Staff Report
MONTGOMERY — It could take a while to sort out what Thursday’s Affordable Care Act decision will mean for Alabama’s citizens, government and businesses.
But reaction from the state’s GOP and business leaders was swift — and largely negative. Many called for its repeal.
Democrats and advocacy groups, however, applauded it.
Gov. Robert Bentley called the law “an overreach by the federal government that creates more regulation, bureaucracy and a dramatic increase in costs to taxpayers.”
Alabama’s top health official said if the state were to expand its Medicaid program under the Affordable Care Act, anywhere from 250,000 to 560,000 more could be added to the rolls.
That’s why some argue that the law is needed.
“In a high-poverty state like Alabama, the Affordable Care Act provides tools to break the chain linking low income to poor health,” Arise Citizens’ Policy Project Executive Director Kimble Forrister said in a written statement. Nearly 750,000 Alabamians, including 100,000 children, are without health insurance, according to Montgomery-based Arise.
But whether the state expands Medicaid will be a financial and political decision, left up to Bentley and lawmakers, said Dr. Don Williamson, the state health officer who oversaw Medicaid for a portion of this year.
Even though the federal government will pay most of states’ costs to expand Medicaid from 2014-16, Williamson estimated it would “cost hundreds of millions of dollars by the end of the decade.”
Bentley’s office said it doesn’t know yet if the state can afford the expansion. But several north Alabama lawmakers have made up their minds.
“That is the only good thing about this ruling — states can’t be penalized for not expanding Medicaid,” said House Majority Leader Micky Hammon, R-Decatur. “We can’t afford to expand it.”
Medicaid serves about 930,000 low-income and disabled Alabamians and receives the largest apportionment from the state’s General Fund budget, about $603 million in 2013.
“Medicaid is already in trouble, and you’re going to expand the rolls by hundreds of thousands?” said state Sen. Paul Bussman, R-Cullman. “That is impossible. It cannot happen and will not happen.”