Insight: Merry Christmas, but my head hurts
by David G. Bronner
Special to The Star
Dec 01, 2013 | 3241 views |  0 comments | 66 66 recommendations | email to a friend | print
Gov. Robert Bentley, who is refusing to expand the Medicaid program in Alabama. Photo: The Associated Press
Gov. Robert Bentley, who is refusing to expand the Medicaid program in Alabama. Photo: The Associated Press
The thought of Alabamians opposing Medicaid expansion makes my head hurt. How can our business community do nothing over the next 30 days and allow $375 million to disappear? How can we sit idle and let Gov. Robert Bentley lose Alabama $1.5 billion per year in our economy for three years at no cost to the taxpayer?

Medicaid expansion allows the federal government to return to Alabama $4.5 billion over the next three years at zero cost to us. The UAB study by David Becker and Michael Morrisey ( shows that if Alabama stays in the program through 2020, Alabama’s cost would total $771 million (6.2 percent) of the estimated $12.5 billion in new Medicaid program costs over the 2014-2020 period. The $11.7 billion in program costs financed by the federal government is an increase in direct revenues to health care providers.

The study projects that the increase in Medicaid spending would generate $1.7 billion in additional state tax revenues during this same time period. Net of Alabama’s costs, Medicaid expansion would increase the state budget by approximately $935 million.

Hello? Alabama comes out way ahead to the tune of $13 billion to $15 billion.

In addition to generating $20 billion in new economic activity, approximately 232,000 individuals would become insured. By using federal funds to assist our state’s poor citizens, the women, children, disabled and elderly who fall into this group will continue to have medical care.

Did you know that some hospitals will lose current reimbursement for the poor when Alabama does not accept Medicaid expansion? That alone will result in the closure of some rural hospitals, devastating communities that depend on those facilities. From an economic standpoint, it will be almost impossible to recruit jobs to a county without a hospital. Note the domino effect.

The uninformed argue that this is just another “entitlement” as if completely unaware that taxpayers are already paying for the poor and uninsured. Now we are being given the chance for federal funds to pay the costs and that is bad?

Our past governors have traveled the world to find companies to locate here. Alabama has paid hundreds of millions of dollars for a mere 1,000 jobs. Industrial recruitment has been absolutely critical to Alabama’s development. Yet when another study funded by the Alabama Hospital Association ( says Medicaid expansion will create 30,700 jobs over seven years, our “Doc” governor claims the study is bogus.

That is nonsense and raw politics at its worst. If the study is only 50 percent or even 25 percent correct, this would still be our largest job creation since the government brought a “Rocket Doc” to Huntsville after World War II, without spending hundreds of millions of Alabama tax money for the jobs.

Alabama’s “Doc” governor will continue to state in the months to come how “…he has saved us taxpayers a billion dollars,” without mentioning that he has done so on the backs of our public employees.

Remember, as he refuses Medicaid expansion, he has wasted $4.5 billion dollars and thousands of jobs. That is shameful — all because of putting his political agenda ahead of what is good for Alabama.

David Bronner is chief executive officer of the Retirement Systems of Alabama.
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Insight: Merry Christmas, but my head hurts by David G. Bronner
Special to The Star

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