Part 2: The effect on 300,000 Alabamians

MONTGOMERY, AL (WSFA) - Treasure Schutz and her husband are part of the population that has fallen through the cracks in the healthcare system.  She doesn't have a job and stays at home to care for their four children, who are all covered by Medicaid.

Treasure would be eligible for health insurance under the Medicaid expansion section of the federal healthcare law. She admits government assistance is not her dream-life.

"I want to say that I'm doing this for my kids and it's not the government paying for them like because there are other people that need it and I feel like if we can afford it then we shouldn't have it. That's just not an option right now."

The kids have some niceties but they come at a price.  Health insurance isn't even in the equation. The family's take-home income is only $1600 per month, and the weekly premiums that her husband's company offers just went up.

There are about 300,000 people just like treasure in Alabama living without health insurance, but who would be eligible for coverage under the law known as Obamacare if Alabama would allow part of it to go into effect.

Governor Robert Bentley doesn't call it Obamacare, and he won't expand Medicaid,  saying it's not right for the state right now, and that the state just can't afford it.

Economists at UAB Medical Center conducted a study that concluded that the Medicaid expansion could bring in $20 billion in new income including $1.6 billion in tax revenues.   The state would have to put up about $770 million to pay for the expansion.

We caught up with Dr. David Becker, one of the authors of the study who said the state needs to look at the expansion as an economic development project.

"I think it's very similar to all of these things that states do to lure businesses. We know that from Thyssenkrupp" said Becker. "We attracted the Airbus facility that is slated to open in Mobile.  States are always competing on the basis of attracting automobile manufacturing plants and other things that create jobs that are good for the state. And in some sense I think this is very similar to that. The big difference which is the ideology part of this is that those are private enterprises."

Not everyone is on board with that line of thinking, like Cameron Smith with the right leaning Alabama Policy Institute, who said signing on blindly to a massive expansion of a program like Medicaid, could have dire consequences.

"The United States, and to be quite frank, many states got into tough financial straits because of the fact they said yes to a lot of good things they couldn't afford. The Medicaid expansion could very well prove to be one of those things. . ."

Smith says making sure everyone in the state has access to quality healthcare is important. . . But not at a cost which, despite some estimates like the UAB study, is basically unknown.

"Well any time you put millions of dollars into a system, there are positive side effects and those shouldn't be ignored. But where did the money come from? Was the money there in the first place? And the notion of magic money is a popular thing in government circles but it doesn't obtain in reality."

In her own right, Treasure Schutz has a laundry list of questions. . . But they're about she and her husband's well-being?

And to her, they're not political. "If my husband has a heart attack, and he has to go the emergency room and he still doesn't have insurance, are they just going to send us home? I don't know? Are they going to perform surgery knowing that we can't pay for it?"

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