As public support for Medicaid expansion grows, local activists ramp up effort
Days after civil rights icon John Lewis laid in repose at the State House, an activist group led by an old friend and former student organizer stirred up trouble at the Capitol when its members attempted to spray paint their message out on the street. In bold yellow letters, it read: “Expand Medicaid.”
For the second time in a matter of weeks, former Tuskegee Mayor Johnny Ford and the Save Ourselves Movement for Justice and Democracy (SOS), had made news in Montgomery for their “destruction of public property” in protest of the state’s failure to act on what they believe is now the most pressing civil rights issue facing the country.
And as COVID-19 rates continue to climb, particularly in Black Belt counties, they say Gov. Kay Ivey’s inaction is costing Alabamians dearly.
“Our only interest is to save lives,” said Ford, who was elected Tuskegee’s first Black mayor in 1972 and now serves as chair of the National Black Leadership Commission on Health.
"I am willing to protest, I’m willing to go to jail, and if necessary, I am willing to die for this cause, just as I was willing to die for voting rights,” Ford said.
For a decade, state leadership has declined to expand Medicaid access through the Affordable Care Act, though 25% of its population — one in four people — qualify for the program statewide. Alabama's eligibility policy remains among the strictest in the country as one of 14 states that offers no Medicaid coverage to adults without children or a disability.
If Alabama expanded Medicaid, it’s estimated that more than 300,000 people would gain coverage. That figure has likely swelled due to the impact of the coronavirus pandemic.
“People die every year because they don’t have insurance under [Ivey’s] watch ... and yet she won’t pass Medicaid. Kay Ivey you are killing your own people,” said SOS member attorney Faya Rose Toure.
According to research and policy institute the Center on Budget Policies and Priorities, 768 Alabamians between the ages of 55 and 64 died between 2014 and 2017 because they lacked health insurance.
“She is not pro-life. She is pro-death when it comes to Black people and poor people,” Toure said.
The governor has expressed her reticence in fiscal terms: the state simply cannot afford to pay for expansion. But Medicaid advocates say that the opposite is true; the human and economic toll of maintaining the status-quo is far too high.
“Any fair discussion of the costs of Medicaid expansion has to look at the cost of not expanding Medicaid,” said Jim Carnes, policy director at Alabama Arise, a nonprofit that works to eradicate poverty through legislative policy.
Carnes described Ivey’s view of the cost issue as “too narrow,” arguing that the price of bearing delayed care for hundreds of thousands of people was a far greater strain on the economy.
Although the state neglected to take advantage of the federal program’s 100% match period between 2014 and 2017, Carnes said that the current 90% match was an extremely favorable deal.
Within the first four years of Medicaid expansion, Arise estimates the federal government would contribute about $7 billion for new health coverage in the state. An investment they calculate would yield $4.6 billion in indirect economic activity, $446 million in new state tax revenue, $270 million in local tax revenue and save $316 million in current state health program costs — all for a 10% match that would add about $168 million more in the first year of expansion to the nearly $2 billion the state currently pays, and just $25 million more each year after.
“This is seed money … that stimulates the economy. There is no bigger economic development action the governor could take than to expand Medicaid. It’s huge,” Carnes said.
Aside of diverging views on SOS's methods that have twice landed members in jail, including Hank Sanders who served as a state senator for almost 40 years, public sentiment seems to be moving in their favor. An Auburn University at Montgomery poll released last month revealed about 64% of Alabama voters now support a plan to expand Medicaid.
Popular opinion aside, the group, which has held demonstrations in Selma, Tuskegee and Shelby County, plans to return to the Capital this week to mark the anniversary of the 1965 Voting Rights Act with a protest.
“In the spirit of John Lewis and the sacrifice of those who fought and died for the Voting Rights Act we’re asking people to join us in the movement,” said Ford, the former Tuskegee mayor.
“We want young people to join us. All of those people out there who do not have insurance we want them to join us. This is your fight,” he said.
Contact Montgomery Advertiser reporter Safiya Charles at (334) 240-0121 or SCharles@gannett.com