Alabama Arise unveils 2023 roadmap for change in Alabama

Expanding Medicaid and ending the state sales tax on groceries will remain top goals on Alabama Arise’s 2023 legislative agenda. More than 400 members voted on Arise’s issue priorities in recent days after the organization’s annual meeting Saturday. The seven issues chosen were:

  • Adequate budgets for human services like education, health care and child care, including Medicaid expansion to make health coverage affordable for all Alabamians.
  • Tax reform, including untaxing groceries and capping the state’s upside-down deduction for federal income taxes, which overwhelmingly benefits rich households.
  • Voting rights, including automatic universal voter registration, removal of barriers to voting rights restoration for disenfranchised Alabamians, and other policies to expand and protect multiracial democracy in the state.
  • Criminal justice reform, including retroactive application of state sentencing guidelines and repeal of the Habitual Felony Offender Act.
  • Death penalty reform, including a law to require juries to be unanimous in any decision to impose a death sentence.
  • Public transportation to empower Alabamians with low incomes to stay connected to work, school, health care and their communities.
  • Payday and title lending reform to protect consumers from getting trapped in debt.

“Arise believes in dignity, equity and justice for everyone,” Alabama Arise executive director Robyn Hyden said. “Our 2023 issue priorities reflect the need to work together to break down policy barriers that keep people in poverty, and that disproportionately harm Black and Hispanic Alabamians. We must build a healthier, more just and more inclusive future for our state.”

Displaying Arise's 2023 Policy Priorities: Tax reform, Adequate state budgets, Voting rights, Criminal justice reform, Death penalty reform, Public transportation, Payday and title lending reform

The time is right to expand Medicaid in Alabama

One essential step toward a healthier future for Alabama is to ensure everyone can afford the health care they need. Arise members believe Medicaid expansion is a policy path to that destination, and research provides strong support for that position.

Expanding Medicaid would reduce racial health disparities and remove financial barriers to health care for more than 340,000 Alabamians. It would support thousands of new jobs across the state. And most importantly, it would save hundreds of lives every year.

Medicaid expansion would ensure health coverage for more than 220,000 Alabamians caught in the coverage gap. These residents earn too much to qualify for the state’s bare-bones Medicaid program but too little to afford private plans. Expansion also would benefit another 120,000 Alabamians who are stretching to pay for coverage they cannot readily afford.

Alabama is one of only 12 states that have not yet expanded Medicaid to cover adults with low incomes. But an Alabama Arise poll earlier this year found that more than seven in 10 Alabamians (71.5%) support Medicaid expansion. That figure included 65.8% of Republican voters.

“Medicaid expansion would boost our economy and improve the lives of hundreds of thousands of Alabamians,” Hyden said. “It’s time for Gov. Kay Ivey and lawmakers to say yes to the generous federal incentives for Medicaid expansion. Making this crucial investment in Alabamians’ well-being now will make our state better for decades to come.”

Why and how Alabama should untax groceries

Alabama’s state grocery tax makes it harder for people with low incomes to make ends meet. The tax adds hundreds of dollars a year to the cost of a basic necessity for families. And most states have abandoned it: Alabama is one of only three states with no sales tax break on groceries.

The state sales tax on groceries brings in roughly 6% of the Education Trust Fund’s annual revenue. But lawmakers have a path available to end the state grocery tax while protecting funding for public schools. Arise will continue to support legislation to untax groceries and replace the revenue by capping the state income tax deduction for federal income taxes (FIT).

The FIT deduction is a skewed tax break that overwhelmingly benefits the richest households. It is also exceedingly rare: Alabama is one of only two states to allow this deduction in full. The FIT deduction and grocery tax are two policies that contribute heavily to Alabama’s upside-down tax system. On average, Alabamians with low and moderate incomes must pay twice as much of what they make in state and local taxes as the richest households do.

“By untaxing groceries and capping the FIT deduction, lawmakers can make Alabama’s tax system more just and equitable,” Hyden said. “This plan would empower more families to keep food on the table while also protecting funding for our public schools. The Legislature should seize this opportunity to make life better for every Alabamian.”

Here’s what Alabama Arise heard from you in summer 2022!

We deeply value the input we get from Alabama Arise members, our allies and most importantly, those directly affected by the work we do together. We depend on what we hear to help guide our issue work and our strategies.

Despite the ongoing challenges of connecting in person, we kept working at finding ways to listen. We did another series of three statewide online Town Hall Tuesdays. And we held seven additional listening sessions around the state, engaging about 200 people.

The town halls happened every two weeks, starting July 12 and ending Aug. 9. Other meetings took place throughout the summer. Below are summaries of what we heard in those meetings.

Town Hall Tuesdays

Food and health

Most participants deeply cared about Medicaid expansion. They discussed how it would help many people, including rural communities struggling with access to care. Many were frustrated that Gov. Kay Ivey has not yet expanded Medicaid in Alabama. Others discussed the connection between health and access to healthy food and nutrition. Some participants noted that other barriers like transportation also directly impact health, nutrition and employment.

Related issues raised were the needs to address the racial wealth gap and increase wages for front-line workers. Many people expressed appreciation for food banks and pantries but acknowledged that they cannot meet all food security needs. Participants encouraged Arise to remain vigilant about the threat to impose stringent work requirements for Medicaid and SNAP food assistance. Many participants also mentioned untaxing groceries as a way to improve food security.

Democracy and justice

Many participants expressed concerns about legislative attempts to suppress voting rights and said Election Day should be a state holiday. Others also expressed concerns about ballot access for people with disabilities, limited numbers of voting precincts and gerrymandering. Bottom line: We should make it easier to vote, as ballot access is key to a strong democracy.

Several participants expressed concerns about the need for more services for people leaving incarceration. We need to expand community corrections programs, enact real prison reform and get rid of unjust fines and fees.

Some participants identified language accessibility as a potential barrier to receiving many services and participating fully in our democracy. Others were concerned about allocation of American Rescue Plan Act funds and wanted more funding for the Housing Trust Fund.

The path forward

This town hall was an opportunity to talk about any issues of concern people wanted to highlight. Participants raised the following needs and concerns:

  • Expand Medicaid in Alabama now and address health disparities, including women’s health issues.
  • Untax groceries and improve our regressive tax system.
  • Improve voting access, including restoration of voting rights for people who were formerly incarcerated.
  • Address environmental issues, including working to improve air quality in schools.
  • Improve affordable housing access and language access, fully fund the child home visitation program and address gun violence.

Group and regional listening sessions

Session participants around the state strongly affirmed Arise’s work on the current 2022 issue priorities. They also emphasized the ongoing work to be done in those areas. Current issues highlighted were Medicaid expansion, criminal justice reform (particularly in the area of unjust fines and fees), more funding for child care and first class pre-K, public transportation and death penalty reform.

Session participants also discussed issues that aren’t on the Arise agenda but are of concern to them and their communities. Some of those issues include:

  • Affordable housing, with a focus on increased funding and availability. One example was discussion of whether to limit the number of vacation rental properties one person could own in an area, as this can contribute to the shortage of affordable housing. Many renters also discussed the soaring prices of rent.
  • Automatic organ donor registration linked to getting and renewing driver’s licenses.
  • Broadband internet extension to reach more rural households and Alabamians with low incomes.
  • Constitutional reform.
  • Government intrusion on private medical decisions. One example shared was concern over lawmakers interfering with rights of transgender teens to seek medical care. Another concern raised was doctors being able to provide medical care during pregnancy and decide the right time to intervene on a pregnancy that threatens the life of the mother.
  • Gun violence prevention.
  • Marijuana sentencing reform.

New Census data reveals how good policy choices can cut poverty, keep Alabamians healthier

People-friendly federal policies reduced poverty and made it easier for people to get health care in 2021, U.S. Census figures released this week show. Perhaps the most eye-opening improvement was a dramatic reduction in child poverty nationwide.

The recent Child Tax Credit (CTC) expansion alone kept 5.3 million Americans above the poverty line. The one-year expansion under the American Rescue Plan Act (ARPA) made the full CTC available to children living in families with low or no earnings. It increased the maximum credit to $3,000 per child and $3,600 per child under age 6. And it extended the credit to 17-year-olds. The expansion expired in 2022 after Congress failed to renew it, but lawmakers could revisit that decision later this year.

Child Tax Credit improvements fuel record drop in U.S. child poverty

CTC expansion helped reduce disparities for Black and Hispanic children. It also drove the U.S. child poverty rate to a record low of 5.2% under the Supplemental Poverty Measure (SPM). Unlike the traditional poverty measure, the SPM reflects the poverty-reducing effects of tax credits and non-cash benefits like food assistance.

Alabama’s official child poverty rate was 22% last year under the American Community Survey (ACS), a more traditional measure that accounts for fewer factors than the SPM. That was an apparent increase from the pre-pandemic level of 21.1% in 2019, though within the margin of error. (ACS data for 2020 is unavailable due to pandemic-related data collection disruptions.)

SPM data paints a fuller picture of the poverty-reducing power of supports like the expanded CTC. Alabama’s three-year average overall poverty rate under the SPM was 10.3% in 2019-21. By contrast, the state’s overall ACS poverty rate moved from 15.5% in 2019 to 16.1% in 2021. That change was not statistically significant.

“The success of the Child Tax Credit expansion was undeniable,” Alabama Arise executive director Robyn Hyden said. “This policy slashed child poverty and helped families make ends meet across our state and our country. Congress needs to renew the Child Tax Credit expansion and make it permanent. And our state lawmakers should do their part to help Alabama families keep food on the table by ending the state grocery tax and replacing the revenue in a responsible way.”

Uninsured rates fall nationally despite tumult of COVID-19 pandemic

Federal policy choices also fueled a slight reduction in the number of uninsured Americans last year. The U.S. uninsured rate dropped to 8.6% last year, down from 9.2% in 2019. Alabama’s uninsured rate stayed relatively flat, moving from 9.7% in 2019 to 9.9% in 2021. That change was within the margin of error.

Alabama continued a years-long pattern of outperforming the national average in insuring children in 2021. The state’s rate of uninsured children (4%) remained the best in the Deep South last year. Much of that sustained success is attributable to ALL Kids, the state’s Children’s Health Insurance Program (CHIP) created in 1998. ALL Kids has played a crucial role in reducing Alabama’s rate of uninsured children from 20% in the late 1990s.

A key factor in the overall health coverage improvements was the federal requirement for state Medicaid programs to keep participants covered throughout the ongoing COVID-19 public health emergency declaration. That declaration may end later this year, underscoring the importance of helping many enrollees transition to new coverage.

Enhanced subsidies under ARPA also helped make health coverage more affordable for millions of Americans with private plans. This includes many of the 219,000 Alabamians with marketplace plans through the Affordable Care Act. Congress renewed subsidy enhancements through 2025 in the Inflation Reduction Act, which President Joe Biden signed into law last month.

“Medicaid, ALL Kids and ACA marketplace coverage have saved and improved the lives of millions of Alabamians,” Hyden said. “Alabama should build on these successes by expanding Medicaid to help more than 340,000 people who are uninsured or struggling to afford health insurance.

“It’s time for Gov. Kay Ivey to say yes to the generous federal incentives for Medicaid expansion. It’s time for her to say yes to a healthier future for Alabama.”

A revenue-neutral plan to untax groceries in Alabama

Alabama Arise supports legislation that would end the state sales tax on groceries and over-the-counter (OTC) drugs and protect school funding. By capping the state income tax deduction for federal income taxes, the plan would bring in $520 million a year, the Legislative Services Agency (LSA) estimates. That would replace the revenue from ending the sales tax on groceries and OTC drugs, which the LSA estimates at $513 million a year. The graph below shows how millions of Alabamians would benefit from untaxing groceries.

Untaxing groceries is the right path for Alabama

Alabama’s sales tax on groceries is a cruel tax on survival, particularly in times of economic insecurity. It increases hunger rates and drives struggling Alabamians deeper into poverty. Here’s why legislators need to end the state sales tax on groceries – and how they can do it:

  • Alabama is one of only three states with no tax break on groceries.
  • The state grocery tax is 4%, equal to two weeks’ worth of groceries each year.
  • Alabama can and should untax groceries quickly and responsibly. That means replacing revenue for public schools in a way that doesn’t harm struggling families.
  • Alabama can protect education funding by limiting or ending its state income tax deduction for federal income taxes (FIT). The FIT deduction is a skewed tax loophole that overwhelmingly benefits rich households.

A revenue-neutral plan to improve Alabamians’ lives

Arise supports legislation to end the state sales tax on groceries and over-the-counter medicines at an annual cost of $513 million, according to the LSA. (Local sales taxes on groceries and OTC medicines would not be affected.) To replace that revenue, the plan would cap the state FIT deduction for individuals. That change would generate $520 million a year, the LSA estimates.

The cap for Alabamians who file as single, head of household or married filing separately would be $3,500 annually. For married couples filing jointly, the FIT deduction limit would be $7,000 a year. The plan would require voter approval of a constitutional amendment.

Both sales tax revenue and individual income tax revenue go to the Education Trust Fund. By capping the FIT deduction, Arise’s plan would allow Alabama to untax groceries without cutting school funding. This plan would be a significant tax cut for nearly all Alabamians, and the largest benefit would go to people with low incomes who need it most.

Bottom line

Untaxing groceries quickly and responsibly would boost economic and food security for all Alabamians. By ending the state sales tax on groceries and over-the-counter medicines and capping the FIT loophole, lawmakers could protect funding for public schools and make life better for families across our state.

Inflation Reduction Act will make Alabama a healthier state

Alabama Arise executive director Robyn Hyden released the following statement Monday in response to the U.S. Senate’s passage of the Inflation Reduction Act on Sunday:

“The Inflation Reduction Act will help build a healthier future for people across Alabama. This plan will make health coverage more affordable for hundreds of thousands of Alabamians and millions of Americans. It will improve air quality by investing in clean energy and reducing emissions that fuel climate change. And it will pay for these investments by closing tax loopholes that subsidize profitable corporations and wealthy households.

“This plan will save money for patients and the federal government by allowing Medicare to negotiate certain prescription drug prices. It will cap the cost of insulin and other out-of-pocket drug expenses for Medicare enrollees. And it will extend enhanced subsidies that make health coverage more affordable for many of the 219,000 Alabamians with marketplace plans through the Affordable Care Act.

“We’re happy that the U.S. Senate passed this important legislation. And we look forward to the House approving it and sending it to President Joe Biden to sign into law.

“We also will continue advocating for state lawmakers to make other needed investments in families and communities. We’ll keep working for additional funding to make child care, housing and public transportation more affordable and available across Alabama. And we’ll continue pushing for Medicaid expansion to help more than 340,000 Alabamians who are uninsured or struggling to afford health insurance.

“These policy choices are essential to improve Alabamians’ quality of life and to boost our state’s economic prosperity. We’re determined to see each and every one of them across the finish line.”

82 Alabama groups urge Ivey, legislators to fund public transportation using ARPA funds

Lawmakers should jump-start public transportation across Alabama with an allocation of $20 million from the state’s remaining federal COVID-19 relief money, according to a letter that 82 churches and organizations across the state sent Wednesday to Gov. Kay Ivey and legislators. Alabama Arise is among the groups that co-signed the letter.

The organizations asked Gov. Kay Ivey and the Legislature to invest $20 million of American Rescue Plan Act (ARPA) funds in the state Public Transportation Trust Fund. That amount is just 2% of the state’s roughly $1 billion of remaining unallocated ARPA funds.

Alabama is one of only three states with no state funding for public transportation, the letter says. Lawmakers created the state Public Transportation Trust Fund in 2018, but it has yet to receive state funding. And the consequences of that state inaction have grown in recent years, the letter says.

“The COVID-19 pandemic only worsened the harm resulting from lack of state support for public transportation,” the letter says. “We know robust investments in public transit will provide strong benefits for people across Alabama. Greater access to work, school, child care and medical care are just a few examples of how public transit is critical not only for an individual’s quality of life but for the state’s economic development and prosperity.”

More public transit funding means fewer service barriers

Investments in public transportation would expand economic opportunity, advance racial equity and strengthen community connections, a recent Arise report found. Arise’s survey of public transit systems in 42 of Alabama’s 67 counties showed how additional funding would empower those systems to lift many service barriers.

“State public transportation funding is an investment in a stronger economy and healthier communities,” Arise executive director Robyn Hyden said. “This investment would allow Alabama to draw down more federal infrastructure dollars. It would allow systems to hire more drivers and add more routes. It would enable them to extend operating hours and modernize technology. And it would bring us closer to the day when all Alabamians can get where they need to go when they need to get there.”

Click here to read the full letter from 82 organizations to the governor and legislators.

Alabama Arise, 81 partner groups urge Alabama to fund public transportation

American Rescue Plan Act (ARPA) relief funding provides an opportunity for Alabama to jump-start public transportation across the state. Alabama Arise joined 81 partner organizations Wednesday in a letter asking lawmakers to allocate ARPA money to public transportation. The full text of the letter is below.

Letter text

Dear Governor Ivey, Lieutenant Governor Ainsworth, members of the Cabinet and the Alabama Legislature:

Public transportation creates jobs, improves lives and keeps people connected to their communities. As you consider how to allocate the remaining estimated $1 billion of state funds from the American Rescue Plan Act (ARPA), we strongly encourage you to support Alabama’s public transportation systems. Specifically, we ask you to invest $20 million of ARPA funds into Alabama’s Public Transportation Trust Fund (PTTF).

The PTTF was established in 2018 but remains unfunded to this day. Alabama is one of only three states that provide no state funding for public transportation. A 1952 constitutional amendment bars the Alabama Department of Transportation (ALDOT) from using revenue from the state gas tax or license fees for public transportation, which is how most states fund public transportation. Instead, nearly all money for public transportation in Alabama comes from federal dollars administered by ALDOT.

It is clear to the undersigned organizations that the COVID-19 pandemic only worsened the harm resulting from lack of state support for public transportation. Limited funding has forced some local transit systems to curtail specialized services for riders with disabilities or serious health conditions.

We know robust investments in public transit will provide strong benefits for people across Alabama. Greater access to work, school, child care and medical care are just a few examples of how public transit is critical not only for an individual’s quality of life but for the state’s economic development and prosperity.

We urge you to invest $20 million in the PTTF using ARPA’s designated revenue replacement funds. This move will allow those funds to go even further by matching incoming federal dollars for public transportation. And it will make Alabama a better place to live and work for years to come.

Thank you for your consideration.

Signatories

Sincerely,

82 Alabama community-based organizations:

  1. AIDS Alabama
  2. Alabama Arise
  3. Alabama Black Women’s Roundtable
  4. Alabama Coalition Against Domestic Violence
  5. Alabama Coalition for Immigrant Justice
  6. Alabama Forward
  7. Alabama Rivers Alliance
  8. Alabama Rural Ministry
  9. Alabama State Conference of the NAACP
  10. All Nations Church of God (Montgomery)
  11. All Saints Episcopal Church (Mobile)
  12. Amalgamated Transit Union Local 770
  13. American Association of University Women Alabama (AAUW)
  14. American Association of University Women (AAUW) – Huntsville Branch
  15. Anniston First United Methodist Church – Church & Society Committee
  16. Baldwin County Trailblazers
  17. Bay Area Women Coalition, Inc. (Mobile)
  18. Beloved Community Church, UCC (Birmingham)
  19. Birmingham Footmad
  20. Birmingham Friends Meeting (Quakers)
  21. Bold Goals Coalition (Central Alabama)
  22. Childcare Resources (Birmingham)
  23. Christian Methodist Episcopal Church – Birmingham District Lay Leadership
  24. Church Women United Montgomery
  25. Citizens’ Climate Lobby – Alabama
  26. Collaborative Solutions (Birmingham)
  27. Communities of Transformation
  28. Community Action Association of Alabama
  29. Community Enabler (Anniston)
  30. Eastwood Neighborhood Association (Birmingham)
  31. Edgewood Presbyterian Church (Homewood)
  32. Fairhope Unitarian Fellowship
  33. Faith in Action Alabama
  34. First Presbyterian Church of Birmingham
  35. GASP
  36. Grace Presbyterian Church, PCUSA (Tuscaloosa)
  37. Greater Birmingham Ministries
  38. Gulf Coast Creation Care
  39. ¡HICA! Hispanic Interest Coalition of Alabama
  40. H.I.V.E. Alabama
  41. Heritage Training and Career Center (Montgomery)
  42. Holy Comforter Episcopal Church Gadsden Missions Committee
  43. Hometown Action
  44. Immanuel Presbyterian Church PCUSA (Montgomery)
  45. Independent Living Center of Mobile
  46. Inspire United Appeal Fund Corporation (Mobile)
  47. Jackson District Women’s Home and Overseas Missionary Society A.M.E. Zion Church
  48. Jobs to Move America
  49. League of Women Voters of Alabama
  50. Lighthouse Community Development Corporation (Mobile)
  51. Low Income Housing Coalition of Alabama
  52. Mary’s House Catholic Worker (Birmingham)
  53. Mission Committee, First Presbyterian Church of Auburn
  54. Mobile Environmental Justice Action Coalition
  55. Monte Sano United Methodist Church – Missions Chair
  56. NAACP Tuscaloosa Branch
  57. National Federation of the Blind of Alabama
  58. Neighborhood Concepts, Inc. (Huntsville)
  59. North Alabama Peace Network
  60. One Roof (Birmingham)
  61. Open Table United Church of Christ (Mobile)
  62. Ozanam Charitable Pharmacy, Inc. (Mobile)
  63. Project Hope to Abolish the Death Penalty
  64. Sisters of Mercy Alabama
  65. SPLC Action Fund
  66. St. Luke’s Episcopal Church (Jacksonville)
  67. St. Peter AME Church (Montgomery)
  68. SWEET Alabama (Birmingham)
  69. Systems Change/Economic Justice Workgroup – Greater Birmingham Ministries
  70. The Downtown Jimmie Hale Mission (Birmingham)
  71. The Horizons School (Birmingham)
  72. The Institute for Community, Youth & Family Services (Birmingham)
  73. The Right Place, Inc. (Anniston)
  74. The Sisters (Tuscaloosa)
  75. Thrive Alabama (Huntsville)
  76. Transform Alabama
  77. Transit Citizens Advisory Board (Birmingham)
  78. Trinity United Methodist Church (Homewood)
  79. Unitarian Universalist Church of Birmingham
  80. Unitarian Universalist Church of Huntsville
  81. YMBC Civic Forum (Birmingham)
  82. Youth Towers Incorporated (Birmingham)

Alabama needs to invest in our people

Do you know how hard it is to pass just one bill in the Alabama Legislature? We often measure progress on our issue priorities over periods of four-year quadrenniums, or even decades.

So it’s remarkable that during the 2022 regular session, Arise members helped pass numerous priority bills on everything from equitable tax reforms and adequate state budgets to criminal justice reforms.

Still, many of our lawmakers do not share our vision for a truly inclusive economic recovery.

When it comes to spending the remaining $1 billion in American Rescue Plan Act funds to build a lifeboat for all Alabamians hit hard by COVID-19, it’s our job to help them see the vision.

As we look ahead to another special session on ARPA funds, we’re working to tell lawmakers what you all know to be true: Investments in our people, our most valuable resource, are what matter most.

Check out our ARPA advocacy resources at al-arise.local/arpatoolkit. And tell your lawmakers now that you expect them to use this opportunity to address longstanding human needs.

Postpartum Medicaid extension brings a glimmer of hope for new mothers in Alabama

This story originally appeared on AL.com.

On Mother’s Day in 2014, I found out I was pregnant. For me, the existential dread set in just as deeply as the morning sickness.

Motherhood and its crushing weight had been drilled into me my entire life. I told myself it was too hard, that I just wasn’t strong enough to handle parenthood and all its pressures. And I feared that my family’s legacy would repeat itself.

Maude Wakefield, pictured with her husband, William (Andy) Ingle of Nauvoo, Ala. Maude is holding one of their 72 grandchildren. (Photo courtesy of Whit Sides)

One summer day in 1932, while pregnant with her 14th child, my great-grandmother Maude Wakefield finally reached her breaking point. She set off behind her home in Winston County and climbed high into a tree on my family’s land. She had been pregnant regularly since 1906 and decided enough was enough.

So she offered an ultimatum: She would return to her infinite load of daily household duties only if my great-grandfather would promise that this was it – no more babies. Not long after what would become her infamous last stand, she passed away due to a stroke worsened by postpartum hypertension. My grandmother was left to live without her mother at age 12.

Nearly a century later, during a routine blood pressure check, I was deemed high risk for the same life-threatening condition that killed my great-grandmother.

I didn’t want that same lonely future for my daughter.

The life-saving power of health coverage

Fortunately, I had health insurance. My blood pressure continued to rise to dangerous levels as my pregnancy progressed. After reviewing my family history, my doctor decided it was best for both me and the baby to deliver early under supervision to prevent preeclampsia, a condition that can lead to maternal death during or after delivery.

Because I had access to care, I was easily treated, and it ended up saving my life. Now, when I take my blood pressure pill every morning, I can’t help but think how things could have been different for my great-grandmother.

Hope can be hard to come by in Alabama. Stories like mine remind us how far we’ve come. But when you’re left without coverage, it’s never as simple as a pill and a copay.

Medicaid covers about half of all births in Alabama. And for many new moms, health coverage expires shortly after the baby is born.

Medicaid postpartum coverage extension is a step in the right direction

Some good news could be coming as soon as this fall. On April 7, Gov. Kay Ivey signed a new General Fund budget into law. It includes an extension of postpartum Medicaid coverage from 60 days of coverage to 12 months. This life-saving change will provide thousands of families consistency in care during the critical time after childbirth.

Alabama has the nation’s third-worst maternal death rate. Each year, roughly 40 new mothers in the state die within one year after delivery. Nearly 70% of those deaths are preventable, the state Maternal Mortality Review Committee found. And the toll on Black mothers is nearly three times that on white moms.

In Alabama, children living in households with low or middle incomes are widely eligible for coverage through Medicaid or ALL Kids, Alabama’s Children’s Health Insurance Program (CHIP). For adults, it is much harder to qualify for Medicaid. Just 17% of Medicaid participants in Alabama are adults under age 65 who do not have a disability.

Our state has some of the most stringent income limitations for Medicaid. For example, a single parent of two without a disability is ineligible if they make more than $346 a month. These harsh Medicaid eligibility limits mean affordable health insurance is simply not an option for many people in our state.

Medicaid expansion would ensure coverage for more than 340,000 Alabamians, including those left uninsured by these tight limits. These folks do not qualify for Medicaid, but they are unable to afford a marketplace plan or other private coverage. However, the new postpartum coverage extension means there will now be a brief inclusive window during and after pregnancy.

A lifeline in a time of need

Moms like my friend Brittany Kendrick of Blountsville call this coverage a lifeline.

Brittany lost her fiance, Dylan, in a car accident two months before her daughter Khaleesi was born. They had everything planned out, but her health insurance expired after Dylan’s death. Brittany turned to Medicaid to cover the costs.

Blountsville resident Brittany Kendrick holds her daughter Khaleesi. Medicaid was a lifeline for Brittany after her fiance, Dylan, died shortly before Khaleesi’s birth. (Photo courtesy of Brittany Kendrick)

Then, in August 2021, she made the hour-long drive to Children’s Hospital in Birmingham, where she found out her newborn had contracted COVID-19. After getting emergency care, her baby made a recovery. But as soon as they got home, Brittany tested positive and started to feel worse.

Being able to see a doctor and seek treatment quickly was just the blessing they needed during what Brittany calls the hardest year of her life.

“Medicaid paid for all of our hospital and doctor bills,” Brittany said. “It gave me a chance to use the money I had in savings for a safer car and a new apartment for me and the baby.”

Brittany hopes she will be among those eligible for the new postpartum extension. Having consistent care has brought balance to her life in more ways than one. “I can take medicine for anxiety and depression now. I need that, to stay strong for her,” she said.

Khaleesi Rider in April 2022. (Photo courtesy of Brittany Kendrick)

‘Why not offer this to all mothers?’

Extending Medicaid coverage doesn’t just support new or single parents.

Sarita Edwards of Madison is a mother of five and founder of the E.WE Foundation, a health care advocacy organization. She began her foundation after receiving a rare prenatal diagnosis of Edwards’ Syndrome (trisomy 18) for her son Elijah. The high mortality rate associated with her son’s diagnosis meant her family racked up thousands in medical debt before baby Elijah was even born.

Madison residents Kareem and Sarita Edwards hold their son Elijah. Sarita founded the E.WE Foundation after her son received a rare prenatal diagnosis. (Photo courtesy of Sarita Edwards)

Sarita says every day with Elijah has been a juggling act. Elijah’s condition is terminal, and his care can be exhausting and expensive. She now spends her time advocating for more equitable treatment and access in health care. She knows our leaders can do more, because she’s seen it firsthand.

“I know what our state can do when offering care to mothers and children with rare diseases,” Sarita said. “Why not offer this to all mothers?”

Elijah Edwards, age 5. (Photos courtesy of Sarita Edwards)

The new General Fund budget includes more than $8 million to extend Medicaid coverage for 12 months after childbirth. But the funding is guaranteed only for one year – on a trial basis.

This year marked another Mother’s Day when Alabama mothers are still dying from pregnancy and childbirth at twice the national rate. Reliable health coverage – and the access to care that comes with it – can prevent many of those deaths. Sarita sees no reason to hold off on making Medicaid’s postpartum coverage extension permanent.

“Our babies are taken care of, but what about the mothers?” Sarita asked. “I don’t know why it takes Alabama so long to do the right thing sometimes.”

About Alabama Arise and Cover Alabama

Whit Sides is the story collection coordinator for Alabama Arise, a statewide, member-led organization advancing public policies to improve the lives of Alabamians who are marginalized by poverty. Arise’s membership includes faith-based, community, nonprofit and civic groups, grassroots leaders and individuals from across Alabama. Email: whit@alarise.org.

Arise is a founding member of the Cover Alabama Coalition. Cover Alabama is a nonpartisan alliance of more than 115 advocacy groups, businesses, community organizations, consumer groups, health care providers and religious congregations advocating for Alabama to provide quality, affordable health coverage to its residents and implement a sustainable health care system.

Alabama Arise, partners urge no disruption to summer food program in Alabama

The Summer Food Service Program has been a critical tool to fight child hunger during the COVID-19 pandemic. But many key program flexibilities will expire June 30 unless Alabama applies for a waiver. Alabama Arise and our partners in the Hunger-Free Alabama coalition wrote a letter Thursday to state school Superintendent Eric Mackey to urge him to request federal permission to continue uninterrupted program service throughout the summer:

Letter text

Dear Dr. Mackey,

Alabama Arise appreciates the Alabama State Department of Education’s (ALSDE) commitment to ensuring that Alabama’s children receive the meals they need to learn and thrive, especially during these last few difficult pandemic years. As you know, access to nutritious meals is key to our children’s ability to learn and succeed in school and in life. Nowhere is that access more important than in our schools, both during the school year and during the summer, when childhood hunger often increases.

The U.S. Department of Agriculture (USDA) recently informed state Summer Food Service Program (SFSP) administrators, including the ALSDE, that some program flexibilities, scheduled to expire on June 30, could now be continued for the entire summer if the state requests to do so. These flexibilities include:

  • Permitting non-congregate meal service, which allows parents, guardians or children to take meals from the pickup site and allows meal provision for multiple days at once;
  • Allowing parents or guardians to pick up meals for their children; and
  • Allowing state flexibility in program monitoring.

Alabama Arise, our 150 member groups and more than 20 partners in the Hunger-Free Alabama coalition believe these flexibilities are critical for the 2022 Summer Food Service Program. We strongly encourage you to take advantage of, and apply for, these waivers.

The June 30 end of the original waivers would happen right in the middle of summer food service. This could not be more problematic for both families and providers. Changing food service operations, including the reimposition of on-site food consumption, would disrupt families’ work and child care arrangements and would require that providers completely alter how they feed children in midstream. Providers would have to try to communicate these changes, and the reason for them, adequately to children and their parents. We expect this would result in considerable confusion and frustration. For exactly these reasons, many SFSP providers already have decided to discontinue operations on July 1 if this waiver is not extended. Others, unfortunately, may not participate in the program at all this summer.

We know the hunger crisis caused by the pandemic and its economic disruption has not ended yet. The latest Census Household Pulse Survey (March 30-April 11) found that 15% of responding families with children said they sometimes or often did not have enough to eat. Of those families with children identified by the Census Bureau as food insecure, 25% said their children sometimes or often were not eating enough because food was unaffordable. School meals and the SFSP are critical for these families and their children.

The SFSP waivers have been important during the pandemic, addressing health concerns, supply chain disruptions and community program disruptions caused by the health crisis and economic challenges. Keeping these flexibilities in place for the remainder of the summer will help feed children and help summer meal sites operate safely and efficiently. We urge you to apply for these waivers as quickly as possible, knowing that time is of the essence as providers and families complete their summer planning process.

We appreciate your attention and your continued concern for the needs of our children. And we look forward to working with you to continue to feed Alabama’s schoolchildren this summer and into the future.

Sincerely,

Robyn Hyden
Executive Director, Alabama Arise