MONTGOMERY, AL (WSFA) - Gov. Robert Bentley will travel to Washington, D.C., Monday to meet with the White House about changing Alabama's Medicaid structure. While Bentley is optimistic about the possibilities for reshaping Medicaid for the state, in fact he believes the state will benefit from not expanding Medicaid under the Affordable Care Act, commonly referred to as "Obamacare".
"They [the Trump administration] are not for expanding Medicaid further," Bentley stated. "In fact, there will be a reduction on that with time. We will be rewarded because we did not expand Medicaid. I think that will help us set up our RCOs [Regional Care Organizations]. We are going to be better off in the way we handled it in the beginning."
Others squarely disagree, stating there are few specifics in the proposed legislation about how it will handle a pool of money set aside for states that did not expand. Bentley believes The White House will give him the flexibility to make needed changes to Medicaid. That flexibility could come in the form of training requirements, imposing premiums, and copays.
"They want to work with each individual state, that's what's so encouraging about this," the governor said. "It's not one size fits all. They said it's a different day, Governor, and we are going to work with you."
Medicaid funding has long plagued Alabama lawmakers. The proposed healthcare bill would change the current state-federal match funding program to a per capita spending program. Alabama's lean Medicaid program wouldn't get the same return as other states with more robust programs. Those in the healthcare field expect this could overwhelm Alabama's already cash-strapped General Fund budget because it's generated to reduce federal spending and shift that burden back to the states.
Bentley expects this new flexibility to aid the state in its plan to shift the way doctors are paid for treating Medicaid patients. This would transition Alabama Medicaid from a fee-based system to the RCOs.
Under this structure, hospitals would be allowed to "stand up" an RCO, which would allow that system to manage the costs for treating Medicaid patients. That rollout is slated for October, but some of the largest hospitals, including UAB, have suspended plans to create an RCO to evaluate loopholes that allow out-of-state companies to manage Medicaid programs – forcing the hospitals to compete with commercial companies.
The American Hospital Association, AARP, The American Health Care Association, among other notable organizations, all oppose the American Health
Care Act. You can read their letters to members of Congress below:
American Hospital Association:
Joint letter – American Academy of Family Physicians, American Academy of Pediatrics, American College of Obstetricians and Gynecologists and American College of Physicians: