The head of the Retirement Systems of Alabama is calling on Gov. Robert Bentley to expand the state's Medicaid Agency to include more than 300,000 new eligibles under the Patient Protection and Affordable Care Act.
"I cannot understand why you would throw away a billion and a half dollars" Dr. Bronner said during an exclusive interview.
Under the federal healthcare law, also known as Obamacare, states have the option to expand their Medicaid programs to include individuals who are at 133% of the poverty level and don't have health insurance. In Alabama, that makes up about 300,000 people.
To Dr. Bronner, he doesn't see how anyone could turn those people away from health insurance.
Bronner said, "You can help three hundred thousand women and children and to the person who doesn't want to help three hundred thousand women and children, what's wrong with you?"
When he brought up the idea of waiting until 2014 to expand the program, Dr. Bronner called that prospect, "disgusting."
Alabama would have no costs for the first three years. Under the law, starting in 2014 and ending in 2016, the entire cost of the Medicaid expansion would be covered by the federal government. Beginning in 2017, Alabama will have to cover 5% of the cost of the Medicaid expansion and beginning in 2020, the state would have to cover 10% of the entire Medicaid expansion. Estimates by the Kaiser Family Foundation and economists at UAB Medical Center project the state price tag to be in the range of $700 million to $800 million.
Democrats in the Alabama Legislature proposed an expansion of Medicaid during the 2013 Regular Session but Republicans who control supermajorities in both the House and Senate basically ignored the proposal.
Overall, the state would receive $1.5 billion annually to cover the expansion of Medicaid. Alabama's Medicaid Agency is currently undergoing historic reforms to transform the program from a fee-for-service, to a capitated model, which is billed as a cost saving measure. Medicaid takes up approximately one third of the state's General Fund Budget, more than $600 million annually.
In a statement, Gov. Bentley's Press Secretary Jennifer Ardis said, "Governor Bentley has said all along that Medicaid is a broken system and believes it is irresponsible to expand a broken Medicaid system. It will take some time for these reforms to be implemented and begin to benefit patients currently on the Medicaid rolls."
Dr. Bronner says it's not just about providing people with health insurance who otherwise wouldn't be able to afford it. He also says Medicaid expansion is an economic development opportunity that the state can't pass up. Bronner even said it would be bigger than the Hyundai, Mercedes-Benz, and Airbus projects combined.
"I don't know how many jobs you would create but I do know Georgia says it would create 70,000 and we're half the size of Georgia" Dr. Bronner said. "So if we create 35,000 that would be the biggest thing in the history of the state that I know of."
If Alabama doesn't expand Medicaid by December 31, then it will miss out on the first quarterly payments from the federal government.
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