MONTGOMERY, AL (WSFA) - The long-term plan for Medicaid, the largest agency in Alabama, is up in the air. Despite repeated efforts and moves, many healthcare questions still exist in Washington.
When asked when she wanted the healthcare debate in Washington to be finished, Gov. Kay Ivey said "yesterday."
"It needs to be resolved as soon as we can. So let's hope they can get it right and get it done so we can tend to our people here in Alabama," Ivey said.
Medicaid takes up more resources than any other program in the state, and Alabama relies heavily on federal funds to foot the bill.
"The state can't do it themselves, and we depend on a federal match," said Jim Carnes, policy director of Alabama Arise. "In our case, because we are a high poverty state, the federal government gives us about 70 percent of our Medicaid expenses."
Often though the money hasn't been enough. Year after year lawmakers seem to return to Montgomery facing a Medicaid funding shortfall.
"We are probably going to see a hole in the Medicaid budget again," Carnes said.
Lawmakers have struggled to deal with the rising cost of Medicaid. Some lawmakers thought they had the solution by moving Medicaid to a system of Regional Care Organizations. However, the program was scrapped before its implementation after a lack of long-term funding led to some groups d ropping out of the plan.
Alabama's healthcare system relies heavily on Medicaid, especially in rural counties. Without dollars from Medicaid, the Medicaid commissioner, lawmakers, advocates and others say hospitals could close.
"It's great if I have a card from an insurance company, but what if there is no hospital in my county," Carnes said.
Complicating matters is the CHIPs program, which the federal government has yet to fund. The program provides health insurance for more than 80,000 Alabama children. Medicaid has reserves to fund the program for some time but not in the long run.
Lawmakers do have more than $90 million of BP settlement money to help address Medicaid and other costs this year, but much is expected to be eaten up by potential Medicaid increases.