Bentley: Lottery last hope to save Medicaid

Bentley: Lottery last hope to save Medicaid

MONTGOMERY, AL (WSFA) - A week after the first critical round of cuts to Medicaid providers, Governor Bentley is asking lawmakers to see the lottery through a different lens.

"This is all about people", Governor Bentley explained. "The lottery is just a means to an end – that's all."

Bentley made two stops Wednesday, pushing his proposal to protect the state's most vulnerable population. He's hinging his arguments for a lottery on Medicaid, but the funding from a potential lottery amendment would benefit all essential services appropriated by the general fund budget.

"There are a half a million children born into poverty, half a million", Bentley sympathized. "That was not their fault. They did not choose where they were born or what situation they were born. These children deserve to be taken care of, Medicaid is the only thing we have right now." 

Bentley is pushing the lottery as a moral issue, to help and save sick children but he is clear, this will not expand casino gambling. Bentley explained to the Children's Cabinet he doesn't see families being hurt by the lottery in the same way it affects those who gamble at casinos.

When asked, the governor explained his decision to leave casino gambling out of the bill had nothing to do with his personal convictions.

"When you put the two together, you've primarily lost everything. I want to simply things", Bentley explained.

Bentley will make the legislation public Friday, and admits he's still courting sponsors for the bill.

"The lottery will be very tightly written, the constitutional amendment will be very tightly written", Bentley said. "It will be a very simple lottery. All it is, is to allow the people to approve it or not approve it, and we would come back later with the guidelines that it would have an oversight committee."

If the amendment is codified, the oversight committee would be appointed by the governor, and confirmed by the Senate.

The clock is ticking, if the state cannot shore up funding, it will lose a $748 million dollar allotment from Centers for Medicaid Services, or CMS to implement the Regional Care Organizations and transform the state's Medicaid system.

"CMS said we can't institute the RCOs and we can't keep the $748 million if we cut anything else", Bentley said. "The only thing we could cut was the primary care bump that I didn't want to cut. I do not want to hurt primary care doctors in this state."

Medicaid Commissioner Stephanie Azar is in contact with CMS, who is closely monitoring the situation in Alabama, and doctors who fold under the latest round of reimbursement cuts.

"I've heard a lot from the pediatricians and doctors who have been affected by the bump cut", Azar said.  "Some may possibly lay off employees and leave the system, just on that cut alone."

The special session will begin on August 15th, the timing is also critical as the deadline to add the amendment to the November ballot is August 24th.  Governor Bentley said he's not ready to put out the call for the session, however he's entertaining the idea of adding a bond issue, which would help pay back the Rainy Day Fund and support Medicaid.

"I don't know yet", Bentley said. "I'm not that optimistic on that. I would put broad language in so they won't have to have a 2/3rd vote."

The Governor's Office released a statement in July that projected the lottery could bring in more than $200 million dollars for the general fund. Medicaid faces an $85 million dollar shortfall for fiscal year 2017.

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