HUNTSVILLE, AlabamaWAF) – Imagine you own a business and 10-40% of the customers who walk through your door can’t pay you. You can’t refuse them either.

This is the reality of hospitals: they are required to care for patients whether or not they can pay.

WAFF 48 News explored a plan that some say could solve most of the state’s medical problems.

Year after year, rural hospitals close in Alabama.

To reduce their costs, some hospitals have chosen to close their maternity wards in recent years.

In October 2024, Lawrence Medical Center made its financial problems public, sparking fear among area residents.

Health care advocates continue to point to a possible lifeline, expanding Medicaid to the 300,000 uninsured Alabamians who fall into a health coverage gap.

As the CEP at Thrive Community Health Centers, Mary Elizabeth Marr sees uninsured people show up at her clinics every day.

“There are people who may have two jobs and neither of those jobs make enough money for them to be able to enter the market or their company doesn’t offer insurance. So what are these people doing? These people end up going to emergency rooms and urgent care and it all becomes uncompensated care,” Marr said.

To date, 40 states, including Washington, DC, have adopted Medicaid expansion; Alabama is not on this list.

The expansion will go beyond just insurance coverage for children, pregnant women, the elderly and the seriously disabled.

“It expands Medicaid to people with poverty levels at or below 138 percent,” Marr added, which includes people with incomes below $20,000 a year.

Marr can’t think of any other reason why expansion hasn’t happened in Alabama other than: “Politics is at play. I’ve been doing this for 30 years and it’s a no-brainer to me.”

State House Minority Leader Anthony Daniels agreed: “It’s very political, I think right now you’re seeing states where it started as a political issue because it’s ‘Obamacare “, but right now it’s about dollars and cents and it’s about saving lives. »

Gov. Kay Ivey has the authority to expand Medicaid without a vote in the Legislature.

However, the governor’s office released this statement saying:

“Ensuring that Alabamians across the state have access to quality health care is important to the Governor. However, on the issue of Medicaid expansion, she remains concerned about how the state might fund it in the long term.

After compiling years of research and data on other states’ successes, Danne Howard, deputy director of the Alabama Hospital Association, believes she has found an answer to that question.

“The plan that we have proposed and continue to discuss will not cost the state anything for at least the five-year term of the waiver,” Howard said.

The so-called “All-Health” plan that Howard presented to lawmakers would offer a “public-private” partnership in which federal funds from the Affordable Care Act would offset costs, with an employer-sponsored insurance plan where the state covers the employee’s expenses. share or offer traditional Medicaid to those below the poverty line.

“The All-Health plan model is not a Democratic or Republican plan, it checks the box for a bipartisan plan. It closes the insurance coverage gap responsibly, in a fiscally conservative way that keeps people working and encourages work. I don’t care how you look at it, healthy people are able to work and find better jobs to get them out of dependent programs like this and be able to afford insurance coverage on their own . Howard added.

Expanding Medicaid in this state won’t solve all of our health care problems, but Alabama could use Arkansas as an example of success on the “public-private” model.

Arkansas expanded its Medicaid program in 2014 and has not had to close a single rural hospital since.

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