Supporters of Medicaid expansion renew effort
by Tim Lockette
Nov 19, 2013 | 2736 views |  0 comments | 37 37 recommendations | email to a friend | print
Barbara Howard of the Health Disparities Institute at Tuskegee University speaks on the steps of the Alabama State Capitol.
Barbara Howard of the Health Disparities Institute at Tuskegee University speaks on the steps of the Alabama State Capitol.
MONTGOMERY — On Tuesday morning, John Zippert sat around at a breakfast table with other members of Greene County Hospital's board of directors, listening to details on how the Affordable Care Act would affect federal reimbursement to the hospital.

By noon, Zippert was on the steps of the Alabama State Capitol at a press conference, demanding that the governor expand Medicaid.

“Without the Medicaid expansion, the numbers don't add up,” Zippert said.

Zippert was one of about two dozen people, most of them community leaders from Black Belt towns, who gathered on the state Capitol steps Tuesday to again appeal to Gov. Robert Bentley to expand Medicaid to roughly 300,000 new customers under the Affordable Care Act. Gatherings like this one, organized by Democratic politicians and the NAACP, have become a regular event in Montgomery, though there's no evidence they're moving the governor to change his mind.

Alabama currently has more than 900,000 people on Medicaid, the state-and-federal program that provides health insurance for some people living below the poverty line. Under the Affordable Care Act, widely known as Obamacare, states have the option of expanding the program to people with incomes slightly above the poverty level, with the federal government footing most of the bill.

Bentley, long a critic of Obama's health care reform, has declined to expand Medicaid, citing the need to cut costs in the program before adding new clients.

"Medicaid in Alabama for years has been a broken system, and our focus is on fixing the system — not expanding something that's broken," Bentley spokesman Jeremy King said Tuesday.

That refusal has become a central theme for Democratic lawmakers, as well as African American leaders. The NAACP brought 200 people to the Capitol steps in January to call for a Medicaid expansion. Democrats in the state Senate opened the legislative session with an announcement that their sole goal for the year was to change the governor's mind. Democrats filed resolution after resolution designed to encourage the expansion, all of which were rejected by the Legislature's GOP majority.

On Tuesday, after a month of bad publicity generated by the botched rollout of the Obamacare website, advocates of the expansion tried to bring attention back to the dollars — and lives — they say will be lost if Bentley doesn't change course.

"People will get sick who did not need to get sick at all," said state Sen. Hank Sanders, D-Selma, an organizer of the event. Sanders and other speakers said that without the expansion, uninsured people will avoid doctors until they need the emergency room, where they have to be treated no matter the cost. That will ultimately cost the system money, speakers said.

"You can't go to the doctor, so you wait until you're really sick, and then you have all those hospital bills," said Selma resident Sherry Mitchell, a speaker at the event who has been unemployed since before the 2008 recession. Speakers at the event described Mitchell as someone who'd been denied Medicaid, though Mitchell told The Star afterword that she'd just been approved for Medicaid.

Zippert, of Greene County Hospital, said the federal government is decreasing "disproportionate share" payments it once gave to hospitals, to offset the cost of treating uninsured people who go to the emergency room. Those payments were decreased on the assumption that Medicaid would be expanded and everyone would have coverage, Zippert said.

"The governor's decision is putting a dagger in the heart of small hospitals," he said.

King, the spokesman for Bentley, said Tuesday that the governor is willing to work with hospitals to offset the cost. He said it's too early to discuss details of how that would be done.

Speakers at the Tuesday event said they intended to make the Medicaid expansion an issue in the 2014 elections. Citing the successes of marchers in the civil rights movement, they said their event was an early step in a movement that would prick the conscience of the governor and the wider public.

"We believe that if we keep on going, Dr. Bentley will change his mind, or the situation will bring him to his knees," Sanders said.

So far, however, proponents of Medicaid expansion lack the one thing they may most need in order to win their cause — a pro-expansion candidate for governor.

Bentley has raised more than $2 million toward re-election in 2014, and his Republican primary opponent, Stacy Lee George, has $48. Democrats have yet to field a candidate, though in past elections, candidates have typically announced their intentions more than a year prior to Election Day.

Democratic Party chairwoman Nancy Worley said the party has two strong potential candidates. She didn't name the two, but said the pair were negotiating between themselves to determine who will run and who will sit it out.

"I think there will be an announcement by one of them soon," she said.

Capitol & statewide correspondent Tim Lockette: 256-294-4193. On Twitter @TLockette_Star.

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