Overcoming Poverty: Alabama looks for ways to provide health insurance coverage for more people

The Alabama Hospital Association believes investing in Alabamian’s health up front could mean big payoffs in the long run.
Published: Aug. 17, 2023 at 7:19 PM CDT
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MONTGOMERY, Ala. (WSFA) - Hundreds of thousands of people in Alabama are living without health insurance, keeping many of them from going to the doctor when they need one. When they do get health care, it ends up costing hospitals thousands of dollars in uncompensated care. These are people who are working and make too much money to qualify for Medicaid but not enough to afford private insurance.

Alabama is one of 10 states that has not expanded Medicaid coverage to include adults who don’t have children or disabilities. The Alabama Hospital Association is working on designing a plan that could consist of more people, and satisfy both political parties, and people like cosmetologist Eryn Mullins.

“We’re independent contractors,” Eryn explains. Her industry is full of people who are self-employed. “I have to be at work to get paid, to pay my bills and take care of my family.”

In her five years in this line of work, she’s managed her finances without insurance.

“When I started doing hair, I didn’t have any coverage, and I was a fairly healthy person, very fortunate about that. So I just did self-pay,” she said.

Eryn is just one of somewhere between 250,000 to 300,000 people in Alabama who fall into what the Alabama Hospital Association calls a coverage gap.

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“If you’re 18 and below, then you qualify for Medicaid as a child. And if you’re 65, then you qualify for Medicare,” the Association’s Deputy Director Danne Howard explained about Alabama’s state-provided healthcare benefits.

In Alabama, a parent or caregiver must make less than $4,000 a year to qualify for Medicaid. Those without dependents or disabilities don’t qualify at all.

“There are some states whose Medicaid program does cover healthy-bodied or able-bodied, childless adults in certain income levels. We elected not to do that many years back when the program was first put into place,” Howard said. “The state does not put the same amount of money into our Medicaid program as most other states do.”

“It’s very broken,” Mullins said, describing the system in place. “You feel invisible.”

The solution isn’t simple. Lawmakers have made it clear their priority is to be prudent with taxpayers’ money. The Alabama Hospital Association believes investing in Alabamian’s health up front could mean big payoffs in the long run.

“So we got to figure out a way to get them health care insurance so that they can be healthier, we have better health outcomes in the state, our workforce, our job force is a healthier workforce, and it pumps so much money back into the economy when you have a healthier population,” Howard insisted. “We will have information, hopefully soon, that we can release on the economic impact of closing the coverage gap.”

Eryn couldn’t wait for the state to figure out its funding. Now she’s a new mom, and her husband’s job offered some insurance.

“It’s okay. It’s affordable for us,” she said. But it’s not everything Eryn needs. And hundreds of thousands are in the same situation.

“There are a number of ongoing efforts right now and discussions in working through and trying to develop an Alabama-specific solution that would incorporate some of the best parts of some our sister states who have it already without putting a drain or strain on the state’s finances,” Howard said with hope.

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