A Health Care V-Blog

Some of what I talk about here has already been covered in prior posts, but I figured I ought to go over it again for the sake of emphasis. The injustice in our health care system is plain to see.




Alabama Medicaid might be able to add 237,000 to its rolls, but only if Federal funding comes through. That's a bit too late for me, though. It would take 90 to 120 days for me to get my Medicaid coverage back.

WASHINGTON -- At least 237,000 Alabamians could gain health coverage through the state Medicaid program under legislation now moving through Congress, according to an official agency estimate, and the expanded rolls could end up costing state taxpayers tens of millions of dollars a year.

The estimate, provided at the Press-Register's request, is based on raising the state's stringent income eligibility cutoffs to match the federal poverty income level, now $18,310 a year for a family of three.

Congressional Democrats have proposed going further in the health care legislation being debated in both the House and Senate, but "unanswered questions" make it difficult to gauge the potential impact, Alabama Medicaid spokeswoman Robin Rawls said in an e-mail.

Of the 237,000 who would become newly eligible by matching the federal poverty level, it is unclear how many are now without health insurance, she said, although many would be parents of children already on the rolls.

Even the more modest increase would represent "a tremendous leap in coverage for Alabama," said Jim Carnes, spokesman for Alabama Arise, a Montgomery-based coalition that lobbies on poverty issues. "Right now, we leave parents and working adults at low incomes out in the cold."

In Mississippi, where about a quarter of the state's population participates in Medicaid, spokesman Francis Rullan said it is "premature" to predict the legislation's impact until lawmakers agree on a final bill.

Created in the mid-1960s, the federal/state program pays for various medical services for some 800,000 poor and elderly Alabamians every month; it is also a financial lifeline for many doctors, nursing homes and public hospitals.

Rawls put the cost of increasing eligibility in Alabama at $371 million annually, not including administrative expenses. Under the House measure, the federal government would pick up the full tab for new participants through fiscal 2014, Solomon said, and 90 percent annually after that. But even 10 percent of the tab would be more than the program could handle, Rawls said. "The money is just not there."

At present, the state's income eligibility limits for working adults are among the nation's tightest, according to the Kaiser Family Foundation, a California-based research organization. Childless adults are generally not eligible; those with families have to be near destitution to qualify.

In the health care debate, public attention has been centered on proposals to add a government-backed "public" health insurance option. Less notice has been paid to plans to expand existing government programs to lessen the ranks of the uninsured.

Nationally, for example, the House bill would add an estimated 11 million people to Medicaid rolls by 2019, said Judith Solomon, a health care specialist at the Center on Budget and Policy Priorities, a liberal-leaning think tank also based in the nation's capital.

For the current fiscal year, Alabama Medicaid has a $4.9 billion budget. While a funding formula typically puts the federal government's portion at close to 70 percent, that share has grown this year because of extra money funneled through an economic stimulus bill. The added funding will be available through the end of next year, Rawls said.