Category Archives: Alabama Politics

Alabama Legislators Want “Blood on the Floor”: Especially the Blood of Children and Grandparents


Well. I heard from a very credible source yesterday that our state legislators are not playing chicken with the budget this time. You know, it seems like every year they expect us to display panic and beg them to fund essential programs– it is so predictable it is almost like we have a set script. We get tired of it, but at the same time we think jeez, if we don’t play our assigned role, maybe they will do the bad thing.

This year may be different, if my source is correct. Their plan this time is to go ahead and pass a severely cut budget, which the governor will refuse to sign, and then override him. Then when there is “blood on the floor” (and I quote), they expect us to come screaming to them to pass taxes and re-fund the state. They do not feel they have support from their base, otherwise.

I don’t know. From my perspective, we already have blood on the floor. People in this state have been bleeding all over the floor for a long time, and it hasn’t mattered so far as the budget. The only blood I think the legislators care about is corporate blood and their own, so maybe the point is that business will begin fleeing the state once Medicaid is defunct and all the people in nursing homes have to move in with their families or be dumped on the street.

Getting even a level budget for mental health would not be a win, because there is major blood on the floor with our current budget. Getting the expected cut to Medicaid ($320 million, taking the federal match into account) would make the floor downright slippery. The cuts to doctors will be so sharp, around 40% cut to payments already well below private insurance rates, that I have personally heard several pediatricians say their plan would be to immediately drop Medicaid. Most practices have overhead in the range of 60 to 75%, so that 40% is at least the entire salary of the physician. There will not be enough of us left to see those suddenly doctor-less kids, even if we worked 24-7 without sleep. The 2 Children’s hospitals will close, because they depend on Medicaid money to fund their specialists. And good luck trying to get programs like that rebuilt to their current level of excellence, once they are gone. It takes decades.

Who will be affected first? The elderly in nursing homes. Children (guess they should take more personal responsibility). Because people of color are disproportionately affected by poverty, this is also a racist move. Some advocates are making a case by reminding legislators and voters that middle class elderly are in nursing homes using Medicaid funds, and that there are more poor white kids than black ones. Why should that even be said, as if poor elderly and black kids matter less? Only a racist and classist audience would need to be told such things.

I asked it there is anything at all we can do to stop this disaster, and my source told me we need to call our legislators. I’m going to add that you really need to talk to your neighbors, co-workers, etc and explain what is about to happen. Because legislators have told me previously that although phone and email contacts matter, they also use their in-house polling results, which are secret. They call their base on a regular basis to check in, and I am betting they are getting the no new taxes response from those voters.

If our legislators were ethical, they would be calling those voters not to ask their opinion but to persuade them– they would be pulling out the stops to stop the bleeding. They would stop putting forward bills that they know will cause us to waste tons of money defending federal lawsuits. The fact that they aren’t doing so says a lot.

I remember the last time this type of cut was proposed, and the legislators came up with a Hail Mary to borrow money for Medicaid– I had prominent progressive friends telling me that I was just playing the game by begging for votes to save the program– that I should let things play out, let the blood flow, call their bluff. So it isn’t just conservatives who are the problem. I do not believe an ethical person who understands these are not numbers– they are human beings– would promote such an idea. We all have our preferred ideas of where the funds should come from, and y’all, we do not have strength in numbers to bicker over that right now. If we do, we will surely lose the farm. I can say that a lottery would come too late and is not a solution for the current funding gap, which could begin as early as June. Otherwise, I’d support whatever taxes they are willing to pass, even though I’d prefer to stop corporate subsidies first.

My source says the fed will not likely permit our Medicaid program to be cut so much without responding. We could be taken into some kind of Medicaid custody. But… the kicker is that they can’t MAKE us write a check, so this is different from school integration. They can put key decision-makers in jail, they can withhold federal funding as leverage, but they can’t issue money from the state, raise our taxes for us, etc.

All that said, I would still call your legislators. I would tell them that level funding is not enough for mental health and that it is killing people as we speak, because of waiting times. And if you happen to have a job opportunity out of state, you might want to strongly consider it, especially if you have children. I’m going to stay as long as I can, but I do have a disabled adult family member who depends on both Medicaid and me, so there will be a limit. I don’t know how long my employer will be able to keep me, if well over my entire salary is defunded. Feel free to share all or part of this post if you think it will help.

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Filed under Alabama Legislative Session 2015, Alabama Politics, Children's Issues, Medicaid

Medicaid and Media in the Alabama Primary: It’s Up to You


Several days ago, I told you about a false choice in the Alabama Primary—Fake Medicaid with Griffith vs No/Fake/Who Knows Medicaid with Bentley. Shortly afterwards, Kevin Bass released a statement to the press outlining his plan for Real Medicaid, with a copy to me in response to my query, and I passed it on to you. Among the corporate news outlets, I can find only ONE reporter who bothered to follow up, at the Tuscaloosa News. Google “Kevin Bass Medicaid” for the past week, and the first two links are his own, followed by the Tuscaloosa piece, and then my blog, and then… crickets.

Stacy Lee George has responded to me as well:  he said, in writing, “Yes, you can quote that I am in favor of Medicaid expansion, not the private option.” Real Medicaid, not Fake. He is opposing Bentley in the Republican primary.

Google “Stacy Lee George Medicaid” for all time, and the first link is his Facebook page followed by my blog. I don’t see a single corporate news article with any specifics about his plan. Yes, I know Google gives different rankings of results for different users. I wasn’t logged in when I searched, and I got a friend to repeat it under her account—same top results. If you get something different, please tell me.

Dr. Jennifer Marsden, who is running in November for State House District 93, took time to comment on my blog, “I support Medicaid Expansion without tricks or gimmicks and asked the Governor to expand it in person last year (he said no). “ I found only two articles mentioning her Medicaid thoughts in any detail—here’s the other. Neither asked how she would structure the program.

Now, I know I’m not a professional reporter.  I’ve never been paid for a blog piece and that’s fine with me. I sometimes go weeks or months without posting, when my work/ family schedule gets hectic. My cross-posts on Left in Alabama do reach a wide audience, however, and my regular blog gets followed by several professional reporters in the state. The first piece on Fake Medicaid got posted on New American Journal, a non-corporate national news site. The information was available for reporters who wanted to find it or who even did a simple Google search.

Even if I had not written about Fake Medicaid, what does this tell you about our corporate media and their role in elections and your policy choices? If you were a reporter, would you have perhaps at least asked other candidates to compare their plans to Griffith’s after he unveiled his specifics? Would you have taken time to educate yourself on the different Medicaid structures and their implications?

If you want others in the state who follow only corporate (fake?) news to know about our Medicaid choices before the primary, it is up to you to spread the word. To exercise choices, we must be aware choices exist. Will you be the media? And will you financially support non-corporate sources like LIA and New American Journal?

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Filed under Alabama Politics, citizen responsibility, Medicaid

Alabama Medicaid and the Primary: Follow-up


I posted two days ago to alert you to Parker Griffith’s plan for Fake Medicaid and to suggest the choice is not between that and fake/no Medicaid from Governor Bentley. There are other candidates, and there is also the possibility of strong pressure convincing Griffith or Bentley to change course if you get busy.

Because I criticized the plans or non-plans of those two, I think it is only fair to let you know about the press release from Kevin Bass yesterday, especially since the corporate media have not mentioned it.  I agree with everything he says, except the part about Fake Medicaid being a Republican plan.  Where these plans have been adopted, it has been in large part due to Democrat support, based on a false choice. I’ll repeat that it isn’t conservative at all, nor is it a better-than-nothing compromise of liberals—it is just a plain scam.

I don’t plan to participate in the primaries.  I don’t support the overall agenda of either party or their general non-responsiveness to voters.  I’m sticking with my intention to support decent independents or write-ins in the general election, and if you want to argue with me about vote-wasting, look me up on Facebook.  If enough of you put your foot down that way, we could see much better choices on our ballots. I do most of my political participation between elections.

I’d love to see a guy like Bass run as an Independent, and if he ever does, I’ll likely vote for him and campaign for him.  If I were a Democrat, I’d vote for him in the primary.  I’ve put a query in to Stacy Lee George in the Republican Primary regarding his position on Medicaid—he’s said publicly he is for the Expansion, but he hasn’t given specifics.  I’ll let you know what he says, if I get an answer.  I can’t even find a website or FB page to contact Bob Starkey, so I don’t suppose he is a serious candidate.  Please let me know if you learn otherwise.

Here is an excerpt from the Bass press release:

“Parker Griffith’s plan to pay third-party insurers to run an expanded Medicaid program in Alabama would waste Medicaid funds that otherwise could be – and should be – used for medical care and could subject them to fees that would discourage them from seeking care, charges Kevin Bass, Democratic candidate for governor.

‘Democrats have challenged Gov. Bentley’s unacceptable refusal to expand Medicaid,’ Bass says. ‘But instead of trying to maximize the funding available to our citizens, Griffith wants to let private insurers line their own pockets by spending as little as they can get away with.’”

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Filed under Alabama Politics, Healthcare reform, Medicaid

Fake Medicaid or No Medicaid? Don’t Buy It


Governor Bentley has persisted in failing to offer hope for the uninsured poor in Alabama, through a Medicaid Expansion or otherwise. Behind the scenes, various insiders are passing rumors not to worry—he really will do it… after the primary. Or after the general election. If the rumors are true, the plan is to apply for a “private option” style Medicaid waiver similar to programs in Arkansas and a handful of other states, and he is making people wait for his personal political interests, without regard to their present needs. If the rumors are not true, one can imagine he might benefit from public perception that he is simultaneously accepting and declining the Expansion.

One of the candidates in the Democratic Primary, Parker Griffith, got supporters by promising to expand Medicaid. Now he has revealed his grand idea: private option Medicaid, the same type of program Governor Bentley is/is not planning.

Except it isn’t such a grand idea.

Private option Medicaid is Fake Medicaid. One writer called it “Conservatives’ Awful New Medicaid Ploy”—and it isn’t even conservative. It is just a way to siphon off federal and eventually state money into private pockets, away from providing needed healthcare. Instead of simply directly adding people to the existing state Medicaid program, to be funded mostly by federal money and with generally about 3% overhead, it uses those funds to purchase private insurance at significantly higher overhead and for profit. It’s a skillful bit of flim-flammery to convince conservatives that this is anything but a scam and liberals that it is the only choice—fake Medicaid or none.

These “new” – what scam is ever really new?—programs don’t just eat up healthcare funds.  They have to limit health services to turn a profit. How?

By charging people with no money premiums and/or co-pays, so they will be discouraged from applying at all or seeking care if they do. You may think $35 a month for a household premium isn’t much—if you do, you aren’t likely poor enough to qualify for Medicaid. Even $3 can mean the difference between filling a prescription and skipping it.

By adding “wellness programs” of no proven cost-savings, an additional time charge for workers without sick leave. See page xix of a large analysis on workplace wellness programs by Rand: “[w]e estimate the average annual difference to be $157, but the change is not statistically significant.” This doesn’t mean $157 isn’t significant—it means the $157 “difference” is most likely due to chance instead of a difference and could just as easily be a $157 loss.

By charging a fine for coming to the ER for a non-emergency, instead of making sure all patients have 24-7 access to primary care and developing better ways to triage and redirect patients to appropriate settings. By charging $50 for the crime of being sick enough to be admitted to the hospital.

Already, just a few months in, Arkansas is finding out how much this fake Medicaid is going to cost them.  Are we really looking to follow their footsteps? If you haven’t read Confessions of an Economic Hitman, I highly recommend it. I suspect we are currently the target of the same strategy used to bring developing countries into debt, except this time it is on our own soil.

Both Bentley and Griffith were practicing doctors. I find it hard to believe they are completely unaware of the harm a private option Medicaid could do to patients and our state’s economy. Even so, it may be worth your time to tell them.

For those who have decided the fake option is better than nothing, it might not be so. Once people get their Medicaid cards, they will no longer be able to visit free clinics, get charity care, or apply for patient assistance programs for medicines. I am not sure how to predict whether on balance more people will be better off. I can say with a fair amount of certainty that a good many people will be actively harmed. Sometimes a false front for a good thing is actually far worse than nothing.

Fortunately, there is no reason to believe the choice is between fake Medicaid and nothing. We have more options. We can support candidates who are supporting the real Medicaid Expansion. Democrats could consider taking a look at Kevin Bass in the primary. Those who are determined to support Griffith could put pressure on him to drop the fake Medicaid idea. Republicans could put Bentley on the spot, and decide not to support someone who is/is not doing—hasn’t done— anything specific to address un-insurance and its economic damage to hospitals around the state. You can speak up against wasting funds in a fake program.

In that same vein, there’s no real reason we need to keep putting ourselves in the position of choosing between only two parties, between private insurance and nothing, or between all manner of pretend reforms and nothing. Some of you reading this are donating substantial sums or time to a lose-lose game. Are you getting what you’ve paid for?

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Filed under Alabama Politics, Bad solutions for the uninsured, Medicaid