Wednesday, April 12, 2023

The workforce benefits of Medicaid expansion in Alabama

  For nearly a decade, Alabama has been outside looking in on a good deal. While hundreds of thousands of Alabamians struggle without health insurance, state leaders have failed to expand Medicaid to cover adults with low incomes. A few loud voices have politicized an issue that shouldn’t be political. And our state has paid the price in lost dollars, lost jobs, and lost lives.

  Reliable access to health care keeps people healthier and empowers them to work. That’s one reason 39 states and the District of Columbia have embraced Medicaid expansion.

  Alabama is one of 11 states that has yet to expand Medicaid. That inaction has left more than 220,000 Alabamians in a health coverage gap. Parents in a family of three making more than $4,475 a year ‒ just 18% of the federal poverty level ‒ don’t qualify for Alabama Medicaid. But unless they make at least $24,860 a year, they also don’t qualify for Marketplace subsidies under the Affordable Care Act. And adults without children or a disability are ineligible for Alabama Medicaid no matter how low their incomes.

  It’s time to end this injustice and close the coverage gap. Medicaid expansion is the single best solution available for lawmakers to make Alabama healthier. And it is one of the best solutions to help cure our state’s workforce woes.

Medicaid expansion would help Alabamians stay employed

  Alabama’s labor force participation rate is lower than that of neighboring states. Fortunately, Medicaid expansion is a proven, pro-work policy. States that have expanded Medicaid have seen a greater increase in labor force participation among people with incomes below 138% of the poverty line than non-expansion states. These are the very people Medicaid expansion would benefit most.

  One in three Alabama adults has a disability, including nearly two in five veterans. Here, too, Medicaid expansion would help. People with disabilities are more likely to be employed in states that have expanded Medicaid than in states that haven’t.

  Harms from being uninsured are all too real. Without treatment, injuries or manageable illnesses like diabetes can get so severe that they prevent people from working or leading healthy lives. Expanding Medicaid would reduce such needless suffering.

  It’s impossible to separate health care policy from workforce policy because health care policy is workforce policy. Why would a family move to Alabama for job opportunities instead of a state that invests more in workers’ health? And how long will businesses keep relocating to Alabama if our workforce isn’t healthy enough to fill vacancies? They could just as easily go to Arkansas, Kentucky, Louisiana, Missouri, or another state that expanded Medicaid.

Healthier workers across a range of industries

  Alabamians work hard every day to provide for themselves and their families. But hundreds of thousands aren’t paid enough to afford health coverage. Fast food workers, cashiers, carpenters, and hotel clerks are among the many folks who work hard at low-paying but essential jobs that often don’t provide health insurance. They are among the Alabamians who would benefit most from Medicaid expansion.

  We sometimes hear unfounded assertions that expanding health coverage somehow would disincentivize work. That notion is insulting to hard-working Alabamians who don’t receive insurance through their employers. And it takes an absurdly reductive view of everyday life. Health insurance helps people get health care, but it doesn’t cover other needs like food, clothing, or housing.

  Many Alabamians want a job but can’t accept or keep one because they can’t afford the health care they need to stay healthy enough to work. Here, again, Medicaid expansion is an essential solution.

Medicaid expansion would boost Alabama’s economy

  Every year Alabama has refused to expand Medicaid, Alabamians’ federal tax dollars have helped foot the bill for expansion elsewhere. Those states have enjoyed budget savings, revenue gains, and economic growth.

  Research has shown no significant increases in state spending due to Medicaid expansion. Studies in Louisiana and Montana found that expansion pumped money into the economy and produced significant budget savings. In Kentucky, expansion infused $1.16 billion into the health care system and overall economy in the first year.

  Medicaid expansion’s financial benefits for Alabama would be enormous. Expansion could save the state nearly $400 million a year over the next six years, the Public Affairs Research Council of Alabama (PARCA) found. Those savings ‒ from federal dollars covering costs the state now pays ‒ would be more than enough to cover the state cost for expansion, PARCA projected. Expansion also would generate nearly $2 billion of annual economic impact during those six years, PARCA found.

  The benefits wouldn’t stop there. Medicaid expansion would support more than 20,000 new jobs annually on average, PARCA projected. It would extend health coverage to more than 220,000 folks who don’t have it. Most importantly, it would save lives.

Listen to the people: It’s time to expand Medicaid

  Federal funds have improved life in Alabama for decades. That money has helped us educate our children, maintain our roads, and keep our water clean.

  Medicaid expansion would address another vital need: strengthening our health care system. And we would get a fantastic deal: a 9-to-1 federal match of state funds. That’s nearly 20 percentage points higher than Alabama’s matching rate for other Medicaid services.

  The vast majority of Alabamians want this investment in a healthier future. More than seven in 10 Alabamians (71.5%) support Medicaid expansion, a Cygnal poll for Alabama Arise found last year. That includes nearly two-thirds of Republican voters.

  Alabama should prioritize a healthy workforce over political gamesmanship. We should ensure health coverage for our neighbors who can’t afford it. It’s the only decision that makes sense, and it would help make this the state our people deserve.

  Let’s put the people of Alabama first and expand Medicaid.

  About the author: Mike Nicholson, Ph.D., is a policy analyst at Alabama Arise, a statewide, member-led organization advancing public policies to improve the lives of Alabamians marginalized by poverty.

  This article was published by Alabama Reflector. 

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