“It’s imperative that Alabama expands Medicaid to the maximum extent possible under the Affordable Care Act (ACA).”- William Elsea, M.D.

Even after the ACA, 11% of Alabamians 0-64 are still without insurance (down from 16% in 2008, per KFF). In fact, there are only 14 other states which have a higher rate of uninsured (AHR,2018).

It is unconscionable that in one of the most religious states in the USA, Alabama has not already acted to provide healthcare coverage for 449,000 of our brothers and sisters whose health is undeniably imperiled by lack of insurance. If Medicaid expansion were approved, 340,000 of them would be covered (UAB, Becker).

Surgeon with Alabama flag on backgroundAlabama is now at the point where thousands of poor people’s lives may be saved by Governor Kay Ivey and the Alabama legislature. Surely the vast majority of Alabamians would choose to do this—to assure health care for the poor, including many of the homeless—when 91% of the cost will be borne by the federal government. Surely, the legislature can find the funds for this vital service, even if it does mean raising taxes.

Thirty-six states have already done this and are using the federal money available to Alabama for Medicaid expansion. Why send Alabama’s hard-earned tax money to treat resident of other wealthy states like NY, CA and Massachusetts when Alabama has more than 400,000 needy citizens? And, there seems to be no other Federal plan to take the ACA’s place, no matter what rhetoric you might hear.

On the national level, Trump has stated time and again that we would all have “great” healthcare… and at a reduced cost. But he just hasn’t figured out what kind of a miracle obtaining that would take for common folks, people who aren’t obnoxious NYC billionaires with inherited wealth who have had everything delivered to them on a silver platter.

Frankly, we have a confused President who has no idea at all what national healthcare reform should look like and no plan to achieve any measurable goals. Meanwhile, Trump has forced the DOJ to refuse to defend the entire ACA, something even conservative AG Barr appears to be resisting.

Of course, if the ACA (Obamacare) departs, say hello to getting booted off policies due to pre-existing conditions. Tell your 23-year-old kid that just got out of college with a sociology degree and severe asthma who happens to be on your insurance to ASAP quit his job as a waiter and find something, anything, that provides health insurance coverage for him. Hard hats and lower middle-class white-collar workers… forget those large subsidies that are now making your premiums affordable.

Just trust that Trump will take care of the problem in 2020 after you elect him. He has publicly promised it to you. That’s right, just like he did in 2015 when he promised to implement his secret healthcare nirvana after the 2016 election. (As a bonus, in 2020 Mexico will be building and paying for the wall as well.)

The problems with the ACA are obvious. Before it was ever implemented, Jack Bernard identified and commented on those problems in the Washington Post, USA Today, NYT and elsewhere. But, until we are willing to go to a proven Canadian or European model (like Medicare for All), we have got to live with both Obamacare’s strengths and weaknesses.

We understand why taxpayers are frustrated. As Jack Bernard wrote in the NYT (10-13) “Americans are generally fed up with what they see as government incompetence and lying.“ However, the clear (undisputed by experts) facts show that the ACA is a world better for the working poor and medically needy than what we had before. That’s why over half of Americans now support it. And, it is very doubtful that even this far-right SCOTUS will find it unconstitutional, given Roberts’ prior views.
Medicaid has enabled provision of essential health care for decades. It has been both effective and cost-efficient, providing preventive and curative services for some of our most underserved residents.

The hundreds of million dollars in new federal funds Alabama would receive under expansion would also help save Alabama hospitals, especially in some smaller rural communities where countless Southern hospitals have already closed their doors due to the strain of indigent care. Further, Medicaid expansion would also directly/indirectly create tens of thousands of new jobs for Alabama residents.

Expansion of Medicaid should not be a partisan issue. It’s a moral issue of concern to all Alabamians, regardless of party. Now is the time to act; delay is unacceptable. Alabama voters: call the Governor’s office and your state legislators to ask them to move ASAP.

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