HB447 By Representatives Moore (M), Lawrence, Chestnut, Rafferty, Forte, Clarke, Daniels, Jones (S), Howard, Bracy, Jackson, Boyd, Morris, Hollis, Drummond, Hatcher, Gray, Rogers, Hall, Givan and Coleman RFD Ways and Means General Fund Rd 1 12-MAR-20

SYNOPSIS: This bill would expand the Medicaid program, in light of our on-going and rural health crisis, to provide assistance to all persons for whom matching funds are available to the state under the Patient Protection and Affordable Care Act.

A BILL TO BE ENTITLED AN ACT

Relating to Medicaid; to expand the program to provide assistance to certain state residents; to direct the Alabama Medicaid Agency to implement the expansion; to direct other state agencies and entities to provide certain assistance; and to provide for appropriations for adequate funding.

BE IT ENACTED BY THE LEGISLATURE OF ALABAMA:

Section 1. The Legislature finds all of the following:

(1) The question of how to provide comprehensive, quality health care to all Alabamians regardless of income, health status, age, or gender has been one the Alabama Legislature has asked itself time and time again.

(2) The residents of this state are suffering because of their lack of access to adequate health care.

(3) Reducing the number of uninsured patients will keep hospitals open. Since 2011, 17 Alabama hospitals have closed, 88 percent of these remaining rural hospitals are operating in the red, and 75 percent of all Alabama hospitals are operating in the red. These hospitals depend on federal dollars to offset the cost of serving a high proportion of low-income and uninsured patients; however, these patients have suffered due to the state's failure to expand Medicaid.

(4) The World Health Organization has classified COVID-19 as a pandemic, and a COVID-19 outbreak in the State of Alabama could be devastating to the state's economy and the health of all residents.

(5) The United States government declared the novel coronavirus a public health emergency on February 4, 2020.

(6) Failing to expand Medicaid ensures that many Alabamians that may become infected will go undiagnosed and untreated: People for whom going to the doctor would result in financial calamity tend not to do so before their health circumstances become dire.

(7) Broad access to health care leads to preventive care, which produces healthier families, a healthier workforce, and an all around healthier state.

(8) The federal government started paying 100 percent of the Medicaid expansion in 2014 under the Patient Protection and Affordable Care Act. The federal government's share dropped to 95 percent in 2017, and ultimately to 90 percent in 2020.

(9) With the expansion of Medicaid, approximately 397,000 uninsured Alabamians would be eligible to receive low-cost health insurance with a majority of these residents employed. Covering low-income adults would also reduce the burden of medical debt, currently the leading cause of personal bankruptcy.

(10) Expansion of Medicaid will result in reduced state spending on health care related services to those previously uninsured residents with incomes below 133 percent of the federal poverty level.

(11) In addition to enhancing access to health care, expansion of Medicaid would promote revenue and economic activity in this state, resulting in the preservation and creation of jobs.

(12) Studies have shown that a one dollar ($1) increase in federal spending on Medicaid yields an additional 65 to 75 cents of economic activity.

(13) The Alabama Health Care Improvement Task Force, created on April 6, 2015, by Executive Order No. 4, unanimously recommended to the Governor to close Alabama's health coverage gap, which the expansion of Medicaid would achieve.

Section 2. (a) The Medicaid program shall provide assistance to all persons who apply and are determined to be eligible for assistance and for whom federal matching funds are available to the state under the Patient Protection and Affordable Care Act, Public Law 111-148, March 23, 2010, as amended by the Health Care and Education Reconciliation Act 4 of 2010, Public Law 111-152, March 30, 2010.

(b) The Alabama Medicaid Agency shall take all steps necessary to implement the Medicaid expansion program as provided for in subsection (a) and shall be the lead agency for the implementation in this state. The Alabama Medicaid Agency shall seek assistance from any state or federal agencies or entities to implement the program as appropriate, and all state agencies or entities shall provide assistance as requested by the agency.

(c) The Legislature shall annually appropriate adequate funding to the Alabama Medicaid Agency for the purpose of implementing and operating the Medicaid expansion program pursuant to this act.

Section 3. This act shall become effective immediately following its passage and approval by the Governor, or its otherwise becoming law.

Medicaid

Medicaid Agency

Health Care