Physicians, medical administrator predict Medicaid cuts will affect everyone

Things will only get worse---and they are already bad—if the Alabama legislature doesn’t find more funding for the state’s Medicaid agency.

That was the message from a trio of local healthcare professionals during a media briefing held Monday. At issue is what they say is a 30 percent cut in payments to healthcare providers.

“After four years and repeated reassurances from (lawmakers) regarding their commitment about primary care, those rates have been cut back to previous levels established in 2006,” said Dr. Michael Ramsey, a physician at Dothan Pediatric Clinic.

He said that is leading to a cut in services and forced the layoff of 10 employees at the clinic and the cancellation of a contract with a nurse PR practitioner. Two more workers resigned Monday for fear their jobs would be eliminated also, Ramsey said.

Over a million Alabamians—585,362 are children—receive Medicaid benefits. However, proponents of additional funding predict that everybody in the state could suffer from cuts.

“Your emergency room may no longer be there, your physician may no longer be there,” said Dr. Beverly Jordon who practices family medicine in Enterprise.

Dale Medical Center Chief Executive Officer Vernon Johnson agrees. “The dollars that Medicaid pays providers for caring for Medicaid patients, support personnel, equipment, and overhead cost assures all have access to care.”

Johnson and Ramsey said plans to construct a new pediatric clinic in Ozark were recently scrubbed because of Medicaid funding issues. A makeshift office continues to operate.

Alabama lawmakers will commence a special legislative session August 15 to consider an increase in funding to Medicaid. Governor Bentley wants them to pass a constitutional amendment calling for a referendum on a state lottery. Bentley estimates one would generate about $220-million annually, if voters approve.

If past history is an indicator of future events, that won’t happen. Lottery proposals---and there have been many---have failed during recent years. One passed in 1999 but Alabama voters rejected it. Polls now show that a lottery referendum would likely be approved by voters.

A constitutional amendment must receive 60 percent support in the House and Senate. Even if one is passed, there’s no assurance all, or any, of the money would go to Medicaid. And, if so, it would be 2018 before a lottery could become operational.

“This is a critical issue. We have looked at the budget, the legislature has looked at the budget, we run one of the most economic Medicaid programs in America. All we are asking is (lawmakers) continue the little funding that we have,” Jordon said.

Medicaid funding allocated for FY-2017 is $700-million dollars, a $15-million increase over this year. However, Medicaid Commissioner Stephanie Azar told lawmakers during the regular legislative session completed in May that $85-million more is needed to keep services at their current level.

Also at issue is the implementation of Regional Healthcare Organizations scheduled to begin October 1. Ramsey said RCO’s are threatened and points out it was lawmakers that approved the move to managed healthcare but now refuse to fund it.

However, some legislators say it’s time to draw a line in the sand. Noting that the agency already receives about 40 percent of all general fund dollars, they say Medicaid must learn to live within its means.

“I think that’s an interesting comment considering the legislature has borrowed money for the past 10 years and moved money around,” Ramsey said. He notes that, since 2009, the number of Medicaid recipients has almost doubled. He also suggested that lawmakers refuse to act because children are most effective and they don’t vote.

State dollars appropriated to Medicaid generate $2.22 in federal funding.

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