MONTGOMERY, AL (WSFA) - A hugely important issue will be decided by the state'svoters Tuesday. The outcome of that decision could impact everything fromnursing home care to health care to whether state prisoners are released early.
Butsadly, it's possible that only one of every five registered voters in the state-- and perhaps even fewer -- will make that decision.
The statewidereferendum on Tuesday would allow the state to divert$147 million a year for three years to the state's General Fund from the $2.5billion Alabama Trust Fund. The Alabama Trust Fund, which comes from revenuesfrom state oil and gas royalties, has been referred to as the state's savingsaccount.
Toput that into perspective, the amount diverted if the referendum is approvedwould amount to about 17 percent of the trust fund.
The state'schief election official, Secretary of State Beth Chapman, predicted that aturnout of 20 percent of the state's voters is probably optimistic. She notedthat 10 percent or fewer of the state's voters cast ballots in mostsingle-issue elections in Alabama.
Thereare exceptions. She told the news media that a referendum on a statewidelottery and a proposal for tax reform drew voters in large numbers But bothwere accompanied by major pro and con advertising campaigns.
Ascurrently written, the biggest hit if the referendum fails would be on thestate's Medicaid program. It would face a $100 million shortfall in revenue asthe state budget is currently written. But since state funds are used to matchfederal funding, the real impact could be much greater than that.
Why is thatimportant? Funding for health care for about 900,000 Alabamians comes throughMedicaid. More than 60 percent of all nursing home residents in Alabama areMedicaid patients.
As importantas their decision will be on Tuesday, Alabama voters should strongly resentbeing put into the position of having to make that choice. Alabamians electgovernors and legislators to provide the kind of leadership that should avoidsuch crisis-style choices.
Foryears now, through the terms of several governors and through many legislativesessions, it has been clear that revenues from the taxes that support thestate's General Fund -- which funds most non-education operations of stategovernment -- have not been growing fast enough to keep up with the demand forservices. But Democratic and Republican administrations alike have failed to doanything significant to address the problem.
Thenalong came the big economic downturn of recent years, and a big problem becamea huge one.
Insteadof getting at the root of the problem -- the year-in and year-out shortfall oftax funding for the General Fund -- the Republicans who control the governor'soffice and the Legislature dumped the issue in the laps of the public withanother temporary fix -- the diversion from the trust fund.
Democratsare decrying the lack of courage among their GOP opponents, but they have noroom to criticize. Not only did they fail to address the General Fund'sweakness when they controlled the Legislature, they have offered no realalternative to the more immediate crisis. They promise to come up with one, buteven if they do they have no power at all to implement it.
Somepeople say they are reluctant to support the referendum because its failurewould force the Legislature to act on a long-term fix to bolster the GeneralFund, and perhaps to even address the overall issue of tax reform.
Whileit's true that the failure of the referendum would put pressure on theLegislature and the governor to increase taxes, it's not likely to happen basedon the records and the statements of legislative leaders and the governor.
Ifthis referendum fails, the Legislature almost certainly will try to spread thepain by moving around some money in the budget. But there are few signs thatthere is the political will among lawmakers to do anything beyond that.
Caughtin the middle of all this are real people, and not just those served byMedicaid. It's also very possible that if the referendum fails, the impact onMedicaid could force the closure of some smaller, rural hospitals around thestate, which would require all residents served by those hospitals to travelfarther for care. And once they close, those hospitals are unlikely to everopen their doors again, even if funding returns in future years.
Dr. Donald Williamson, state health officer, told merecently that he was "as despondent about where we are as I've everbeen."
The impact almost certainly would go beyond Medicaidif the referendum fails. It's possible that state inmates would have to bereleased early. If lawmakers try to shift funds to lessen the impact onMedicaid and prisons, it would mean other services would suffer. County healthdepartment offices might close, or foster children lose care.
But if the referendum passes, what happens once thediverted money runs out in three years? House Speaker Mike Hubbard, R-Auburn,told me recently that the diversion could buy time for two things to occur.
First, he said, it would allow time for some of thecost-saving measures already implemented by the Legislature to begin to have aneffect.
Second, it would give Congress time to address theissue of online sales taxes. Many states are pushing Congress to adopt new lawsto require online sellers to collect state sales taxes, which many buyers nowavoid. If Congress acts, much of that new revenue for Alabama would flow to theGeneral Fund. But it's likely to take several years for Congress to act and anynew law to go into effect.
Alabama voters should not have been forced to makethe decision they will have to make Tuesday. But that makes it no less crucialthat they make the right decision when they go to the polls.