Medicaid was underfunded by $85 million in the 2016-2017 General Fund. This morphs into a billion dollar loss when we factor in matching federal funds and grants. Payments for services by doctors have already been cut by 50 percent. Doctors with large Medicaid practices will be crushed. Rural hospitals teetering on the brink will tumble over. Something must be done. What will this looming special legislative session bring?
The General Fund is in terrible shape. All Alabama state government except public education is supported by the General Fund. The General Fund has $1.8 billion in revenues. That’s the lowest per capita funding in this country. Nearly everything is underfunded from health care to law enforcement, to courts, to prisons, to mental health, to transportation and so on. We cannot even keep driver's license offices open. It’s a chronic mess. What will this looming special legislative session bring?
Medicaid really needs to be expanded. It will save many lives a year, provide tens of thousands of jobs, save rural hospitals, greatly increase state revenues without additional taxes, make so many lives more healthy and so much more. What will this looming special legislative session bring?
Alabama is one of four states in this nation without a lottery. We have been trying to implement a lottery since 1999 without success. Polls show that huge majorities of Alabamians support an education lottery. Alabama is in great need of revenue to adequately operate government. However, we have not been able to do what 46 other states have done. What will this looming special legislative bring?
Gambling is widespread in Alabama. It comes in the form of bingo that ranges far from the traditional bingo. It comes in the form of race tracks. It comes in the form of Indian-operated casinos. It comes in the form of Alabamians traveling to every surrounding state – Florida, Georgia, Mississippi and Tennessee – to gamble. What will this looming special legislative bring?
Will public education be funded better or worse? Public education in Alabama ranks 47th in the nation. There is not nearly enough revenue. However, some continue working to reduce funding for public education. What will the looming special legislative session bring?
The special session is scheduled to commence on August 15. Legislative leaders want to conclude the session by August 24 in order to get the proposed Constitutional Amendment on the ballot. I don’t know what this special session will bring. Various theories, proposals, and rumors are on the loose. I want to share some theories, proposals, rumors, etc. that touch on nearly all the issues raised in the previous paragraphs.
Gov. Robert Bentley will propose a lottery by constitutional amendment. Projected revenue is $225 million. All revenues will go to the General Fund. It will be a year before these revenues are available even if the Alabama Legislature passes the amendment and voters ratify the amendment in November. He will also try to divert $70 million from the BP settlement as a temporary bridge to carry Alabama over this year’s budget deficit chasm.
There is a theory, proposal, rumor, etc. about a secret pact for legislative leaders to substitute the lottery bill with a much broader constitutional amendment that will do the following: (1) legalize expansive gambling at four race tracks; (2) outlaw gambling in other places; (3) establish a lottery; (4) earmark limited funds for Medicaid; (5) merge all revenues with designated percentages for the General Fund and for the Education Trust Fund; (6) tax bingo with revenues allocated to local entities by a two-to-one ratio over the state; and (7) expand gambling beyond the four race tracks by a secret provision. Expansion of Medicaid is not in this proposal although there were discussions. What will this special legislative session bring?
Every crisis is an opportunity for someone. Who will seize the opportunity embedded in this crisis? Will gambling interests seize the opportunity to advance the interests of a few? Will some legislators seize this opportunity to reduce funds for education? Will certain leaders seize this opportunity to meet just a few of the urgent needs of the state? Will other leaders seize the opportunity to advance the state in every conceivable way? What will this special legislative session bring?
Frankly, I do not know of anything that we can do that would be more impactful than the expansion of Medicaid. Thirty thousand jobs all over this state are very impactful. Saving rural hospitals is very impactful. Providing medical insurance to hundreds of thousands of Alabamians is very impactful. Hundreds of millions of additional revenue each year is very impactful. Each of these is impactful, but all of them together are more than impactful; it is far reaching. I will do everything I can to implement an expansion of Medicaid.
EPILOGUE – When opportunities arise, it is up to me to seize them. It is up to you. It is up to us. We all have a role and a duty.
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