Hospitals need Medicaid expansion
Jan 15, 2014 | 3060 views |  0 comments | 93 93 recommendations | email to a friend | print
Word is spreading far and wide that Alabama is a great place for companies to do business.

Gov. Robert Bentley made that statement during his State of the State address Tuesday night, highlighting the jobs brought to the state by some of the larger industrial players who have built and expanded production in recent years. The governor also pledged to do more to help small businesses.

Alabama’s reputation for competing for new industrial jobs has spread far and wide. In fact, Boeing recently engaged Alabama and a few other states in a bidding war for a new aircraft assembly plant. It appears now that the states were being used as leverage to win concessions from one of its labor unions in Washington state. Union members blinked, and production will remain near Seattle. No disclosure has been made about the incentives package the state offered to lure Boeing to Alabama.

Alabama has become well known for being business-friendly in that regard.

Bentley has been an energetic recruiter for jobs for Alabama, traveling to Germany, Japan and other locations to promote our state with business leaders. He has done a commendable job of promoting business in Alabama.

But he also used the speech to defend his decision to refuse expansion of Medicaid in Alabama.

The governor laid out his distrust of promises made by the federal government about the Affordable Care Act — Obamacare. He noted claims that have already been proven to be false — that people could keep their doctors, their insurance policies and that insurance premiums would not go up. He is skeptical of the “free money” the Act promises to states for loosening eligibility requirements so that more people can use Medicaid as their insurance. In Alabama, 300,000 more people would qualify.

Initially, the state would not have to contribute to the added enrollment. By 2020, the state would take on 10 percent of the cost of the additional enrollees, with 90 percent coming from the federal government. By that year, the state would have spent about $771 million on the program, and received almost $12 billion more from the federal government.

A study by UAB estimates the expansion would create 30,000 new jobs for medical care in the state — not quite the 40,000 new and future jobs created since Bentley became governor, but not bad for simply signing on to the program.

Glenn Sisk, CEO of Coosa Valley Medical Center in Sylacauga, spoke at B.B. Comer Memorial Library Monday in support of expanding Medicaid to create jobs and help boost the state’s economy. He also spoke of the impact Alabama’s hospitals will feel if something isn’t done to help. Sisk said 75 percent of the state’s hospitals are already losing money, and on average operating on a margin of 1 percent. Refusal to expand the state’s Medicaid program could make matters worse.

Several hospitals in the state have already closed, illustrating the fragile state of the business even before the new rules begin. Chilton County Medical Center, Randolph Medical Center in Roanoke, Mobile’s Infrmary West and Cooper Green Mercy in Birmingham and Florala Memorial Hospital have closed.

Under Obamacare, hospitals will lose money they now receive that helps them provide care for people who are unable to pay for their medical care. As written, Medicaid would be expanded everywhere. But in a challenge to the Act, the Supreme Court ruled that states cannot be forced to expand their programs. Nationwide, only 25 states have agreed to the expansion. In those states, hospitals will be under additional pressure to operate.

Without the expansion or some other relief to pay for indigent care, hospitals will be under additional pressure to continue to operate.

The governor spoke of plans to help bring the poor out of poverty by improving education and career training programs and by continuing to promote the creation of jobs in the state.

That’s a noble plan that might very well help a lot of people. In a perfect world, everyone would earn enough money to rise out of poverty, and our Medicaid program would be a relic of the past. Unfortunately we do not live in a perfect world.

The governor is far from alone in his dislike and distrust of the Affordable Care Act, but he’s making a mistake by refusing to expand Alabama’s Medicaid program.