed Wednesday. Compared to the vague language of their two earlier summits, Kim and Moon seem to have agreed on an ambitious program meant to tackle soaring tensions that caused many to fear war last year as the North tested a string of increasingly powerful weapons. Both leaders also
Daniel Sutter: Should Alabama bet on sports betting?
The U.S. Supreme Court ruled last May that states could legalize sports betting. New Jersey, Delaware, West Virginia and Mississippi have joined Nevada in offering legal sports betting, and about twenty other states have taken steps toward legalization. Should Alabama join this crowd? The size of the sports betting market is one argument in the affirmative. We lack accurate statistics on the current largely illegal U.S. sports betting market. A 1999 Congressional study estimated that Americans bet between $80 and $380 billion annually, while pro and college football betting has recently been estimated at $100 billion. A study by Oxford Economics for the American Gaming Association estimated that nationwide legalization and mobile betting could result in a $300 billion a year market. Most of the bets are paid out to the winning gamblers, but book makers keep some for expenses and profits. Legalization brings this gaming revenue out of the black market or back from off shore casinos to support jobs in states legalizing betting. Oxford Economics projects that nationwide legalization could create 90,000 jobs and annual tax revenue of $8 billion, through taxes on gambling and taxes paid by now legal employees. Without legalization, Alabama will not share in these jobs and tax revenues. Alabama sports bettors’ money will support businesses and government services in other states. While jobs and tax revenue are nice, prosperity ultimately involves providing goods, services, and activities people want. Jobs from value-creating businesses – those providing the most desired goods and services – create economically thriving communities. Alabama will miss out on a value-creating industry by not legalizing sports betting. But does sports betting truly generate value? A skeptic could point out that gambling is a zero-sum game (the losses cancel out wins) and creates no products. Yet millions of people value having action on games and get satisfaction from their winning bets. People willingly place bets they know they might lose. Economists call such satisfaction utility. All economic activity beyond sustenance and survival is about generating utility by providing people with things they want. Why do people enjoy betting? Economists leave such questions to psychologists. The exclusively voluntary nature of market activities excludes predatory activities from value creation. Everyone must either want to participate (place bets) or be compensated to participate – say cleaning up the sportsbook at night. Sports betting passes the voluntary participation test. Sports betting’s biggest negative is the problem gamblers who lose more than they can afford, resulting in bankruptcy and devastating families. This is most unfortunate, but are problem gamblers better off with prohibition? People have long been able to bet illegally, with online betting only making access easier. Prohibition, however, makes problem gambler’s difficulties worse. Legal sportsbooks will not break legs to collect debts; indeed, it will not be profitable to let gamblers make bets they cannot pay off. Regulations on legal betting can help protect problem gamblers from themselves and ensure help is available when wanted. The increased betting volume from legalization increases the risk of gamblers paying players to fix games. This is a real threat: the “Black Sox” scandal nearly ruined major league baseball, and college players who will never play professionally might find gamblers’ dollars very tempting. NBA Commissioner Adam Silver proposed that an integrity fee on all bets, with leagues using the proceeds to guard against illicit deals. Sportsbooks, though, already have a strong incentive to protect the integrity of games. A $300 billion a year betting market will generate significant profits for years to come provided the public does not view the contests as rigged. Sportsbooks also will not want to pay off rigged bets. Suspicious betting patterns and statistical analysis can help identify rigged contests. Scandals will undoubtedly occur, but cooperation between sportsbooks, the leagues, and law enforcement should keep the contests legitimate. Jobs, taxes, and losing both to neighboring states are all worthwhile considerations. But I think that the most compelling argument is the freedom to engage legally in an activity many Alabamians value. Despite the benefits, I wouldn’t bet on Alabama legalizing sports betting anytime soon. ••• Daniel Sutter is the Charles G. Koch Professor of Economics with the Manuel H. Johnson Center for Political Economy at Troy University and host of Econversations on TrojanVision. The opinions expressed in this column are the author’s and do not necessarily reflect the views of Troy University.
GOP warns time running out for Brett Kavanaugh’s accuser to talk
Republicans are warning that time is running out for Brett Kavanaugh‘s accuser to tell Congress about her claim he sexually assaulted her when both were teenagers, even as President Donald Trump called the woman’s allegation hard to believe in one of the GOP’s sharpest attacks on her credibility. With Kavanaugh’s Supreme Court nomination dangling in the balance, the chairman of the Senate Judiciary Committee said his panel still planned a Monday morning hearing that Kavanaugh and Christine Blasey Ford were invited to attend. Sen. Chuck Grassley, R-Iowa, wrote Ford’s attorneys Wednesday that the panel was giving the California psychology professor until 10 a.m. Friday to submit a biography and a prepared statement “if she intends to testify” Monday. It remained unclear, though, whether Ford would attend or if the hearing would occur without her as a drama that has riveted Washington since emerging a week ago was injected with a fresh burst of election season suspense. After initially saying through a lawyer Monday that she was willing to appear, Ford has since said she first wants a full FBI investigation of her accusation. Trump and Senate Republicans have been emphatic that an FBI renewal of its background checks on Kavanaugh won’t happen, saying an investigation by committee staff — which Democrats are boycotting — is sufficient. Ford’s demand has been fully backed by Democrats. Lisa Banks, a Ford attorney, wrote that Grassley’s plan to call just two witnesses, Kavanaugh and Ford, “is not a fair or good faith investigation” and said “multiple witnesses” she did not name should be included. “The rush to a hearing is unnecessary, and contrary to the Committee discovering the truth,” Banks wrote. The standoff left both parties gambling over which of their approaches would appeal to voters in November’s elections, which will determine House and Senate control. Republican leaders trying to keep GOP senators behind Kavanaugh are offering Ford a chance to describe her allegation, either in a hearing room before television cameras or in private. Republicans have largely stood by Kavanaugh’s denials. Democrats are casting Republicans as strong-arming a wronged woman, their eyes on a #MeToo movement that has caught fire and exploded the careers of dozens of male titans. “Republicans are trying to bully her into a rigged hearing,” No. 2 Senate Democratic leader Dick Durbin of Illinois tweeted about Ford. Trump told reporters, “I can only say this: He is such an outstanding man. Very hard for me to imagine that anything happened.” That remark was noteworthy because most Republicans have handled the question of Ford’s credibility more gingerly. They say they want to give Ford, now a professor at Palo Alto University, every chance to tell her story. Ford has contended that at a house party in the 1980s, a drunken Kavanaugh tried undressing her and stifling her cries on a bed before she fled. Republicans are resisting all Democratic efforts to slow and perhaps block what once seemed a smooth path to confirmation that would promote the conservative appeals court judge by the Oct. 1 opening of the Supreme Court’s new term. A substantial delay could push confirmation past the November elections, when Democrats have a shot at winning Senate control, plus allow more time for unforeseen problems to pop up. There were signs the GOP’s strategy of planning a nationally televised hearing yet also offering Ford the option to testify privately was keeping possible Republican defections in check. The party controls the Senate 51-49 and the Judiciary panel by 11-10, so it cannot afford GOP “no” votes. Moderate GOP Sen. Susan Collins of Maine, who’s had her share of clashes with Trump, said she hoped Ford would reconsider a decision not to testify and “it’s not fair to Judge Kavanaugh” if she refuses. “Otherwise, there are these very serious allegations hanging over the head of a nominee who has emphatically denied them,” she said on radio WVOM in Bangor. Going further, Sen. Lindsey Graham, R-S.C., said Democrats’ demands for an FBI investigation were a ploy to delay a confirmation vote. “It is imperative the Judiciary Committee move forward on the Kavanaugh nomination and a committee vote be taken as soon as possible,” the committee member said in a statement. As for a possible FBI intervention, Grassley said in his letter to Ford’s lawyers, “We have no power to commandeer an Executive Branch agency into conducting our due diligence.” In a separate letter to Democrats, Grassley wrote that committee aides were “even willing to fly to California, or anywhere else, to meet her.” He also wrote that GOP aides tried to arrange interviews with two other “alleged witnesses.” The letter mentioned no names and committee staff declined to identify them. Kavanaugh did not return to the White House Wednesday after spending the two previous days there. He spoke by phone with officials working on strategy, said an aide familiar with the proceedings but not authorized to speak publicly about private conversations. Kavanaugh spent hours Tuesday in the Eisenhower Executive Office Building, part of the White House complex. He prepared for Monday’s potential hearing with officials including White House counsel Don McGahn, Justice Department aides, White House press secretary Sarah Huckabee Sanders and communications director Bill Shine. Shine was ousted from his previous job at Fox News in part due to his handling of sexual harassment claims at the company. Republished with permission from the Associated Press.
