• Alex Nelson

IMO: Why Alabama deserves Medicaid expansion and why you should care

By Jada Shaffer, State Government Relations Director for the American Heart Association

In the State of Alabama, health insurance is something everyone needs, but not everyone can get. In fact, a whopping 220,000 Alabamians are caught in the state’s coverage gap, and about 120,000 more are stretching to pay for coverage they can’t afford. 


Many Alabamians work at jobs that do not offer health insurance. Or they make too much money to qualify for Medicaid but too little to afford care in the insurance marketplace. The 340,000 Alabamians caught in the coverage gap are hardworking, dedicated frontline workers like grocery store employees, nursing home assistants, pharmacy techs and delivery drivers. Many of these individuals are the very fabric of our state and the folks who have managed to help keep us all going in the wake of COVID-19.

What can be done? How can we ensure the well-deserving people of Alabama receive health insurance? The answer lies within expansion of health insurance access — a statewide change that would allow more Alabamians to receive access to affordable healthcare.

Here are four reasons Medicaid expansion needs to happen now:

1. Alabamians deserve medical insurance.

The purpose of the Medicaid program is to provide health insurance for those who are financially struggling (individuals making less than $17,000 per year or families of three making less than $29,000 per year). If Alabama were to finally accept federal Medicaid expansion, an additional 340,000 people could be covered. Those who are currently not covered by Medicaid are WORKING Alabamians who make too much to receive Medicaid in its current state but do not make enough money to pay-out-of-pocket[2] for healthcare coverage within the marketplace. Currently, far too many individuals must choose between paying for healthcare coverage out of pocket and putting food on the table. These Alabamians — the hairdressers, service industry workers, and frontline heroes who enrich all our lives — deserve better.

2. Other states are already reaping the benefits of Medicaid expansion. Why not Alabama?

To date, 38 other states are already getting federal funding for Medicaid expansion, and Alabama is losing out. States like Arkansas, Kentucky and Louisiana have expanded Medicaid to show their residents they believe they deserve healthcare coverage. Alabama is one of only 13 states that have not yet embraced a coverage expansion. Alabamians work just as hard as these states who have opted to expand Medicaid coverage, and our residents have just as many health issues – or more – that require affordable healthcare.

3. Medicaid expansion will make Alabama families healthier.

People living on the lower incomes covered by Medicaid are more likely to have heart conditions than those with other types of insurance. In the State of Alabama, there is a direct correlation between chronic health conditions and poverty, meaning those families financially struggling are far more likely to have medical conditions like heart disease, diabetes and strokes (and a slew of medical bills to coincide with these serious health issues). And Alabama, unfortunately, is far from being the healthiest state in the U.S. In fact, Alabama has the second-highest death rate of cardiovascular disease in the country. Additionally, Alabama lost nearly 3,000 people to strokes in 2017, suffered over 13,000 heart disease-related deaths in 2017, and has a statewide adult population that is more than 70% overweight or obese. Many of these serious conditions are chronic and require those affected to seek continuous medications and treatments they simply cannot afford to pay out of pocket. Medicaid expansion for Alabamians would mean more families could avoid serious health risks like delayed care, unchecked COVID-19 transmission, and unfilled prescriptions for chronic health issues.

4. Expanding Medicaid in Alabama is the financially responsible thing to do.

Expanding Medicaid in our state would bring $1.7 billion of our tax dollars home from Washington every year. For each state that expands Medicaid, the federal government — not the state itself — is responsible for 90% of the costs associated with the expansion. Those 36 other states are already getting federal dollars for Medicaid expansion, while Alabama loses out. We can help our uninsured friends, neighbors and family members gain access to medical care and boost our economy, all by bringing our money home and putting our residents first.

In order to have a thriving state, we must keep our residents healthy. The first step is demanding that Alabama embrace federal Medicaid expansion. We deserve it.

Encourage Alabama to take action toward a healthier future by signing the pledge here.