Alabama's Refusal To Expand Medicaid Costs More Than Jobs

Fri Sep 20, 2013 at 12:54:58 PM CDT

The GOP supermajority that promised in 2010 to focus on "jobs, jobs, jobs" if voters would give them a chance at power has ignored the opportunity to add 62,000 jobs in the state.  Those jobs would come through the expansion of Medicaid and would cost the relatively small sum of $26,000/job.  Compare that with the $200,000/job the state spent on Mercedes.

But the GOP - including our "doctor" Governor Bentley - said no to Medicaid expansion.  And in doing so they're picking the pockets of every low-income worker in this state who would have benefited.

See, here's the deal with the Affordable Care Act, or "Obamacare" if you prefer: depending on income, families may be eligible for subsidies to purchase insurance. Even better for low income families, those eligible for a subsidy receive it up front - it's deducted from your premium cost.  That's particularly important for anyone on a tight budget because it means you don't have to wait to file your taxes and get a refund check.

There's a catch though for families living below the poverty line in states that are refusing to expand Medicaid.  Those people are ineligible for any sort of subsidy and have to pay the entire cost of their coverage.

You can see how this works at the Kaiser Family Foundation Subsidy Calculator.

For example, consider this family of four with an adjusted gross income (AGI) of $27,000 (that's about what two full-time workers making minimum wage bring home). The calculator estimates that they could purchase a medium-level policy at an out-of-pocket cost of $600/year (with the subsidy).

But if this family makes a little less - maybe one spouse is part-time or someone got laid off for part of the year, they could easily drop below the federal poverty line.  If their AGI drops just a few thousand - to $23,400 - they're at 99% of poverty level and their unsubsidized cost for a policy is $10,684.

The people who do these low-paid jobs need health care and so do their families.  They aren't sitting behind a desk moving money from Column A to Column B.  No, they're often doing hard, physical work and often working odd hours or swing shifts.  They're on their feet cooking our food, cleaning our toilets, doing farm work, helping the elderly with home care, etc. etc. 

These workers are all but invisible to most people but they shouldn't be invisible to their state government.  Out of what can only be seen as pure spite, our Governor & his legislative supermajority are leaving these people behind.

The Governor is out of step with the majority of Alabama residents, 64% of whom support Medicaid expansion - and 78% support setting up state-level exchanges.  He and his buddy Speaker Mike Hubbard cite cost.  Yep. The two self-proclaimed "pro-life advocates" think the state can't afford to save 5,000 lives per year:

The federal government would pay all the cost of services for new enrollees for the first three years, but then that amount would drop, hitting 90 percent in 2020. 

We can afford special elections.  We can afford huge corporate giveaways to lure industry.  We can send public money to private schools.  We can spend thousands to redecorate Mike Hubbard's office in Montgomery and pay his political cronies from the public coffers.

But we can't offer expanded Medicaid to our most vulnerable citizens for even three years when it won't cost the state a dime.  Why is that, exactly?