Money matters: Budgets top priority for session; lawmakers also discussing Medicaid expansion, criminal justice reform, voting rights this year

As the Alabama Legislature approaches the 2021 regular session’s final days, both state budgets are halfway to passage. The Education Trust Fund (ETF) budget has passed in the Senate and is in the House’s education budget committee. The General Fund (GF) budget, which funds all non-education services, has cleared the House and awaits Senate committee approval. Despite the COVID-19 recession, both budgets eked out small increases – 3% in the GF and 6% in the ETF. This will allow pay raises for teachers and state employees. It also will fund one-time additional 2022 teacher units and a new salary matrix for certified math and science teachers.

While budgets progressed, the Senate divided over whether to pass a gambling bill that would increase revenue for one or both. After Sen. Del Marsh’s lottery and gaming bill failed March 9, Sens. Garlan Gudger, R-Cullman, and Jim McClendon, R-Springville, introduced lottery bills. Meanwhile, Marsh, R-Anniston, introduced both a new lottery and a new gaming bill.

The Senate may consider some combination of these measures later this session. If approved by legislators and voters, expansion of gambling could increase state revenues anywhere from $118 million to $550 million. (Arise takes no position for or against gambling legislation.)

Health care

A big change on the health care front this year is the prominent role of Medicaid expansion in legislative discussions, both on and off the chamber floors. Gov. Kay Ivey can propose expansion through administrative steps, but lawmakers still control the purse strings. So legislative advocacy is essential!

As the pandemic highlights the need for rigorous health data, Alabama had been one of only two states lacking a statewide hospital discharge database. Now we’ll be shedding that dubious distinction with the enactment of HB 210 by Rep. Paul Lee, R-Dothan, a bill that Arise supported.

The Alabama Department of Public Health (ADPH) has been the target of several proposals to increase political control over the agency’s leadership and decision-making. McClendon’s SB 240, for example, would abolish the State Board of Health, the medical body that appoints the state health officer, and make ADPH’s director a gubernatorial appointment. Other bills would limit state and county health officials’ authority to declare health emergencies. One such measure, SB 97 by Sen. Tom Whatley, R-Auburn, passed the Senate in early April.

Criminal justice reform

Several criminal justice improvements have moved forward this year. These include partial reform of sentencing under the Habitual Felony Offender Act (HFOA) and expanded alternatives to imprisonment. Bigger reforms like HFOA repeal and abolition of driver’s license suspension have been slowed due to opposition, though. That inaction has persisted even in the face of a U.S. Department of Justice lawsuit over unconstitutional prison conditions.

Voting rights

Efforts to protect and expand voting rights continue to face an uphill battle. Bills prohibiting curbside voting have advanced, despite the practice’s success in Mississippi and other states. Meanwhile, a bill allowing no-cause absentee voting stalled, as did measures on early voting and same-day voter registration. Legislation improving voting rights restoration did advance, but only after removal of a provision that would have ended a de facto poll tax: the requirement for people with convictions to pay all fines and fees before regaining voting rights.

American Rescue Plan Act offers path to recovery

As vaccinations continue across Alabama, COVID-19’s viselike grip on our lives is loosening. The pandemic has caused immense physical, emotional and economic suffering, and those aftereffects will not fade quickly. But the American Rescue Plan Act – the federal relief package that President Joe Biden signed March 11 – includes many important policies to begin the healing.

Some of the most crucial investments come in health care. The law increases subsidies for marketplace health coverage under the Affordable Care Act. It also creates new incentives that would more than offset the cost of Medicaid expansion. The incentives would remove Alabama’s last financial barrier to extending coverage to more than 340,000 adults with low incomes.

If Gov. Kay Ivey agrees to expand Medicaid, Alabama would receive between $740 million and $940 million over two years. That would result from a 5-percentage-point federal funding increase for traditional Medicaid coverage.

Alabama State Capitol in Montgomery

“Medicaid expansion is the single biggest step Alabama can take to recover from the pandemic,” Alabama Arise campaign director Jane Adams said.

“Congress did their job. Now it’s time for the governor and state lawmakers to do theirs.”

The act also slashes poverty by boosting unemployment insurance and nutrition assistance benefits and expanding the Child Tax Credit and Earned Income Tax Credit. It funds rental and mortgage assistance to help prevent evictions and foreclosures. And it provides Alabama’s state and local governments with $4 billion of federal assistance to help avoid cuts to education and other vital services.

Persistent disparities – and how to end them

The relief package provides opportunities to begin dismantling longtime structural barriers in Alabama. Arise offers many such policy recommendations in our recent report, The State of Working Alabama 2021, which details how COVID-19 cost hundreds of thousands of Alabamians their jobs and fueled a rapid surge of hunger and hardship across our state.

COVID-19’s toll has been especially heavy for women and people of color, the report finds. The pandemic exacerbated Alabama’s preexisting racial, gender and regional disparities in health care, housing, nutrition and economic opportunity. These inequities – the legacy of bad policy decisions – prevent Alabama from reaching its full potential.

“Alabama’s economic, racial and gender inequities are preventable and reversible,” Arise policy director Jim Carnes said. “By making better policy choices now and in the future, we can chart a path toward a more equitable economy.”

New Medicaid expansion incentive clears the path to a healthier Alabama

The American Rescue Plan Act of 2021 answers a question Alabama policymakers have been asking for years: How can we pay for Medicaid expansion? It’s a solution that lawmakers should embrace immediately to build a better, healthier future for our state. And it’s a step you can urge the governor to take today.

An incentive in the new federal COVID-19 relief package means Medicaid expansion in Alabama effectively would pay for itself. Medicaid expansion would bring peace of mind to more than 340,000 adults with low incomes who are uninsured or struggling to afford health coverage. It also would save lives, create jobs and help protect rural hospitals across our state.

If Alabama agrees to expansion, the law will reduce the state’s costs to provide Medicaid coverage for the much larger non-expansion population for two years. This offer would add 5 percentage points of federal funding to the generous match Alabama already receives for Medicaid expenditures.

The enhanced federal match would create more than enough General Fund (GF) “breathing room” to cover the state’s 10% share of Medicaid expansion costs for the first two years, which are the most expensive. Since 2014, Alabama taxpayers have paid $4 billion in federal taxes to help support Medicaid expansion in other states. This new provision is an unprecedented opportunity to bring some of those tax dollars home to cover Alabamians.

How the new federal Medicaid incentives work

Alabama’s “regular” Medicaid match rate (known as the Federal Medical Assistance Percentage, or FMAP) adjusts slightly from year to year. It will be 72.37% for 2022. And the state already is receiving an additional 6.2-percentage-point boost until the COVID-19 public health emergency ends. That brings the overall federal share to 78.57%.

With the additional 5 percentage points, Alabama’s federal match to cover current Medicaid enrollees would increase to 83.57% until the emergency ends. (It would revert to 77.37% for the remainder of the two-year incentive period after the emergency.) An even higher federal match of 90% will apply permanently to coverage for people newly eligible under Medicaid expansion.

Estimates of the value of Alabama’s incentive over the two years range from $740 million (Kaiser Family Foundation) to $940 million (Center on Budget and Policy Priorities). Even at the lower end, the increase would free up far more than the state’s estimated net share of the first year of Medicaid expansion ($168 million).

Research findings from UAB – and other states’ experiences – suggest Alabama’s net costs will drop dramatically after Year 1. (A UAB study projects the state’s net cost for expansion will be around $25 million a year in Alabama.) That’s because the increased federal funding would produce new tax revenues and offset previous state spending on newly covered services.

Alabama is one of 14 states eligible for the new incentive. They include two states – Missouri and Oklahoma – that have passed expansion by referendum but haven’t implemented it yet. They also include the 11 other states, mostly in the South, that have not yet moved to expand Medicaid. Those states are Florida, Georgia, Kansas, Mississippi, North Carolina, South Carolina, South Dakota, Tennessee, Texas, Wisconsin and Wyoming.

Why the time for Alabama to expand Medicaid is right now

Timing is a critical factor. While the two-year incentive offer remains available for 10 years, current conditions are especially favorable for Medicaid expansion in Alabama. Medicaid will enter the 2022 budget year with a $252 million “carryforward” from this year.

That surplus likely will allow lawmakers to reduce Medicaid’s GF appropriation next year and keep some funds in reserve. The 2022 GF budget that legislators are considering also was written before the new 5-percentage-point boost became available. So the difference truly would be a windfall.

Alabama can’t use federal funds to match federal funds. But hundreds of millions of dollars of additional, unanticipated federal money would relieve pressure on state budgets. And that would free up enough state funds to pay for Alabama’s share of Medicaid expansion for many years.

The Medicaid expansion incentive is a part of federal COVID-19 relief funding for a reason. The pandemic has tested our health care system to its limits. Besides killing more Alabamians than all modern wars combined, the crisis has revealed deep gaps in care and coverage that leave hundreds of thousands of Alabamians extra vulnerable to the virus and unable to pay for the care they need. A “lost year” has left local communities, businesses and families reeling.

The single biggest step our leaders can take to bridge Alabama’s health care gap and accelerate our economic recovery is to expand Medicaid. The new federal incentive removes the last hurdle in our way. It’s time to expand Medicaid now.

You can speak up now for this investment in a healthier future for Alabama. Click here to email Gov. Kay Ivey and urge her to save lives and create jobs by expanding Medicaid.

Arise legislative recap: March 12, 2021

Arise’s Carol Gundlach breaks down the American Rescue Plan and what it means for Alabama families including expansions to the Child Tax Credit and EITC helping to reduce poverty across Alabama.

Federal relief package will reduce Alabamians’ unmet health needs, hunger, housing instability and other hardships

The American Rescue Plan Act of 2021 will reduce poverty while expanding health care, housing and nutrition protections across Alabama, according to analyses by Alabama Arise and other research organizations. President Joe Biden signed the new federal COVID-19 relief package into law Thursday.

The law will slash poverty by expanding tax credits to struggling households and boosting unemployment insurance (UI) benefits. It also will provide Alabama $2.3 billion of federal assistance to help avoid cuts to education and other vital services. Local governments in Alabama will receive another $1.7 billion in federal funding.

Some of the relief package’s most transformative investments will come in health care. The law will increase the affordability of health coverage through the marketplace created under the Affordable Care Act (ACA). And it will create new federal incentives that would more than offset the state’s cost to expand Medicaid, providing health coverage to hundreds of thousands of Alabama adults with low incomes.

“The American Rescue Plan Act throws Alabama’s struggling families a much needed lifeline,” Alabama Arise executive director Robyn Hyden said. “And it offers budgetary breathing room for policymakers to tackle chronic problems, address longstanding racial and gender inequities and build an economy that works for every Alabamian. Medicaid expansion should be at the very top of our legislators’ to-do list.”

A new pathway to Medicaid expansion in Alabama

The relief package could bring overdue peace of mind to some 300,000 Alabamians living in the health coverage gap. They earn too much to qualify for Medicaid under the state’s stringent income limit but too little to qualify for subsidized ACA marketplace plans.

Nearly seven in 10 Alabamians support expanding Medicaid to cover these adults, a statewide poll found last month. If Gov. Kay Ivey agrees to expansion, the law would give the state a 5-percentage-point increase in federal funding for its traditional Medicaid coverage for two years.

That would bring Alabama an additional $940 million over two years, the Center on Budget and Policy Priorities (CBPP) estimates. And it would remove any remaining financial barrier to Medicaid expansion, said Jane Adams, the Cover Alabama campaign director for Alabama Arise.

“This law is a much-needed step toward closing the health coverage gap in Alabama. We have no time to waste,” Adams said. “Tens of thousands of people have died in the South ‒ my home ‒ because they couldn’t afford to get the health care they needed.

“Medicaid expansion is the single biggest step Alabama can take to weather and recover from the COVID-19 pandemic and move our state forward. Congress did their job. Now it is time for Governor Ivey and our state lawmakers to do theirs and immediately expand Medicaid in Alabama.”

Enhancements to existing Medicaid, marketplace coverage

The relief package also makes multiple coverage improvements for tens of millions of Americans with Medicaid or ACA marketplace plans. Among other changes, the law:

  • Reduces or eliminates marketplace premiums through 2022. Subsidies will increase across the board, and no one will pay more than 8.5% of income for their health plan.
  • Eliminates COBRA premiums through September 2021.
  • Protects against tax liability on premium assistance because of income fluctuation.
  • Increases funding for COVID-19 testing and vaccine distribution.
  • Gives Alabama the option to increase the income limit and coverage period for postpartum Medicaid coverage.
  • Increases federal funding for home- and community-based Medicaid long-term care services.
  • Increases federal funding for substance abuse prevention and treatment and a broad spectrum of mental health services.

Child Tax Credit, EITC expansions will reduce poverty across Alabama

Poverty rates will fall nationwide thanks to tax credits and stimulus payments in the American Rescue Plan Act, studies predict. One of the greatest gains will result from a Child Tax Credit (CTC) expansion that could cut the U.S. child poverty rate in half, a Columbia University analysis found.

The relief package makes the full CTC available to children living in families with low or no earnings. It increases the credit’s maximum amount to $3,000 per child and $3,600 for children under age 6. And it extends the credit to 17-year-olds. This CTC expansion will help four in five Alabama children (or nearly 1.1 million), as well as nearly 1 million adults, the Institute on Taxation and Economic Policy (ITEP) estimates.

Direct payments and expanded tax credits will help Alabamians make ends meet as well. Among other changes, the law:

  • Provides a one-time payment of $1,400 per person for individuals making up to $75,000 and couples making up to $150,000. Individuals with incomes up to $80,000 and couples with incomes up to $160,000 are eligible for partial payments. These stimulus payments will benefit 91% of adults (3.1 million) and 92% of children in Alabama, ITEP estimates.
  • Raises the maximum Earned Income Tax Credit (EITC) for working adults without children from roughly $530 to roughly $1,500. The law also increases the income limit for these adults to qualify from about $16,000 to at least $21,000.
  • Expands the age range of EITC-eligible workers without children. Younger adults aged 19-24 who are not full-time students can qualify now, as can people 65 and over.
  • Helps more than 280,000 Alabamians with the EITC improvements mentioned above, CBPP estimates. The vast majority of the Alabamians who will benefit (205,200) have annual incomes below $20,400, according to ITEP.

Boosts to SNAP, unemployment, housing assistance to help Alabamians make ends meet

The American Rescue Plan Act includes additional provisions to keep more households fed and housed. Most urgently, it extends until Sept. 6 the supplemental $300 federal UI benefits that were set to expire this weekend. This extension more than doubles Alabama’s maximum total weekly benefit to $575, or roughly 60% of median household income.

The law also provides $37 billion nationwide in rental and mortgage assistance to help prevent evictions and foreclosures. For Alabama, this would mean an increase of more than 1,400% from 2020 Emergency Solutions Grant funding if states receive funding proportionate to their populations.

In addition, the package continues a 15% boost to food assistance under the Supplemental Nutrition Assistance Program (SNAP) through September. This increase will help nearly 800,000 Alabamians and bring $64 million in additional SNAP benefits into Alabama, CBPP finds.

The plan takes many other steps to alleviate hardship. Among other changes, the law:

  • Provides Alabama with $10 million in emergency pandemic Temporary Assistance for Needy Families (TANF) funding. This money is usable for one-time benefits like cash assistance, rental assistance or clothing allowances.
  • Allows states to continue Pandemic EBT (P-EBT) benefits through early September. P-EBT replaces the value of meals that children miss when schools are closed.
  • Increases the monthly allocation for fruits and vegetables in the Women, Infants and Children (WIC) program from $9 to $35 for four months.
  • Makes the first $10,200 of UI benefits non-taxable for households with incomes below $150,000.
  • Excludes discharged student loan amounts from taxable income calculation through 2026.

“Everyone should know the security of having food on the table and a roof overhead,” Hyden said. “The American Rescue Plan Act will help ease Alabamians’ suffering during the COVID-19 pandemic. And it will lay a foundation to build a stronger, more inclusive Alabama in its aftermath.”

Policies to advance racial, gender equity key to Alabama workforce’s COVID-19 recovery, new Alabama Arise report shows

State of Working Alabama logo

Alabama should rebuild from the COVID-19 recession by lifting policy barriers to economic opportunity and charting a path toward a more equitable and inclusive future, according to The State of Working Alabama 2021, a new report that Alabama Arise released Monday.

Medicaid expansion and a state law guaranteeing paid sick leave both would help strengthen Alabama’s workforce, the report says. Other policy recommendations include higher funding for nutrition and housing assistance and improvements to the state’s unemployment insurance (UI) system.

The Alabama Legislature moved quickly to pass “pro-business” bills in the opening days of the 2021 regular session. These measures included a new law providing a broad range of civil immunity against claims related to coronavirus exposure. As lawmakers return to Montgomery after a weeklong break, their policymaking focus should shift toward addressing their constituents’ urgent needs during and beyond the COVID-19 pandemic, Alabama Arise executive director Robyn Hyden said.

“Legislators spent the first two weeks of this session protecting the interests of corporations,” Hyden said. “They should spend the rest of the session protecting the interests of the people of Alabama. And Arise’s State of Working Alabama report provides a blueprint for how to do just that.”

COVID-19’s toll has fallen heavily on women, Black and Hispanic/Latinx Alabamians

Arise’s seven-section report examines economic challenges – both old and new – that Alabamians have faced over the last year. Health coverage, housing, hunger, wages and working conditions for front-line workers are among the topics covered in The State of Working Alabama 2021. The report also highlights how the pandemic has exacerbated preexisting racial, gender and regional disparities in our state.

COVID-19 job losses hit Black workers nearly twice as hard as other Alabamians. Black workers made up 25% of Alabama's workforce in 2020 but 47% of Alabama's unemployment insurance claimants in 2020.

“When the COVID-19 pandemic hit Alabama in March 2020, it didn’t just cause massive human suffering and economic disruption,” the Arise report says. “It also revealed suffering and disruption that have long existed and that policymakers have long neglected – or even perpetuated.”

Past policy decisions left Alabama inadequately prepared to respond to the pandemic, the report finds. They also created and maintained racial and gender disparities that prevent our state from reaching its full potential. Among the report’s major findings:

  • Alabama’s “essential workers,” hailed as pandemic heroes, often lack the basic protections of a living wage, health insurance, paid sick leave and family medical leave.
  • COVID-19 has caused disproportionate unemployment for Black people and women in Alabama. Economically disadvantaged counties in the Black Belt and other parts of Alabama also have lagged behind in unemployment recovery.
  • Before the pandemic, 62.2% of Alabama’s white workers had health insurance through their jobs. The same was true for only 46.4% of Black workers and just 35.5% of Hispanic/Latinx workers. The pandemic has widened those racial/ethnic disparities in health coverage.
  • Hunger has been widespread in Alabama’s communities of color during the COVID-19 recession. Early in the pandemic, nearly 21% of Black residents and 19% of Hispanic/Latinx residents said they didn’t have enough food.
  • Black and Hispanic/Latinx Alabamians are at higher risk of eviction for inability to pay rent. Even basic apartments are out of financial reach for low-wage workers everywhere in Alabama.

Policies to increase equity, expand economic opportunity for working Alabamians

Alabama’s policy legacy has exacerbated the damage that COVID-19 has wreaked on working people across the state, the report finds. The State of Working Alabama 2021 outlines a policy agenda to repair that damage and promote broadly shared prosperity. Among the report’s key recommendations:

  • Expand Medicaid to ensure more than 300,000 Alabamians with low incomes can afford treatment for COVID-19 and other health problems.
  • Guarantee permanent paid sick leave for all working Alabamians, so that no one has to choose between earning a paycheck and going to work sick.
  • Roll back the 2019 cuts to Alabama’s UI benefits and create a modernized claims system capable of handling future crises.
  • Provide state support for the Alabama Housing Trust Fund and abandon efforts to impose harmful limits on safety net programs.
  • Expand high-speed, affordable broadband technology, targeting rural and low-income communities and explicitly addressing racial equity in broadband access.

Hispanic and Black Alabamians are more likely to lack health coverage. 32.8% of Hispanic/Latinx residents were uninsured in the spring/early summer stage of the pandemic, and 20.7% were uninsured in the late summer/fall stage. The corresponding rates for Black residents were 17.8% and 13.5%. For white residents, the rates were 11.7% and 11.5%.

“The economic, racial and gender inequities in Alabama are preventable and reversible,” Alabama Arise policy director Jim Carnes said. “These disparities are the direct result of bad policy choices in the past. By making better choices now and in the future, we can chart a path toward a more equitable economy. The power to build a stronger, more inclusive Alabama is in the hands of our lawmakers – and all of us.”

About The State of Working Alabama 2021

Click here to read the executive summary of The State of Working Alabama 2021. Links to each of the report’s seven sections are available at the bottom of the page. You also can jump directly to a section using the links below.

  1. Introduction: The high cost of failing to protect the common good
  2. Unequal by design: COVID-19 and Alabama’s policy legacy
  3. Assessing the damage: COVID-19 and Alabama’s labor market
  4. Praised but underprotected: Front-line workers in the pandemic
  5. Why coverage matters: Health care in the time of COVID-19
  6. The ugly reality: Alabama’s hunger problem during the pandemic
  7. No place to call home: Housing insecurity amid COVID-19

The State of Working Alabama 2021

State of Working Alabama logo next to a portrait of a young woman wearing a face mask and protective workwear in a warehouse

Introduction

When the COVID-19 pandemic hit Alabama in March 2020, it didn’t just cause massive human suffering and economic disruption. It also revealed suffering and disruption that have long existed and that policymakers have long neglected – or even perpetuated.

COVID-19 has laid bare deep racial inequities in Alabama’s economy and social system that have left our state unprepared to meet the needs of its people in this disaster. As the workers predominantly on the front lines, women and people of color bore the brunt of the economic meltdown. They also simultaneously have suffered greater exposure to the virus that caused it.

Alabama has a weak safety net for struggling families and an approach to economic growth that all too often leaves workers underprotected and underpaid. This ongoing policy legacy has exacerbated the damage that the virus has wreaked on the state’s working people.

In The State of Working Alabama 2021, Alabama Arise explores COVID-19’s significant and negative impacts on the state’s workforce. We also look ahead to outline a state and federal policy agenda for repairing the damage – not by repeating the policy mistakes of the past, but by charting a new path toward a more equitable economy marked by broadly shared prosperity.

Report navigation

You can read all seven sections of the report by clicking on the corresponding section’s icon at the bottom of this page. The executive summary of each section and of some of the report’s key policy recommendations is below, as are the report acknowledgments.

You can click any image in this report to enlarge it. To download a printable version of the executive summary, click here. To read our news release on the report, click here.

COVID-19 and Alabama’s policy legacy

COVID-19 struck Alabama’s families and communities hard, and the toll has been especially high for Alabamians of color. The virus and the shutdown exacerbated massive underlying disparities in health care, economic security and access to essential resources that policymakers have long ignored. And they revealed how our neglect of the common good – through low wages for average working people, low taxes for rich people and racially discriminatory policies for our entire state – has left many Alabamians unable to weather a crisis and hindered the entire state’s ability to rebound.

  • The “essential workers” hailed as pandemic heroes often lack the basic protections of a living wage, health insurance, paid sick leave and family medical leave.
  • Alabama’s fundamental state policies have been unequal by design, including its explicitly racist 1901 constitution. Right-to-work laws, preemption and other measures have blocked efforts to protect and support working families.
  • Working Alabamians without health coverage are at even greater risk during the pandemic due to extension of broad liability protection to corporations and other entities for damages related to COVID-19.

Labor market

The COVID-19 recession hit vulnerable Alabama workers hard and fast, disproportionately affecting women and workers of color.

Rural Black Belt counties were slower to recover from peak unemployment. The percentage of peak unemployment in Black Belt counties (excluding Montgomery) did not return to the statewide average until October.

  • Alabamians working in already low-wage industries suffered immediate and severe job losses, which fell hardest on women and people of color. By December 2020 – nine months into the pandemic – Alabama still had a net loss of 35,400 jobs, a 1.7% decline from pre-pandemic levels. The hardest hit industry was leisure and hospitality, including entertainment and food service establishments where workers were already struggling.
  • Unemployment insurance (UI), designed for just such a moment, was inadequate and insufficient to meet working people’s needs because of Alabama’s policy choices. In 2019, the state cut compensable weeks of UI and tied benefit extensions to longer-term statewide unemployment rates. This framework is wholly unsuited to catastrophe response.
  • COVID-19 has caused disproportionate unemployment for Black people and women. Economically disadvantaged counties in the Black Belt and other parts of Alabama also have lagged behind in unemployment recovery.
  • Alabama’s lack of investment in updated claim processing systems has caused harmful lags in paying out UI claims. The state’s failure to modernize claim processing damages the well-being of people who drive the economy. Modernization would be quick, efficient and helpful to Alabamians.
  • Alabama’s failure to invest in rural broadband made it even more difficult for people in large swaths of the state to work or attend school remotely. This “digital divide” is depriving many Alabamians of opportunities to learn and earn.

COVID-19 job losses hit Black workers nearly twice as hard as other Alabamians. Black workers made up 25% of Alabama's workforce in 2020 but 47% of Alabama's unemployment insurance claimants in 2020.

Recommendations

  • Establish a state minimum wage significantly higher than the current federal minimum wage. The pandemic recession’s impacts have fallen hardest on people who were already struggling to make ends meet.
  • Roll back the harmful 2019 cuts to UI benefits. Those changes reflected a shortsighted approach to UI and demonstrated counterproductive hostility to working people who have lost their jobs.
  • Invest in support structures to allow communities that are at an economic disadvantage to participate fully in the workforce.
  • Create a reliable, modernized claims system capable of handling a crisis with claims significantly exceeding peak UI claims resulting from the pandemic.
  • Expand high-speed, affordable broadband technology, targeting rural and low-income communities and explicitly addressing racial equity in broadband access.

Front-line workers 

Since the beginning of the COVID-19 pandemic, Alabamians have come to recognize a new category of “heroes.” Front-line workers in grocery stores, hospitals, pharmacies and other settings perform necessary tasks to keep our communities functioning during the public health emergency.

  • Front-line workers, who face greater exposure to COVID-19 than the general population, are disproportionately women and people of color. Because of barriers to health care, Black and Hispanic/Latinx workers also are more likely to have underlying conditions that worsen COVID-19 outcomes. State and national policy failures on the pandemic response, especially inadequate supplies of personal protective equipment (PPE), are more likely to hit front-line workers the hardest.
  • Thousands of working Alabamians were left out of paid sick days protections. Between half and three-quarters of all Alabamians were left out of the paid sick days protections in the federal Families First Coronavirus Response Act. This omission places entire workplaces at risk of exposure to the virus.

Recommendations

  • Implement hazard pay for front-line workers during the pandemic.
  • Guarantee permanent paid sick leave for all working Alabamians, regardless of employer size, so that no one has to choose between earning a paycheck and going to work sick.
  • Expand Medicaid so front-line workers have affordable, timely access to treatment for health risks that worsen COVID-19 outcomes.

Health care

While the COVID-19 pandemic has slammed all segments of our economy and society in one way or another, health care is where most of these effects converge.

  • Alabama had the 11th highest COVID-19 death rate among states in mid-February 2021. That means a higher share of Alabamians have died from the virus than in most other parts of the country. By mid-February, Alabama’s COVID-19 deaths in less than a year had surpassed 9,200, far more than the number of Alabamians who died in World War II and all subsequent wars (8,215).
  • COVID-19 has exposed a shameful legacy of unequal access to health care. In the early days of the pandemic, Black Alabamians accounted for as many as 55.2% of Alabama’s daily COVID-19 deaths, more than double their 26.8% share of the population.
  • The pandemic widened racial/ethnic disparities in health coverage. Before the pandemic, 62.2% of Alabama’s white workers had health insurance through their jobs. The same was true for only 46.4% of Black workers and just 35.5% of Hispanic/Latinx workers. Early in the COVID-19 shutdown, Hispanic/Latinx Alabamians reported lack of insurance at nearly three times the rate of white residents.
  • COVID-19’s disparate impact on communities of color has opened a new conversation about health equity. A smart recovery will take a broader approach to building a healthy workforce by adopting policies that address food security, adequate housing and other social determinants of health.

Hispanic and Black Alabamians are more likely to lack health coverage. 32.8% of Hispanic/Latinx residents were uninsured in the spring/early summer stage of the pandemic, and 20.7% were uninsured in the late summer/fall stage. The corresponding rates for Black residents were 17.8% and 13.5%. For white residents, the rates were 11.7% and 11.5%.

Recommendations

  • Expand Medicaid to cover more than 300,000 Alabama adults with low incomes. This health coverage expansion would facilitate COVID-19 testing, treatment and vaccination; allow working people to stay healthier and more productive; and strengthen Alabama’s health care system, especially rural hospitals. The Legislature’s eagerness to provide businesses with immunity against COVID-19 liability claims only makes the need for worker protections like health coverage more urgent.
  • Make reducing health disparities a state priority. Alabama should adopt a rigorous program of data collection across state agencies to identify disparities in health outcomes related to race/ethnicity, income and geography. This effort should engage research universities and state health agencies in developing and implementing a strategic plan to reduce targeted health disparities and give all Alabamians a chance to thrive.

Hunger

Job and income losses during the pandemic have contributed to widespread hunger in Alabama.

  • Too many people struggled to keep food on the table during the COVID-19 pandemic. During the spring/early summer stage of the pandemic (April through July 2020), 12% of all Alabama families and 13% of Alabama families with children either sometimes or often didn’t have enough food to eat.
  • Hunger was much more widespread in communities of color. Nearly 21% of Black residents and 19% of Hispanic/Latinx residents said they didn’t have enough food.
  • Proven safety net programs played a critical role in alleviating hunger. Food assistance through the Supplemental Nutrition Assistance Program (SNAP) was key to helping hundreds of thousands of Alabamians keep food on the table during this recession. And emergency food and child nutrition services eased hardship among Alabama’s children as schools closed or went virtual.

Recommendations

  • Alabama lawmakers should abandon efforts to slash the state’s safety net. Past proposals to restrict SNAP and other safety net programs would have made the recent hunger and hardship in Alabama even more dire.
  • Congress should move quickly to institutionalize recently increased UI, child nutrition and SNAP assistance. Hunger has grown during the pandemic, reaching crisis proportions. Boosts to UI, child nutrition and SNAP benefits have been essential tools to help struggling Alabamians meet their basic needs.
  • Congress should provide additional cash assistance, similar to the earlier relief payments, targeted specifically to families with low incomes. Targeted relief should include a fully refundable Child Tax Credit and an expanded Earned Income Tax Credit (EITC). Relief payments were a significant source of cash for food and other basic needs during early stages of the recession. And federal assistance will remain important as struggling Alabamians rebuild in the aftermath of the COVID-19 recession.

Housing

Thousands of Alabamians face potential eviction and homelessness because of inadequate response to the COVID-19 pandemic and its associated recession.

  • Alabamians can’t afford adequate housing. Many Alabamians in the workforce face housing insecurity because low wages burden renters heavily. Even basic apartments are out of reach for low-wage workers everywhere in the state.
  • COVID-19 has caused increased housing insecurity. Alabamians face high risk of eviction during the COVID-19 pandemic, largely because of insufficient state-level protections.
  • Housing insecurity is significantly racially disparate. Black and Hispanic/Latinx Alabamians face far higher risk of eviction for inability to pay rent. Long-standing inequities in the state’s economic structure have caused Black and Hispanic/Latinx communities to have fewer resources in reserve for weathering hard times.

Recommendations

  • Fund the Alabama Housing Trust Fund (AHTF). Lawmakers in 2012 created the AHTF as a vehicle to promote safe, affordable homes for people with extremely low incomes. A small increase in the recording fee for mortgages could boost the AHTF and significantly increase housing availability. This would facilitate more construction of affordable homes in the Black Belt and other rural areas.
  • Renew the state moratorium on evictions. Job losses amid the pandemic recession are causing evictions that otherwise would not have happened. The current limited federal moratorium fails to cover all Alabamians and requires administrative hurdles that leave holes in the system. By restricting evictions during the pandemic to reasons directly related to public safety, the governor could protect thousands of Alabamians from higher risk of COVID-19 transmission and from devastating long-term economic consequences.

Acknowledgments

This Alabama Arise report was made possible by a generous grant from EARN in the South. The findings and conclusions presented in this report are those of Arise and do not necessarily reflect the opinions of EARN in the South.

The report’s authors are Arise policy director Jim Carnes, policy analysts Carol Gundlach and Dev Wakeley, visiting fellow Allan Freyer and intern Resha Swanson. Arise communications director Chris Sanders was the report’s primary editor. Arise communications associate Matt Okarmus designed the charts and graphs and provided online design for the report. Bixler Creative designed the report logo and provided print design for the executive summary. Other report editors and contributors included Arise executive director Robyn Hyden and organizer Mike Nicholson.

Special thanks to Adelante Alabama Worker Center for producing a companion report to The State of Working Alabama 2021 and to Marie-Pier Frigon at New Mexico Voices for Children for providing guidance on chart and graph design.


The State of Working Alabama 2021

Introduction: The high cost of failing to protect the common good (Section 1)
Unequal by design: COVID-19 and Alabama’s policy legacy (Section 2)
Assessing the damage: COVID-19 and Alabama’s labor market (Section 3)
Praised but underprotected: Front-line workers in the pandemic (Section 4)

 

 

 

 

 

 

Why coverage matters: Health care in the time of COVID-19 (Section 5)
The ugly reality: Alabama’s hunger problem during the pandemic (Section 6)
No place to call home: Housing insecurity amid COVID-19 (Section 7)

The State of Working Alabama 2021, Section 1 – Introduction: The high cost of failing to protect the common good

State of Working Alabama logo

When the COVID-19 pandemic hit Alabama in March 2020, it didn’t just cause massive human suffering and economic disruption. It also revealed suffering and disruption that have long existed and that policymakers have long neglected – or even perpetuated.

COVID-19 has laid bare deep racial and gender inequities in Alabama’s economy and social system that have left our state unprepared to meet the needs of its people in this disaster. As the workers predominantly on the front lines, women and people of color bore the brunt of the economic meltdown. They also simultaneously have suffered greater exposure to the virus that caused it.

Alabama has a weak safety net for struggling families and an approach to economic growth that all too often leaves workers underprotected and underpaid. This ongoing policy legacy has exacerbated the damage that the virus has wreaked on the state’s working people.

In The State of Working Alabama 2021, Alabama Arise explores COVID-19’s significant and negative impacts on the state’s workforce. We also look ahead to outline a state and federal policy agenda for repairing the damage – not by repeating the policy mistakes of the past, but by charting a new path toward a more equitable economy marked by broadly shared prosperity.

The lessons of COVID-19

This report makes the case that economic recovery from the COVID-19 recession requires more than restoring the former status quo. All Alabamians are eager to feel connected, productive and at ease again. But for many individuals and families across the state, disruptions and barriers to a decent, sufficient – “normal” – quality of life are nothing new.

A smart plan for restoring and expanding Alabama’s economy will take long-standing inequities explicitly into account to elevate the common good. That plan will require accommodations, supports, policies of inclusion and other interventions to create new opportunities for participation and empowerment. The result will be a post-pandemic Alabama that’s more vibrant, resourceful and equitable than the state we had before.

The spike from record low unemployment to record high in a few weeks in spring 2020 left Alabama families reeling. Many found themselves in desperate situations they never envisioned. Many others, however, have long experienced marginalization and exclusion from the workforce, or have worked for generations at low wages without benefits.

Before COVID-19, Black and Hispanic/Latinx Alabamians had significantly higher rates of poverty than white Alabamians.[1] Communities of color also experienced higher rates of medical debt in collections and defaulted student loan debt.[2] Accumulated debt from COVID-19 likely will increase this already alarming disparity. A smart recovery plan should protect workers against unreasonable debt, eviction, predatory lending and other financial burdens that will slow their ability to return to or gain economic independence.

While the COVID-19 recession has caused unprecedented layoffs, it also has highlighted the critical role of service workers in keeping our communities going. Our state leaders hail these front-line and essential workers as heroes – but often in name only, denying them the respect of decent wages and strong protections.

Shortcomings on paid leave, wages, health coverage

The Families First Coronavirus Response Act of March 2020 required many businesses to offer sick leave with full or partial pay. But this benefit expired Dec. 31, and broad exemptions left thousands of Alabama workers unprotected.

Like our Deep South neighbors, Alabama has resisted implementing mandatory paid sick leave or family medical leave for private-sector workers. Lack of paid sick leave gives underpaid working people in particular a stark choice: Continue to work while sick, or stay home and lose pay – or even lose their jobs.

Efforts to strengthen the minimum wage have begun to gain traction at last in the Deep South. Florida voters in November 2020 approved a gradual minimum wage increase,[3] the first such step in a state neighboring Alabama.

Prior to COVID-19, Alabama’s refusal to extend health coverage to adults with low incomes had already left hundreds of thousands of Alabamians in the coverage gap. Most of them are working people. They also include family caregivers, students, people awaiting disability determinations and others who have no affordable coverage option.[4]

The COVID-19 recession has only widened this coverage gap and the suffering associated with it. People without health insurance often struggle to work while dealing with health problems that sap their productivity, add stress to their households and worsen without timely care.

The changing nature of workplaces

For another range of workers and employers, the recession has transformed assumptions about how workplaces operate and how workers function. It also has raised questions about how work and family life interact and highlighted what employers are capable of doing to accommodate workers’ needs. Many changes are adaptations that people with disabilities, child care responsibilities, inadequate transportation and other challenges have sought for decades.

The surge in telecommuting is both an impressive achievement and a cautionary tale. Remote working and learning have helped many families keep their lives moving forward during the pandemic. But for households lacking high-speed broadband service, working from home doesn’t work, and children’s progress in school has stalled.[5]

Recent federal broadband grants can go a long way toward bridging Alabama’s “digital divide” if administered under strict equity guidelines and community oversight.[6] Technology access aside, many jobs are impossible to perform remotely, and this limitation falls disproportionately on low-wage workers.

Innovative public programs kept families fed

The COVID-19 pandemic and its accompanying recession have highlighted the critical role of the safety net during a crisis. Families who never before had to seek assistance suddenly found themselves unable to afford the basics of life – food, shelter, utilities, health care – and turned to public assistance for the first time.

Enrollment for food assistance under the Supplemental Nutrition Assistance Program (SNAP) rose 12% between February 2020 and October 2020.[7] Federal waivers allowed the Department of Human Resources (DHR) to cut red tape and increase assistance for most SNAP participants. State and county SNAP workers worked nights and weekends to process more than 83,000 new SNAP applications.[8]

DHR and the state Department of Education also partnered to create – in just weeks – an entirely new program, called Pandemic EBT (P-EBT), that replaced school meals lost when schools closed.[9] By the end of the 2019-20 school year, P-EBT had distributed at least $132 million in food assistance to more than 420,000 Alabama children.[10]

Meanwhile, workers in school districts and emergency food closets across the state risked their own health to distribute federally funded school meals and food boxes to hungry families waiting in lines that ran for blocks. Federal Emergency Solutions Grants will help community-based agencies prevent an eviction epidemic if a federal moratorium ends in 2021.[11]

Efforts to cut the safety net are cruel and shortsighted

For the past five years, the Alabama Legislature has attempted to cut and restrict critical safety net programs. Fortunately, those efforts largely have failed because of hard work by advocates and directly affected Alabamians. The one safety net restriction that lawmakers approved – reducing the time workers could receive unemployment insurance (UI) benefits – was effectively reversed briefly when the state Department of Labor implemented federal extended benefits (EB) that were available because Alabama’s reported unemployment rate had exceeded 5.9%. But this reversal of the state’s policy failure was only temporary. The EB program has stopped paying benefits as of Oct. 3, 2020.[12]

Had proponents of safety net cuts been more successful, critical programs like Medicaid, SNAP and Temporary Assistance for Needy Families (TANF) might have not been available to meet Alabamians’ most basic needs today. Our leaders should remember this moment and the importance of the safety net as they prepare for future emergencies.

How we should respond now

Alabama is a torchbearer to the nation for civil and human rights achievements. We boast a world-class medical research center and regional hubs of education, business, manufacturing and finance. Our rich cultural legacy has produced artists of world renown.

But these proud assets stand against a backdrop of low wages, lingering rural and urban poverty, and racial injustice rooted in slavery and violent oppression. These structural failures have created unequal access to basic necessities, education and economic opportunity; wide health disparities; and other violations of the common good.

The COVID-19 crisis has created new challenges for our state and worsened persistent ones. If there is a bright spot to be found, it is in the light the pandemic has shined on these old problems and on new ways we can and must address them. We call on our leaders to envision a new Alabama beyond the pandemic horizon, where all residents can share in the best the state has to offer.

In focus

The Household Pulse Survey: An important new source of data on the pandemic’s impact on Alabamians

Shortly after the pandemic began, the U.S. Census Bureau launched the Household Pulse Survey to get a sense of the rapid changes occurring in people’s lives and livelihoods.[13] A sample of residents from every state answered questions – weekly for several months, then later every two weeks – about how the pandemic was affecting their household finances, health, education and other social and economic activities.

The survey asked people questions like:

  • Have you or anyone in your household experienced a loss of income since March 13?
  • In the last seven days, how difficult has it been for your household to pay for usual expenses?
  • How confident are you that your household will be able to afford the food you need for the next four weeks?
  • How confident are you that your household will be able to pay your next rent or mortgage payment on time?

We now have more than 20 installments of Alabama responses to this survey, and they are both frightening and telling. These responses inform much of this report. They provide snapshots of the impact of the pandemic and resulting recession on Alabamians’ economic and employment status. They provide crucial information about Alabamians’ ability to pay bills, access health care and participate in education. And they show us how people are making ends meet – or not – during the crisis.

Snapshots of pandemic life in Alabama

The Household Pulse Survey has rolled out in three phases, reflecting stages of the pandemic. The spring/early summer stage ran from late April until late July. The late summer/fall stage ran from mid-August until late October. And the winter stage runs from Oct. 28 until March 2021.

Because the questions have been tweaked and the frequency of the survey has changed between the phases, we can’t compare results in one phase to that in others, so we have to treat each stage as its own snapshot during each season of the pandemic. It’s important to know, too, that not everyone who answered the survey answered every question. Some survey questions have a high “non-response rate,” which could skew our understanding of the results. Household Pulse data included in this report does not include non-responses. While these caveats limit the conclusions we can draw from the data, the survey nonetheless offers valuable real-time reporting on the pandemic’s profound and far-reaching impact on our state.

Click here for more information on the survey.[14]


The State of Working Alabama 2021

The State of Working Alabama 2021: Executive summary
Unequal by design: COVID-19 and Alabama’s policy legacy (Section 2)
Assessing the damage: COVID-19 and Alabama’s labor market (Section 3)
Praised but underprotected: Front-line workers in the pandemic (Section 4)

 

 

 

 

 

 

 

Why coverage matters: Health care in the time of COVID-19 (Section 5)
The ugly reality: Alabama’s hunger problem during the pandemic (Section 6)
No place to call home: Housing insecurity amid COVID-19 (Section 7)

 

 

 

 

 

 

 


Footnotes

[1] Kaiser Family Foundation, “Poverty Rate by Race/Ethnicity,” State Health Facts 2019, https://www.kff.org/other/state-indicator/poverty-rate-by-raceethnicity/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D.

[2] Urban Institute, “Debt in America: An Interactive Map” (Dec. 17, 2019), https://apps.urban.org/features/debt-interactive-map/?type=overall&variable=pct_debt_collections&state=1.

[3] Andrea Hsu, “Florida Just Passed a $15 Minimum Wage. Is the Time Right for a Big Nationwide Hike?,” NPR (Nov. 18, 2020), https://www.npr.org/2020/11/18/934476124/florida-just-passed-a-15-minimum-wage-is-the-time-right-for-a-big-nationwide-hik.

[4] Alabama Arise, Medicaid Matters: Charting the Course to a Healthier Alabama, “Section 3 – Who’s still left out of health coverage in Alabama?” (June 17, 2020), https://www.alarise.org/resources/medicaid-matters-section-3-whos-still-left-out-of-health-coverage.

[5] A+ Education Partnership, “No Child Left Offline: Tackling the Digital Divide in Alabama” (Aug. 17, 2020), https://aplusala.org/blog/2020/08/17/no-child-left-offline-tackling-the-digital-divide-in-alabama.

[6] U.S. Department of Agriculture, “USDA Invests $62.3 Million in Rural Broadband Infrastructure for Alabama Families” (Dec. 5, 2019), https://www.usda.gov/media/press-releases/2019/12/05/usda-invests-623-million-rural-broadband-infrastructure-alabama.

[7] Alabama Department of Human Resources (DHR), Detailed Monthly Statistical Reporting for DHR Services, Table 19: Food Assistance Program (February 2020), https://dhr.alabama.gov/wp-content/uploads/2020/05/STAT0220.pdf; ibid. (October 2020), https://dhr.alabama.gov/wp-content/uploads/2020/12/STAT1020.pdf.

[8] Ibid.

[9] Celida Soto Garcia, “P-EBT, rapid school actions keep Alabama children fed,” Alabama Arise (Sept. 23, 2020), https://www.alarise.org/blog-posts/p-ebt-rapid-school-actions-keep-alabama-children-fed.

[10] Koné Consulting, Report: Pandemic EBT Implementation Documentation Project 13 (September 2020), https://frac.org/wp-content/uploads/P-EBT-Documentation-Report.pdf.

[11] Benefits.gov, “Emergency Solutions Grants (ESG),” https://www.benefits.gov/benefit/5890.

[12] Alabama Department of Labor, “ADOL Announces Extended Benefits Program to Expire: Benefits to Continue Through October 3” (Sept. 14, 2020), https://labor.alabama.gov/news_feed/News_Page.aspx?id=274.

[13] U.S. Census Bureau, Household Pulse Survey Data Tables, https://www.census.gov/programs-surveys/household-pulse-survey/data.html.

[14] U.S. Census Bureau, “Household Pulse Survey: Measuring Social and Economic Impacts during the Coronavirus Pandemic,” https://www.census.gov/programs-surveys/household-pulse-survey.html.

The State of Working Alabama 2021, Section 3 – Assessing the damage: COVID-19 and Alabama’s labor market

State of Working Alabama logo

Where are we now?

The COVID-19 recession hit vulnerable Alabama workers hard and fast. Alabamians working in low-paying industries suffered immediate and severe job losses, which fell hardest on women and people of color. Unemployment insurance (UI), designed for just such a moment, was inadequate and insufficient to the needs of these workers because of Alabama’s policy choices.

By December 2020, after the first nine months of the pandemic, 35,400 fewer Alabamians were employed than in February 2020.[1] That reflects a 1.7% drop in overall employment, which includes people who have dropped out of the labor market. The hardest-hit industry was leisure and hospitality, which lost 19,000 jobs, a 9.1% decline.[2] People working in this industry, which includes restaurants and entertainment establishments, often have fewer educational opportunities and lower incomes. They also are disproportionately women, people of color and younger adults.[3]

Also hard-hit was the education and health industry, which lost 16,600 jobs (a 6.6% decline) and also disproportionately employs women.[4] In Alabama, 81% of health care workers are women, as are 89% of child care and social service workers.[5] Almost instantly as the pandemic struck, Alabama’s official unemployment rate shot up to 13.8%.[6] By December, it had declined to 3.9% – still an increase of 1 percentage point over February 2020.[7]

The precipitous increase in unemployment during the first six months of the COVID-19 recession was nearly five times Alabama’s job loss during the first six months of the Great Recession.[8] Many Alabama workers simply had no cushion to reduce the damage.

Job losses hammered women, people of color

The official unemployment rate masks the true extent of the damage, especially among women and communities of color. The true number of jobless Alabamians is much higher once we also take into account the people temporarily furloughed when their businesses were closed. These are real job and income losses that are not included in the official unemployment rate. By this count, almost two out of every five working-age Alabamians reported they were not working during the spring/early summer stage of the crisis (late April until late July).[9]

In the same period, women and workers of color – especially Black workers – were hit the hardest. Half of women reported they were not working, compared to 43% of men.[10] Nearly 53% of Black respondents reported they were not working, compared to 47% of white people.[11] Hispanic/Latinx respondents reported not working at a rate roughly the same as white respondents.[12]

Joblessness remained elevated above pre-pandemic levels into mid-December, especially for women. While three out of 10 working-age Alabamians reported not working, a full 47% of women were jobless, a number significantly elevated above the 38% of men who were out of work.[13] The large differences in the percentages of men and women working during both the spring/early summer and late summer/fall stages reflect both the concentration of women working in the hardest-hit industries and the impact of child care responsibilities on working women.

UI claims reflect recession’s racial, gender disparities

Alabama’s claims for UI benefits tell a similar story. More than 967,000 initial unemployment claims were filed between the weeks of March 14, 2020, and Feb. 6, 2021.[14] If each claim were from a single worker, that number would be 45% of all employed people in Alabama as of December 2020.[15]

Alabama unemployment insurance claims have slowed but continued to rise. The graph shows the steepest increase between March and May and fairly steady cumulative growth in UI claims since then. Cumulative claims through the first 11 months of the pandemic have reached nearly 1 million.

With the U.S. average duration of unemployment at 22.8 weeks[16] and an Alabama initial claim payout rate of 47%,[17] the state would be on pace to pay more than 9.4 million weeks of benefits on claims arising through the week of Feb. 6, 2021, with the same benefit duration and eligibility structure available under the Coronavirus Aid, Relief and Economic Security (CARES) Act. This is a massive increase over pre-pandemic unemployment.

There were fewer than 2,000 UI claims for the week of March 14, 2020, the claim period immediately before the pandemic began causing widespread business shutdowns. Since then, the average weekly number of UI claims has been 1,105% higher than that amount, as of Feb. 6, 2021.[18]

UI claims underscore the racial inequities driving COVID-19’s unequal impact on employment. Black workers lost their jobs because of the COVID-19 pandemic at a much higher rate than their percentage of the overall workforce. Forty-seven percent of state UI claimants since March are Black, far higher than the 25% Black share of the state’s total workforce.[19]

COVID-19 job losses hit Black workers nearly twice as hard as other Alabamians. Black workers made up 25% of Alabama's workforce in 2020 but 47% of Alabama's unemployment insurance claimants in 2020.

Gender disparities in UI claims also reflect worsening inequities in the workforce. Women make up 58% of Alabama’s UI claimants since March but only 47% of the workforce overall.[20] Women also face greatly increased exposure to the dangers of COVID-19 because they work the majority of health care jobs.[21]

The pandemic’s high economic toll in rural Alabama

The recovery from catastrophically high unemployment has been inequitable by region. Rural counties in Alabama’s Black Belt in particular have lagged behind the state average in returning to pre-pandemic UI claim levels. The populations of these counties are disproportionately Black, and residents continue to face long-term negative consequences both from centuries of wealth extraction and the state’s failure to invest adequately in community well-being.

Black Belt residents also have been economically harmed by unusually high long-term unemployment.[22] Persistently high unemployment resulting from the pandemic simply compounds the region’s existing unemployment and wage disparities.

Rural Black Belt counties were slower to recover from peak unemployment. The percentage of peak unemployment in Black Belt counties (excluding Montgomery) did not return to the statewide average until October.

How did we get here?

Long-term neglect and recent harmful policy changes to the UI system failed Alabama’s workers when they needed the most support. The COVID-19 pandemic has exposed the state’s failure to maintain and modernize its UI claim infrastructure.[23] Alabama’s UI claim system was unsuited to the unprecedented demand, in part because it operated on outdated technology, as do many other states’ systems. The state’s failure to modernize its computer systems caused long periods of severe financial stress for Alabamians who could afford it the least.

The flawed structure of the state’s UI system is intentional. Alabama’s low-road policy decisions have consistently devalued workers and perpetuated inequality by keeping people insecure about meeting basic needs. The state’s neglect of the claims system is a passive example of undermining worker well-being, but officials also recently have taken active steps that harmed workers.

In 2019, the Legislature and governor enacted a law that lowered the total amount of UI benefits significantly. The law reduced the length of time a worker could claim benefits from 26 weeks to 14, or 19 if a worker could participate in approved job training.[24] It also tied a potential increase of weeks of benefits to reported overall state unemployment rates from the prior quarter.

Besides its harmful impact on workers, the recent UI restriction has two major conceptual flaws. First, the changes fail to account for significant differences in employment opportunities across the state. This increases pressure on people to find work where few or no jobs exist. Second, the lag in reporting the unemployment rate failed to account for the sort of catastrophic economic conditions that COVID-19 delivered. When unemployment rises quickly and sharply, the number of weeks that UI benefits are available does not increase quickly enough to prevent economic pain for unemployed workers.

A UI system that isn’t meeting Alabamians’ needs

Alabama’s UI system has a low payout rate. Though the number of repeated weeks of claims for a single loss of employment has dropped since March 2020, fewer than half of initial claims had been deemed valid and paid out through Nov. 30.[25] This low payout rate shows Alabama is not doing enough to provide UI coverage to people harmed by layoffs.

The state’s failure to pay out claims in a timely manner has compounded the hardship for Alabamians out of work because of COVID-19. And further, the state response has inaccurately assessed the damage that the pandemic has caused to Alabama workers. The state Department of Labor has classified a substantial portion of these UI claims as unrelated to COVID-19.[26] But that characterization is unpersuasive in light of the drastic increase in claims, with the pandemic’s beginning the only major change in workforce conditions.

Lack of broadband access limits opportunities

The COVID-19 shutdown has heightened the impact of Alabama’s “digital divide.” As schools and many workplaces shifted to online activities, workers with lower incomes often found themselves at a double disadvantage. First, their jobs were less likely to be adaptable to remote settings. Second, their households were less likely to have the reliable internet connection and computer equipment required for online learning or work.

Alabama’s lack of broadband internet can limit remote work even for people whose jobs allow it. The Alabama Broadband Accessibility Act defines an “unserved area” as a rural part of the state where internet service falls below the minimum threshold of an average 25 megabits per second for downloading and 3 megabits per second for uploading.[27] And much of Alabama is designated as “unserved” by the state authority that oversees broadband access.[28] Huge swaths of rural Alabama are caught in this gap, including almost all of Greene and Perry counties and much of west Alabama from Fayette and Lamar counties in the north to Choctaw and Clarke counties in the south.[29] Even in relatively urbanized counties like Jefferson, Madison, Montgomery and Shelby, many rural areas lack reliable internet service.[30]

One-time relief payments simply aren’t enough

Relief payments helped individuals and families pay the bills but went away too soon. The quick passage of the CARES Act in late March 2020 provided a lifeline for Alabama families reeling from the shutdown.[31] In the spring/early summer stage, an average of 23% of Alabamians who were not working (including both those who were unemployed and those who are retired) reported relying on the relief payments to help with bills.[32]

In a telling and troubling sign, the percentage of such households declined over the same period.[33] This probably reflects exhaustion of one-time stimulus checks as people used them to meet basic needs. In mid-June, 34% of people who were not working said they used relief funds to pay bills during the past week.[34] This percentage declined to 17% by mid-July.[35]

What should we do now?

Alabama can create a better system for responding to the needs of workers who lose their jobs. Worker-friendly policies create a better, more stable economy for everyone. Alabama can make several changes that would improve conditions for unemployed workers, including strengthening work supports, fixing the UI system and improving implementation of federal COVID-19 relief measures. Specifically:

  • Alabama must invest in its UI compensation infrastructure, both human and technological, to improve our ability to get these funds out quickly to unemployed people. Specific changes would include institutionalizing the recent temporary move to 26 or more weeks of UI assistance and permanently repealing the 2019 law cutting available weeks of assistance. In addition, the Alabama Department of Labor should issue guidance to allow people at high risk from COVID-19 to retain UI benefits if they quit a job that is taking insufficient virus precautions.
  • The state should stop conditioning receipt of benefits on participation in job training programs. Workers receiving UI benefits already have demonstrated a desire to work and the ability to maintain long-term employment by meeting the minimum earnings and time requirements for UI eligibility. Creating barriers for people who lose their jobs only serves to punish job seekers and burden an already strained state claims system.
  • The state should expand the availability of work supports, including training, child care and transportation. To get to work, people first need the ability to get to the workplace. They also need adequate job preparation and reliable care for family members to ensure full participation in the state’s economy.
  • Expand high-speed, affordable broadband technology, targeting rural and low-income communities and explicitly addressing racial equity in broadband access.
Federal relief
  • Alabama should direct significant federal relief funds to emergency housing and utility assistance. Unemployed Alabama workers are facing hunger, eviction and utility shutoffs in the dead of winter. And Alabamians already pay one of the highest rates for electricity in the South. While federal relief funding is available for emergency housing and utility assistance, the housing assistance is still being processed by the state, and utility assistance ran out in January. CARES Act funding could fill the temporary void in housing assistance and supplement the inadequate federal utility assistance.
  • Congress should pass a comprehensive new relief package. Significant numbers of unemployed Alabamians relied on relief payments to meet basic needs early in the recession. That need has not disappeared. Congress’ next relief measure should increase targeted relief payments and reinstate the $600 weekly federal UI boost for eligible workers. The package also should expand the Earned Income Tax Credit (EITC) and make the Child Tax Credit fully refundable. And it should extend the December 2020 increase to Supplemental Nutrition Assistance Program (SNAP) benefits.

The State of Working Alabama 2021

The State of Working Alabama 2021: Executive summary
Introduction: The high cost of failing to protect the common good (Section 1)
Unequal by design: COVID-19 and Alabama’s policy legacy (Section 2)
Praised but underprotected: Front-line workers in the pandemic (Section 4)

 

 

 

 

 

 

 

Why coverage matters: Health care in the time of COVID-19 (Section 5)
The ugly reality: Alabama’s hunger problem during the pandemic (Section 6)
No place to call home: Housing insecurity amid COVID-19 (Section 7)

 

 

 

 

 

 

 


Footnotes

[1] Economic Policy Institute (EPI) analysis of Local Area Unemployment Statistics data from the Bureau of Labor Statistics (BLS), December 2020.

[2] EPI analysis of BLS Current Employment Statistics, December 2020.

[3] Hye Jin Rho, Hayley Brown & Shawn Fremstad, “A Basic Demographic Profile of Workers in Frontline Industries,” Center for Economic and Policy Research (April 7, 2020), https://cepr.net/a-basic-demographic-profile-of-workers-in-frontline-industries.

[4] EPI analysis, supra note 1.

[5] Rho, supra note 3.

[6] Alabama Department of Labor, http://www2.labor.alabama.gov/LAUS/LAUSTab.aspx.

[7] Ibid.

[8] EPI analysis, supra note 2.

[9] Alabama Arise analysis of U.S. Census Bureau, Household Pulse Survey, Phase 1, April 23 – July 21, 2020, https://www.census.gov/programs-surveys/household-pulse-survey/data.html#phase1.

[10] Ibid.

[11] Ibid.

[12] Id.

[13] Alabama Arise analysis of U.S. Census Bureau, Household Pulse Survey, Phase 2, Aug. 19 – Oct. 26, 2020, https://www.census.gov/programs-surveys/household-pulse-survey/data.html#phase2.

[14] Alabama Department of Labor, “Initial Unemployment Claims for Week Ending 2/6/2021,” https://www.labor.alabama.gov/news_feed/News_Page.aspx?id=318.

[15] Bureau of Labor Statistics, “Economy at a Glance,” https://www.bls.gov/eag/eag.al.htm.

[16] Bureau of Labor Statistics, “Unemployed persons by duration of unemployment” (Feb. 6, 2020), https://www.bls.gov/news.release/empsit.t12.htm.

[17] The Century Foundation, “Who Is Getting UI?” (Jan. 24, 2021), https://tcf.org/content/report/unemployment-insurance-data-dashboard.

[18] Alabama Arise calculations based on Alabama Department of Labor, supra note 14.

[19] The Century Foundation, “Who Is Getting UI?,” supra note 17.

[20] Ibid.

[21] Bureau of Labor Statistics, “Employed persons by detailed industry, sex, race, and Hispanic or Latino ethnicity” (Jan. 22, 2020), https://www.bls.gov/cps/cpsaat18.htm.

[22] Alabama Department of Labor, “Civilian Labor Force by County – December 2020,” http://www2.labor.alabama.gov/LAUS/clfbycnty.aspx (citing 2019 unemployment data).

[23] Lydia Nusbaum, “State’s system overwhelmed as number of unemployment claims surge,” WSFA 12 News (March 25, 2020), https://www.wsfa.com/2020/03/25/states-system-overwhelmed-number-unemployment-claims-surge.

[24] SB 193, 2019 Regular Session of the Alabama Legislature, https://legiscan.com/AL/bill/SB193/2019.

[25] The Century Foundation, “Unemployment Insurance Data Dashboard” (updated Jan. 24, 2021), https://tcf.org/content/report/unemployment-insurance-data-dashboard (citing Alabama Department of Labor report to U.S. Departments of Treasury and Labor).

[26] See generally Alabama Department of Labor, News, https://labor.alabama.gov/news_feed/News_Page.aspx (linking press releases with individual weekly breakdowns of UI claims caused by COVID-19 and purportedly not caused by COVID-19).

[27] Alabama Department of Economic and Community Affairs (ADECA), “Alabama Broadband Accessibility Fund Frequently Asked Questions,” https://adeca.alabama.gov/Divisions/energy/broadband/Broadband%20Docs/Frequently%20Asked%20Questions.docx.

[28] ADECA, “Alabama Broadband Eligibility Map – Unserved Areas as of 11/23/2020,” https://adeca.alabama.gov/Divisions/energy/broadband/Broadband Docs/Alabama_Broadband_Eligibility_Map_Unserved_Areas.pdf.

[29] Ibid.

[30] Ibid.

[31] Sharon Parrott, Chad Stone, Chye-Ching Huang, Michael Leachman, Peggy Bailey, Aviva Aron-Dine, Stacy Dean & LaDonna Pavetti, “CARES Act Includes Essential Measures to Respond to Public Health, Economic Crises, But More Will Be Needed,” Center on Budget and Policy Priorities (March 27, 2020), https://www.cbpp.org/research/economy/cares-act-includes-essential-measures-to-respond-to-public-health-economic-crises.

[32] Alabama Arise analysis of U.S. Census Bureau, Household Pulse Survey, Phase 1, April 23 – July 21, 2020, https://www.census.gov/programs-surveys/household-pulse-survey/data.html#phase1.

[33] Ibid.

[34] Alabama Arise analysis of U.S. Census Bureau, Week 7 Household Pulse Survey: June 11 – June 16, Employment Table 2, https://www.census.gov/data/tables/2020/demo/hhp/hhp7.html.

[35] Alabama Arise analysis of U.S. Census Bureau, Week 12 Household Pulse Survey: July 16 – July 21, Employment Table 2, https://www.census.gov/data/tables/2020/demo/hhp/hhp12.html.

The State of Working Alabama 2021, Section 5 – Why coverage matters: Health care in the time of COVID-19

State of Working Alabama logo

Where are we now?

While the COVID-19 pandemic has slammed all segments of Alabama’s economy and society in one way or another, the health care industry is where most of these effects converge. By the end of 2020, more than 350,000 Alabamians had tested positive or were considered likely positive for the virus, 72% of them in the working-age range of 18 to 64.[1] More than 4,500 Alabamians had died of COVID-19 by Christmas.[2]

The pandemic’s toll has continued to mount in 2021. Alabama had the 11th highest COVID-19 death rate among states in mid-February 2021.[3] That means a higher share of Alabamians have died from the virus than in most other parts of the country. By mid-February, Alabama’s COVID-19 deaths in less than a year had surpassed 9,200,[4] far more than the number of Alabamians who died in World War II and all subsequent wars.[5] The average risk of death from the virus remains low, but:

  • The risk is not distributed evenly across age, racial/ethnic and economic groups.
  • Complications can be long-lasting and debilitating.
  • Everyone with a positive diagnosis has a new preexisting condition. This could affect their access to health coverage if Congress seeks to remove Affordable Care Act protections in the future.

Pandemic’s burden heavier on women, Black Alabamians

As COVID-19 swept across the country in spring 2020, the virus’s disproportionate impact on Black Americans quickly became apparent in emergency rooms, ICUs and death data, where that information was available.[6] When the Alabama Department of Public Health (ADPH) began daily COVID-19 data reporting in early April, Black people accounted for 52.1% of confirmed deaths,[7] while comprising only 26.6% of the population. Americans of color are more likely to have chronic health problems than their white counterparts for numerous reasons. These factors include barriers to health care, transportation, adequate nutrition and other basic necessities.

Other sections of this report highlight Alabama’s disproportionate reliance on women and people of color in various jobs that pose high risk of coronavirus exposure. Health care workers are a special case in this regard. For these workers, contact with infected individuals is not just a risk but a job requirement. And the Alabamians meeting this challenge are overwhelmingly women, at 80.6% of the health care workforce.[8] Black people make up 31.2% of Alabama’s health care workers, as compared to their 25% share of the state workforce overall.[9]

As providers of costly health services, doctors’ offices, clinics, hospitals and nursing homes are businesses, too. They can’t operate without keeping their personnel safe, functional and paid, without essential supplies on hand, and without keeping the doors open – challenges for any business during a pandemic. While many retail, manufacturing and hospitality businesses have seen their customer bases shrink dramatically during the shutdown, many health care providers have experienced waves of increased demand. Alabama’s failure to expand Medicaid to cover adults with low incomes has placed economic strain on providers serving these patients.

How did we get here?

The lifeblood of all this activity is the health insurance coverage that, for most Alabamians, pays much of the bill. While 55.9% of Alabama workers had employer-sponsored coverage in 2019, this overall rate masked wide disparity by race and ethnicity.[10] Among white workers, 62.2% had health insurance through their jobs, while the same was true for only 46.4% of Black workers and just 35.5% of Hispanic/Latinx workers in our state.[11]

Prior to COVID-19, almost 300,000 Alabamians with low incomes were caught in the state’s health coverage gap.[12] They earn too much to qualify for Medicaid under the state’s stringent eligibility limits but too little to afford private plans. Working-age Alabama parents are generally ineligible if their income is above 18% of the federal poverty line – just $3,960 a year for a family of three.[13] And virtually all Alabama adults without children are ineligible regardless of income.[14]

COVID-19 deepens coverage disparities by race, income

Working Alabamians make up the majority of those in the coverage gap, along with people who are caring for family members, going to school or awaiting disability determinations.[15] And the racial coverage disparity is stark: Forty-nine percent of uninsured Alabamians with low incomes are people of color, even though people of color make up just one-third of the state’s population.[16]

Job losses during the pandemic have reinforced racial disparities in health coverage. The initial impact during spring and early summer fell particularly hard on working-age Hispanic/Latinx Alabamians, who reported being uninsured at a rate of 30.3%. That was nearly twice the rate for Black people (15.7%) and nearly three times the rate for white people (10.3%).[17] Despite some gains, by late summer and early fall, Hispanic/Latinx Alabamians still reported being uninsured at twice the rate for white people.[18]

 

Hispanic and Black Alabamians are more likely to lack health coverage. 32.8% of Hispanic/Latinx residents were uninsured in the spring/early summer stage of the pandemic, and 20.7% were uninsured in the late summer/fall stage. The corresponding rates for Black residents were 17.8% and 13.5%. For white residents, the rates were 11.7% and 11.5%.

An analysis of uninsured rates by income level reveals even more striking disparities. During both the spring/early summer and late summer/fall stages of the pandemic, uninsured rates were highest by far for workers earning below $35,000 a year, and the rates decreased consistently as income increased.[19] In the first stage, Alabamians earning below $35,000 reported an uninsured rate of 27.2%, while those earning $100,000 and above showed a rate of just 3.8%.[20] In the second stage, those rates dropped to 22.9% and 1.8%, respectively.[21] Broadly speaking, the higher the income, the more likely workers are to have either employer-based health insurance or the means to purchase private plans.

 

Alabamians with lower incomes are more likely to lack health coverage. 27.2% of residents with an annual household income below $35,000 were uninsured in the early spring/summer stage of the pandemic, while 22.9% were uninsured in the late summer/fall stage. The corresponding rates for residents with incomes between $35,000 and $75,000 were 9.8% and 10.9%. For residents with incomes between $75,000 and $100,000, the rates were 3.5% and 4.9%. For residents with incomes above $100,000, the rates were 3.8% and 1.8%.

Expand Medicaid to save lives, advance racial equity

The most direct solution to these coverage gaps is Medicaid expansion. A 2019 UAB study estimated that expansion would enroll more than 346,000 Alabamians – most of the eligible uninsured, plus some people who are paying for insurance they can’t afford.[22] Alabama’s high uninsured rate for low-wage workers underscores the fact that Medicaid expansion is a pro-worker policy. And given the disproportionate share of people of color in the coverage gap, expanding Medicaid is the biggest step Alabama can take to advance racial equity in our health care system.

It’s been hard to break through with numerous policy solutions to remove Alabama’s barriers to health care. For example, Alabama Medicaid was unwilling to cover most telehealth services for people who lack reliable transportation – until the COVID-19 shutdown made remote services imperative. And though nutritional supports like vouchers for healthy groceries are available through Medicaid in some states, they’re not in Alabama.

Alabama also has refused to remove the 4% state sales tax on groceries,[23] which would make nutritious food more affordable and give all state households the equivalent of two weeks of free groceries every year. And most notably, Alabama has yet to join 38 other states (plus the District of Columbia) in covering working people with low incomes through Medicaid expansion,[24] a policy change that would directly address Alabama’s racial/ethnic health disparities.

As noted elsewhere in this report, many Alabama lawmakers have expressed more interest in protecting businesses from COVID-19 liability claims than in protecting working people from health risks and economic hardship. A balanced approach to corporate immunity would include expanding health coverage and workers’ compensation for the working Alabamians who have enabled companies to stay in business during the pandemic.

What should we do now?

Just as a hurricane or earthquake tests the strength of buildings and provides a template for improving durability, a health crisis like COVID-19 offers clear lessons for strengthening worker health protections and services. The following measures would help Alabama be better prepared for the next pandemic. They also would promote a healthier workforce and an economy in which everyone has an equal opportunity to thrive. Alabama should:

  • Provide health coverage for adults with low incomes by expanding Medicaid. This single step would facilitate more COVID-19 testing, treatment and vaccination; increase worker health and productivity; and strengthen Alabama’s health care system, especially rural hospitals. Lawmakers’ rush to immunize businesses against pandemic-related claims only makes the need for worker protections like health coverage more urgent.
  • Expand use of telehealth services by means of universal broadband access and provider incentives.
  • Identify and address health disparities. Adopt a rigorous data collection program across state agencies to identify health outcome disparities related to race/ethnicity, income and geography. Engage research universities and state health agencies in developing and implementing a strategic plan for reducing targeted health disparities.
  • Support community health. Develop and implement a strategic plan for linking underserved communities with health care by means of community health workers. Alabama is one of just three states that have not defined a role for community health workers in the state health care system, according to the National Academy for State Health Policy. Our state’s failure to act is depriving underserved communities not only of improved health services and outcomes but also job creation and economic development.
  • Promote community-based participatory research to increase chronic and infectious disease awareness, preventive behaviors and health equity.
In focus

Powering up for recovery: The vaccine trust factor

If we’re smart, the links between social justice and health that the pandemic is exposing will improve our chances for beating it. All eyes are on vaccine distribution. Immunizing Alabama against COVID-19 is a matter not just of coordinating vaccine delivery and covering costs, but also building trust.

Alabama had mixed success with the adoption of protective equipment and protocols to mitigate COVID-19’s spread during most of 2020. Similar resistance to accepting the vaccine could delay our state’s economic recovery even further.

Understanding the relative influences of skepticism and lack of information and access on vaccine participation warrants further research. But Alabama’s public health legacy – and living memory – adds a painful dimension to this issue. In the home state of the racist and deadly Tuskegee syphilis experiment,[25] public health officials have a long way to go to win the full confidence of communities long betrayed.[26]

Nationally, Black Americans are significantly less likely than white people to get the annual flu vaccine.[27] This fact raises the stakes for a new vaccination campaign. A 2020 CDC study found that Hispanic/Latinx adults had lower flu vaccine uptake than any other racial/ethnic group.[28] People with disabilities also have shown lower flu vaccine participation.[29] And a recent study found that unemployed Americans were less likely to receive the flu vaccine and also less likely to say they would accept a COVID-19 vaccine.[30]

We have to make sure – and make clear – that Alabama’s response to the COVID-19 pandemic and our plans for recovery take all segments of our population into equal account. The ADPH deserves applause for its efforts to account for racial inequities by partnering with historically Black colleges and universities and other Black-led institutions and networks in its COVID-19 vaccination planning.

Public health funding cuts haunt Alabama

Despite this collaborative approach, though, the state’s vaccination rollout got off to a troubled start. Inadequate vaccine supplies only compounded the challenge of conducting a massive public health campaign with a system undermined by chronic budget cuts. In 2019, Alabama’s state-administered county health departments operated at 65% of the professional staffing they had in 2010.[31]

The ADPH’s phased vaccine distribution plan places front-line health care workers, first responders and support personnel (e.g., hospital janitorial and medical transportation services) at the “head of the line” in Phase 1a for receiving the vaccine, along with residents and staff of nursing facilities.[32] These initial target populations are easy to identify, but some of the targets for Phases 1b and 1c – people with age- and health-related risk factors – will be more challenging to reach.

Community outreach and referral will play a critical role in successful implementation of these phases. Phase 1b also targets front-line essential workers, who are comparatively easy to identify and reach. But both this phase and the later Phases 1c and 2 include industries and general population groups that will require diversified and sustained communications and engagement.

Medicaid expansion would help ensure Alabama is prepared for the next pandemic

The COVID-19 vaccine will pose numerous logistical and economic challenges. Getting ahead of those challenges will be a key part of strengthening Alabama’s workforce as our state recovers. Let’s bring more than 340,000 Alabamians into a health care system that can provide them with accurate information, encourage them to get vaccinated and pay the cost when they do. And let’s make sure the pandemic and its associated recession don’t break our hospitals and our communities.

That’s the kind of heavy lifting Medicaid expansion was made for. Medicaid expansion is a tool for removing barriers, improving health outcomes and saving lives. Now, of all times, why aren’t we using it?


The State of Working Alabama 2021

The State of Working Alabama 2021: Executive summary
Introduction: The high cost of failing to protect the common good (Section 1)
Unequal by design: COVID-19 and Alabama’s policy legacy (Section 2)
Assessing the damage: COVID-19 and Alabama’s labor market (Section 3)

 

 

 

 

 

 

 

Praised but underprotected: Front-line workers in the pandemic (Section 4)
The ugly reality: Alabama’s hunger problem during the pandemic (Section 6)
No place to call home: Housing insecurity amid COVID-19 (Section 7)

 

 

 

 

 

 

 


Footnotes

[1] Alabama Department of Public Health, Alabama’s COVID-19 Data and Surveillance Dashboard, https://alpublichealth.maps.arcgis.com/apps/opsdashboard/index.html#/6d2771faa9da4a2786a509d82c8cf0f7.

[2] Ibid.

[3] John Elflein, “Death rates from coronavirus (COVID-19) in the United States,” Statista (accessed Feb. 16, 2021), https://www.statista.com/statistics/1109011/coronavirus-covid19-death-rates-us-by-state.

[4] Bama Tracker, Alabama COVID-19 Deaths, https://bamatracker.com/chart/deaths (reflecting cumulative + probable COVID-19 deaths).

[5] Congressional Research Service, American War and Military Operations Casualties: Lists and Statistics (updated July 29, 2020), https://fas.org/sgp/crs/natsec/RL32492.pdf; Statista, “U.S. military fatalities in Iraq and Afghanistan, by state” (accessed Feb. 16, 2021), https://www.statista.com/statistics/303472/us-military-fatalities-in-iraq-and-afghanistan.

[6] Centers for Disease Control and Prevention, “Health Equity Considerations and Racial and Ethnic Minority Groups” (updated July 24, 2020), https://www.cdc.gov/coronavirus/2019-ncov/community/health-equity/race-ethnicity.html.

[7] Alabama Department of Public Health, Laboratory-Confirmed COVID-19 Case Characteristics (April 7, 2020), https://www.alabamapublichealth.gov/covid19/assets/cov-al-cases-040820.pdf.

[8] Hye Jin Rho, Hayley Brown & Shawn Fremstad, “A Basic Demographic Profile of Workers in Frontline Industries,” Center for Economic and Policy Research (April 7, 2020), https://cepr.net/a-basic-demographic-profile-of-workers-in-frontline-industries.

[9] Ibid.

[10] Kaiser Family Foundation, “Employer-Sponsored Coverage Rates for the Nonelderly by Race/Ethnicity” (2019), https://www.kff.org/other/state-indicator/nonelderly-employer-coverage-rate-by-raceethnicity/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D.

[11] Ibid.

[12] David J. Becker, “Medicaid Expansion in Alabama: Revisiting the Economic Case for Expansion,” University of Alabama at Birmingham School of Public Health, Department of Health Care Organization and Policy (Jan. 31, 2019), https://docs.wixstatic.com/ugd/72a465_8f37c24eeccf4e15bc6b2b97c00c3922.pdf.

[13] Alabama Arise, Medicaid Matters: Charting the Course to a Healthier Alabama, “Section 1 – How does Medicaid work in Alabama?” (June 17, 2020), https://www.alarise.org/resources/medicaid-matters-section-1-how-does-medicaid-work-in-alabama.

[14] Ibid.

[15] Alabama Arise, Medicaid Matters: Charting the Course to a Healthier Alabama, “Section 3 – Who’s still left out of health coverage in Alabama?” (June 17, 2020), https://www.alarise.org/resources/medicaid-matters-section-3-whos-still-left-out-of-health-coverage.

[16] Alabama Arise, Medicaid Matters: Charting the Course to a Healthier Alabama, “Section 4 – How can we make Alabama healthier?” (June 17, 2020), https://www.alarise.org/resources/medicaid-matters-section-4-how-can-we-make-alabama-healthier.

[17] U.S. Census Bureau, Household Pulse Survey, Phase 1, April 23 – July 21, 2020, https://www.census.gov/programs-surveys/household-pulse-survey/data.html#phase1.

[18] Alabama Arise analysis of U.S. Census Bureau, Household Pulse Survey, Phase 2, Aug. 19 – Oct. 26, 2020, https://www.census.gov/programs-surveys/household-pulse-survey/data.html#phase2.

[19] Alabama Arise analysis of U.S. Census Bureau, Household Pulse Survey, https://www.census.gov/programs-surveys/household-pulse-survey/data.html.

[20] Arise analysis of U.S. Census Bureau, supra note 17.

[21] Arise analysis, supra note 18.

[22] Becker, supra note 12.

[23] Carol Gundlach, “How the state grocery tax hurts struggling Alabamians,” Alabama Arise (Feb. 22, 2019), https://www.alarise.org/resources/how-the-state-grocery-tax-hurts-struggling-alabamians.

[24] Kaiser Family Foundation, “Status of State Medicaid Expansion Decisions: Interactive Map” (updated Feb. 12, 2021), https://www.kff.org/medicaid/issue-brief/status-of-state-medicaid-expansion-decisions-interactive-map.

[25] Tuskegee University, “About the USPHS Syphilis Study,” https://www.tuskegee.edu/about-us/centers-of-excellence/bioethics-center/about-the-usphs-syphilis-study.

[26] Reuben C. Warren, Lachlan Forrow, David Augustin Hodge, Sr. & Robert D. Truog, “Trustworthiness before Trust – Covid-19 Vaccine Trials and the Black Community, New England Journal of Medicine (Nov. 26, 2020), https://www.nejm.org/doi/full/10.1056/NEJMp2030033.

[27] Sandra Crouse Quinn, “African American adults and seasonal influenza vaccination: Changing our approach can move the needle,” National Center for Biotechnology Information (Nov. 17, 2017), https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5861789.

[28] Centers for Disease Control and Prevention, “Influenza (Flu) General Population Vaccination Coverage” (Oct. 1, 2020), https://www.cdc.gov/flu/fluvaxview/coverage-1920estimates.htm.

[29] Jenny O’Neill, Fiona Newall, Giuliana Antolovich, Sally Lima & Margie Danchin, “Vaccination in people with disabilities: a review,” National Center for Biotechnology Information (July 24, 2019), https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7012164.

[30] Amyn A. Malik, SarahAnn M. McFadden, Jad Elharake & Saad B. Omer, “Determinants of Covid-19 vaccine acceptance in the US,” The Lancet (Aug. 12, 2020), https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(20)30239-X/fulltext.

[31] Arian Campo-Flores, “Why Alabama Has the Worst Covid-19 Vaccination Rates,” Wall Street Journal (Feb. 11, 2021), https://www.wsj.com/articles/why-alabama-has-the-worst-covid-19-vaccination-rates-11613048418.

[32] Alabama Department of Public Health, Alabama COVID-19 Vaccination Allocation Plan (updated Jan. 29, 2021), https://www.alabamapublichealth.gov/covid19vaccine/assets/adph-covid19-vaccination-allocation-plan.pdf.