ACPP news releases

'Flagrantly cruel' Medicaid changes would mean 'poorer, more desperate and less healthy Alabama families,' Arise tells state officials

Alabama’s proposed new Medicaid work requirement waiver would be costly, counterproductive, ineffective and harmful to thousands of families who live in deep poverty, Arise Citizens’ Policy Project wrote in official comments submitted to state Medicaid officials on Thursday, March 22, 2018.

“Threatening loss of health care in an attempt to force work efforts, without providing the supports that would make those work attempts successful, is flagrantly cruel and will result in no outcome other than poorer, more desperate and less healthy Alabama families,” Arise’s comments concluded.

Medicaid covers about 1 million Alabamians. Of that total, the waiver would target 7.5 percent of them – about 75,000 adults with extremely low incomes who qualify for Medicaid as parents or other caretaker relatives of children. Alabamians in this group are ineligible for Medicaid if their incomes exceed 18 percent of the federal poverty level (about $312 a month for a family of three).

Because Alabama has not expanded Medicaid to cover adults with incomes below the poverty level, the state’s work requirement plan would create a “catch-22 that forces people into the coverage gap,” Arise wrote. About 300,000 Alabamians already are caught in the coverage gap, earning too much for Medicaid but too little to qualify for federal subsidies for Marketplace plans.

Parents who work just 10 hours a week at minimum wage earn too much to qualify for Medicaid. But the state’s proposal would require them to engage in work-related activities between 20 to 35 hours a week. That would leave thousands of Alabama parents in a no-win situation: They would lose their Medicaid coverage if they don’t work – and also if they do. Virtually all of them would end up uninsured, without access to employer-provided coverage or an affordable private plan.

Alabama’s proposal does not project the state’s cost to track Medicaid enrollees’ work activities and exemptions. It also does not identify whether or how the state would invest in child care, job training, transportation and other supports that low-income parents need to get and keep work.

Arise’s full comments on Alabama’s proposed Medicaid work requirement waiver are available here.

Click here to read a PDF version of this news release.

Alabama mothers, children bear brunt of proposed new Medicaid restrictions

Alabama’s bid to impose a work requirement on parents receiving Medicaid could cost as many as 8,700 people their health coverage in the first year, mainly affecting mothers whose children also would feel the impact, according to a new analysis by the Georgetown University Center for Children and Families (CCF) and Arise Citizens’ Policy Project (ACPP).

The proposal would create a Catch-22 for these families who already live well below the poverty line: Any parent working the 20 to 35 hours required under the state proposal would make too much money to qualify for Medicaid – but likely not enough to afford private insurance. These harsh new restrictions would disproportionately hurt families living in Alabama’s rural communities and small towns where jobs are scarce.

“Alabama’s proposal creates more barriers to Medicaid coverage and will not help families rise out of poverty. In fact, the opposite is true – many parents and children are likely to lose health coverage, which exposes them to greater financial instability,” said Joan Alker, director of the Georgetown University research center. “It’s hard enough to raise a family on such a limited income without someone putting more roadblocks in the way.”

Alabama is not the first state to seek a work requirement, but it is one of the first to do so without accepting federal funding to expand Medicaid to adults with incomes slightly above the poverty line (138 percent of the federal poverty level). Around 300,000 Alabamians are caught in the coverage gap, earning too much to qualify for Medicaid but too little to qualify for subsidies for marketplace coverage through the Affordable Care Act.

In Alabama, only the poorest parents and caregivers, those making 18 percent of the poverty level or less – $3,740 a year for a family of three, or about $312 a month – now qualify for Medicaid. That is the strictest eligibility requirement in the nation (along with Texas). Because Alabama has not expanded Medicaid, the work requirement would apply only to parents with extremely low incomes.

The analysis found that among this population:
•    More than 85 percent are women.
•    60 percent are not in the workforce, in many cases because they are caring for someone else or have an illness or disability; 24 percent describe themselves as unemployed. The remainder are already reporting some work.
•    58 percent are African American; 40 percent are white.
•    35 percent are young parents under age 30.

A proposal for a Medicaid work requirement, now undergoing a state public comment period before submission to the federal government, could prove disastrous for many Alabama families, ACPP policy director Jim Carnes said.

“The goal of this cruel, counterproductive plan is to take health insurance away from thousands of Alabamians who are living in desperate poverty,” Carnes said. “By creating barriers to coverage rather than promoting it, Alabama’s work requirement fails the most fundamental test for Medicaid policy changes.”

Alabama’s proposal also seeks to trim eligibility for Transitional Medical Assistance – despite the fact that TMA is designed specifically to provide stability in health coverage for families whose incomes are increasing because they are working more.

In addition, the proposal could fuel an increase in the number of Alabama children without health coverage, according to the report, because uninsured parents are more likely to have uninsured children. Alabama’s rate of uninsured children – just 2.4 percent – is the lowest in the South. Overall, children and families in Alabama’s rural communities and small towns are more likely to use Medicaid coverage to meet their health care needs than those in metropolitan areas, a 2017 Georgetown University CCF/University of North Carolina study showed.

“As a pediatrician practicing in rural Alabama for 37 years, I have seen firsthand what happens when parents cannot access health care: Their children’s health suffers,” said Dr. Marsha Raulerson, who is a pediatrician in Brewton and a member of the American Academy of Pediatrics. “If approved, the Alabama Medicaid work requirement would be a step backwards for a state that has been a national leader in covering children.”

Click here to read a PDF version of this news release.

House vote for public transportation bill is a win for mobility, economic development across Alabama

Arise Citizens’ Policy Project executive director Kimble Forrister issued the following statement Thursday, Feb. 22, 2018, in response to the House passage of a bill to create the Alabama Public Transportation Trust Fund:

“Creating the Alabama Public Transportation Trust Fund is an important step forward for public transportation. Today’s House vote for SB 85 brings us closer to the day when our state will finally step up and make a meaningful investment in public transportation so all Alabamians can get where they need to go in a timely manner.

“Alabama is one of only five states with no state funding for public transit. That lack of investment makes it harder for thousands of Alabamians, especially seniors and people with disabilities, to meet basic everyday needs like going to the doctor’s office or the grocery store. It also serves as a barrier to economic development, making it harder for people to get to work and costing our state tens of millions of dollars in federal matching funds every year.

“This bill does not provide state funding, but it sets the stage for needed investment by creating a landing place for future appropriations to support and expand public transportation across Alabama. We thank Sen. Rodger Smitherman and Rep. Jack D. Williams for sponsoring this important legislation, and we urge Gov. Kay Ivey to sign it into law.”

Senate committee vote for '30 days to pay' was a good first step on payday lending reform in Alabama

Arise Citizens’ Policy Project executive director Kimble Forrister issued the following statement Thursday, Feb. 15, 2018, in response to a Senate committee’s approval of a bill that would give Alabama borrowers 30 days to repay payday loans:

“Today’s Senate committee vote in favor of the ‘30 days to pay’ bill was a big win for consumers and communities across Alabama. This common-sense bill would ease financial pressure on struggling families and put payday loans on the same repayment cycle as other debts, such as mortgages, utilities and credit cards.

“This bill would help thousands of Alabamians avoid falling into a debt trap. By increasing the amount of time that borrowers have to repay, it effectively would cut the maximum annual percentage rate on payday loans in half, from 456 percent to about 220 percent. That would boost Alabama’s economy by reducing the amount of fees that are taken out of our communities every year to benefit out-of-state corporations.

“The ‘30 days to pay’ bill is simple but important legislation that would be good for consumers, good for our state’s economy and good for Alabama. We thank Senator Arthur Orr for sponsoring it, the Senate Banking and Insurance Committee for approving it, and the many members of Alabama Arise and the Alliance for Responsible Lending in Alabama who came to the State House to promote it. We urge the Senate to pass this bill in a timely fashion, and for House members to do the same.”

White House's proposed cuts to nutrition, health care and housing would hurt struggling Alabamians

Arise Citizens’ Policy Project executive director Kimble Forrister issued the following statement Tuesday, Feb. 13, 2018, in response to the release of the White House’s proposed 2019 federal budget:

“The White House’s budget proposal lays out a vision of a dark and troubling future for struggling families across Alabama. This plan would slash services like nutrition assistance, health care and affordable housing, making it even tougher for hard-working Alabamians struggling to make ends meet. Life would become harder for everyday families, even as big corporations and wealthy people would continue to enjoy the huge federal tax cuts that were just enacted.

“This budget plan would cut more than $200 billion over the next decade from SNAP assistance, which helps one in five Alabama families put food on the table. It would cost Alabama more than $140 million in federal funding for affordable housing next year, even as the state faces a shortage of more than 76,000 affordable and available homes for households with extremely low incomes. And it would cut hundreds of billions of dollars by 2028 from Medicaid, which provides health coverage for one in five Alabamians – almost all of whom are children, seniors, pregnant women, or people with disabilities.

“Public policies should make it easier, not harder, for working families to get ahead. This budget is a wake-up call about the legislative goals and values of this administration. It paints a bleak picture for our country’s future, and we can’t afford to allow that vision to become a reality. Alabama’s members of Congress should reject this misguided agenda and instead work to ensure that families have the resources and opportunities they need to reach their full potential.”

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