May 14, 2024

Medicaid Expansion


Montgomery, AL – May 14, 2024 – More than 80 organizations sent a joint letter to Gov. Kay Ivey on Monday urging immediate action to close Alabama's health coverage gap. The groups are partners in Cover Alabama, a nonpartisan coalition dedicated to ensuring quality, affordable health coverage for all Alabamians. 


“We are writing today to ask you to close Alabama’s health coverage gap immediately,” the letter said. “Alabama faces a significant challenge in ensuring access to affordable health care for all its residents. Our state continues to maintain a substantial gap in coverage, leaving nearly 300,000 Alabamians without access to the care they need to stay healthy and thrive.” 


The groups’ call to action came after a recent joint hearing of the Senate and House health committees. During the hearing, Republican lawmakers from Arkansas and North Carolina testified about their respective approaches to expanding health care access. 


“Alabama is one of only 10 states that have not closed the coverage gap,” said Debbie Smith, Alabama Arise’s Cover Alabama campaign director. “Our lawmakers heard two successful options to expand health care and the benefits of each, and there are many more positive examples across the country.” 


The hearing demonstrated two potential approaches Alabama could emulate to close the coverage gap — traditional Medicaid expansion, like North Carolina, or a public-private option, like Arkansas. 


“I live in a very rural and very conservative area,” North Carolina state Sen. Jim Burgin said during the hearing. “I have not had one person that has come up to me and told me, ‘Jim, you shouldn’t have done that, and we’re against you for doing that.’ But I’ve had hundreds of people come up to me and thank me because their loved one is now getting help.” 


North Carolina expanded Medicaid in 2023. In 2014, Arkansas leveraged a public-private option to expand health care access.  


“At the end of the day, looking at those health care providers, what they were facing, and our hospitals, we’re going to pay for these folks one way or the other,” Arkansas state Sen. Missy Irvin said. “So you might as well legalize a structure where you can get premium tax to help pay for a program, and you get higher reimbursement rates.” 


Cover Alabama’s letter to Ivey implores her to recognize the urgency of closing the coverage gap and to take swift action to ensure Alabamians have access to health care. The letter highlights the economic benefits of expanding health care access, citing improvements in workforce participation, economic growth and productivity. The letter also outlines key recommendations for an Alabama solution, emphasizing the importance of covering adults with incomes up to 138% of the federal poverty level, supporting rural access to health care and maximizing federal funds to reduce state costs. 

The Alabama Legislature’s 2024 regular session ended last week without any legislation passed to close the coverage gap. But the governor can answer the call for health care expansion with executive action at any time. 


“Alabama shouldn’t be left behind any longer,” Smith said. “Gov. Ivey should take immediate action to close the coverage gap now.” 




About Cover Alabama: 

Cover Alabama is a nonpartisan alliance of advocacy groups, businesses, community organizations, consumer groups, health care providers and religious congregations advocating for Alabama to provide quality, affordable health coverage to its residents and implement a sustainable health care system. 

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