MONTGOMERY, AL (WSFA) - Over the course of the next week, we will look at the different candidates seeking to become Alabama's next governor through different issues. on Thursday, the third part of this series, our story focuses on healthcare and Medicaid.
Healthcare has long been a major source of debate in Washington and the case is no different in Alabama. The race for the governor's office sees a deep partisan divide on how to deal with healthcare, especially over Medicaid.
Medicaid is the state's largest agency, with an annual budget well over $700 million. Democrats are in favor of expanding the program while Republicans are looking for ways to control the program's costs.
Gov. Kay Ivey says the state is on the right path when it comes to Medicaid and believes reforms instituted by the state's Medicaid agency have helped reduce the increase over the last several years.
"It's refreshing to know some cost-saving measures that the commissioner and the department are helping so that's a good thing. So we are on the right path," Ivey contends.
"I think it's a tax and spend philosophy and say 'hey we need to expand Medicaid'," according to Battle. Instead, the Huntsville mayor wants Alabama to "think outside the box" when it comes to solving the ever-rising healthcare costs.
Battle threw out suggestions like using nursing homes in rural areas and telecommunications with nurse practitioners. He was clear, though, that the state needs to be more proactive instead of reactive when it comes to healthcare, to help the state avoid paying big-ticket costs like hospital visits.
Medicaid costs have risen by tens of millions of dollars and it continues to be the state's largest agency in the General Fund.
"Our healthcare is a mess because the government is involved," the state senator says.
Hightower wants to allow market forces to work when it comes to healthcare in the state. He supports bringing in block grants from the national government to allow for the state to innovate how to deliver care for its citizens. He believes the state could be an "incubator" for new ideas to help reduce costs.
Dawson wants a performance audit of the different state agencies. The goal is to free up cash and see where any potential waste may be. He says the money could help to rural healthcare which he described as being in "crisis".
SUE BELL COBB
"We've got to expand Medicaid," says Cobb.
According to the former chief justice, former Gov. Robert Bentley's decision to not expand Medicaid costs the state billions of dollars and "no telling the lives."
Cobb says the Medicaid program is vital to keep rural hospitals open. It is a claim backed up by Alabama's Medicaid agency, itself, as it has fought for increased funding amounts in the legislature over the last few years.
Cobb says if she is not elected, many of the hospitals could be at risk.
"If Sue bell Cobb is not elected on June 5, and doesn't become governor, I predict 20 percent or more of rural hospitals are going to close," she predicts.
The question, though, with expanding Medicaid, is how to pay for the increase. Cobb says the state could work the "pharmaceutical side" to take out the middleman. The savings generated would be enough to expand Medicaid to 120 percent of poverty line.
Any additional funds could be found through things like a compact with the state's Native Americans or by legalizing sports betting.
Cobb also proposes taking hospitals' unused beds and turning them into locations to help those with substance abuse problems.
Maddox says he would expand Medicaid on "day one." Tuscaloosa's mayor thinks the state has already missed out on $1.8 billion and 30,000 new jobs.
He believes the failure to expand Medicaid puts certain hospitals at risk of closing and if a hospital were to close it would permanently harm the area's ability to attract jobs.