Issue: Health

Here’s what Alabama Arise heard in 2024!

By Presdelane Harris

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

We held two virtual statewide Town Hall Tuesdays this summer, and each featured three to four listening session breakouts. Arise staff either facilitated or were part of 20 additional listening sessions, both online and in person around the state. We engaged more than 500 people in a total of 27 listening opportunities.

Following are direct notes from the town halls and highlights from the other sessions. These notes and highlights are listed under the names of the Arise organizers who heard them.

Town Hall Tuesdays

A better Alabama is possible, July 16

We had four breakout rooms during this session. We asked folks in each group to discuss their thoughts on current issues and to share other priorities they had. Here’s what our organizers heard from participants:

Pres Harris:

  • Death penalty reform. We need to consider the impact that potential new appointees to the U.S. Supreme Court might have on this issue at the state level.
  • Concern about new school choice laws that divert funding from public education. There is special concern in rural areas where there are either no or very limited options to public education for children. Many participants said this is a way to take more money from funding public education. Several participants agreed with the education concern.
  • A sight-impaired participant lifted up education, voting rights and public transportation as key issues impacting people living with disabilities. There is a disparity in education among low-vision students. The disabilities community has been advocating for electronic voting so that sight-impaired people can vote with privacy. And lack of public transportation is a barrier to voting and other quality-of-life activities.
  • Concern about the maternal health crisis and subsequent infant health care needs. We need to improve access to maternal care and health care overall. We need to expand Medicaid.
  • One participant raised the need for people to have legal representation in civil issues like family issues, bankruptcy, school issues, etc. Another participant said the Alabama State Bar might be an ally in advancing such an issue.
  • Public transportation was highlighted again as a need and a quality-of-life issue.
  • In the main session, a participant raised the need to address a variety of veterans’ issues, with emphasis on veteran housing availability.

Stan Johnson:

  • More funding for education programs for children ages 0-3. For a better Alabama, we need to focus on early education. Alabama has a home visitation program called First Teachers, designed to support families at risk for poor developmental outcomes. They use a variety of models, including Parents as Teachers and First Family Partnership. They go and visit families with children 0-3 years of age. Alabama is not putting additional money into 0-3 education. A participant noted that the state budget has included such funding in the past, and he wants to ensure it stays there. We have appropriated a couple million dollars, but Alabama receives more from the federal government than what the state puts in for this service. Minnesota puts 10 times as much money into their program as Alabama. Missouri has universal access to 0-3 education.
  • Kids need to master their social and emotional milestones, and the ability to have a two-way productive interpersonal relationship. They need the ability to modulate their emotions appropriately in a group setting, to have a sense of curiosity and to have a sense of who they are. If they do not get the basic scaffolding in the first three years of life, then all the remediation in the world will not help them get through high school. Efficacy-based programs exist and have proved effective. Alabama is not doing enough about it.
  • A participant said she is a retired teacher and could tell the difference between kids who were read to, loved and cuddled. The first three years make a world of difference. She said this does not need to be a named Arise priority, but it should be addressed.
  • We have picked up momentum with Medicaid, but not nearly enough. Many participants said this needs to continue to be the No. 1 issue. Adequate health care is important for a better Alabama.
  • Participants said they want to help with Medicaid expansion. They understand all it would take is for the governor to sign it and it would be a done deal. They do not understand why people would say they do not want money from the feds. For every dollar we send, we get back $2.17.
  • Participants opposed turning back federal infrastructure money and ARPA money. The argument has no logic.
  • Rural hospitals and departments closed this year, including in Thomasville, Monroe County and Union Springs. What are the governor’s plans to help those areas? Some voters in those areas do not realize that state policies have caused them to lose their health care. We have been saying for years that lack of Medicaid expansion would cause hospitals to close.
  • Some women are now having to drive as far as 90 minutes away to get to an OB-GYN. We can see the harm that elected officials are causing to their constituents.
  • Unfortunately, people do not realize when they vote that they sometimes are voting for representatives who do not seem to have their best interest in mind. We have already lost $7 billion in funding by not expanding Medicaid.
  • One participant said the new teacher certification test is an issue for young or new teachers. What are some alternate ways toward certificates?
  • A participant said Congress should have passed a Medicaid expansion bill, the Save Rural Hospitals Act. This would have helped rural areas to reopen hospitals. The state chose to enhance the port in Mobile instead of providing funding to rural hospitals. The hospitals would have provided jobs and training for RNs, LPNs, CANs and other hospital staff, as well as other jobs once the hospitals opened.
  • We have to educate our decision-makers about looking at cost holistically and not just as a one-time investment. We are losing people due to not investing and not expanding Medicaid.

Adam Keller:

  • It’s hard to begin, because all of the issues are so interrelated and important.
  • Public transportation is so important to access to food and work. Several participants weighed in on public transportation.
  • One participant said crime is out of control and expressed concern about gun safety. They are concerned about gun violence and how Gov. Kay Ivey and lawmakers have loosened restrictions. They emphasized the need for citizen participation.
  • There are false narratives around crime. We need more community-based public safety.
  • A participant brought up the lack of Medicaid expansion, closing of rural hospitals and lack of OB-GYNs. She had a medical incident and only survived because she had immediate attention.
  • A participant said the secretary of state’s salary should be tied to voter registration. They also brought up bicycles as a help for transportation, as well as university bike share programs and bike grants. They said the state needs to grant more paroles and shouldn’t require people to pay a bunch of fees before voting rights are restored.

Formeeca Tripp:

  • It’s important to know the history of Alabama so we can understand the past and where we are going.
  • A longtime Alabama Arise member is eager to keep learning more. He believes the issues proposed are good, and we need to keep focusing on them.
  • One big supporter of Medicaid expansion believes it needs to keep being addressed in the legislative sessions. He also supports the end to the state grocery tax but is lost on “what else can we do?” He also has concerns with gun violence, along with other participants.
  • Another longtime member is a big supporter of Medicaid expansion and believes we need to keep working on the current list of priorities for the next legislative session.
  • Another participant believes payday and predatory lending should be addressed and a priority issue. Transportation, specifically for disabled veterans, is important and needs to be addressed, not just grouped under the general transportation umbrella. She also would like to see gun violence reduction as a priority issue and has a movement called “SWAG – Safer Without A Gun,” to buy back real and toy guns as well as educate on gun safety, conflict resolution and problem-solving skills, especially in underserved communities.
  • Medicaid expansion, transportation and gun violence were the dominant topics in our breakout room.

Building toward a better Alabama, Aug. 6

We had three breakout rooms during this session. We asked folks in each group to discuss what motivates them to act on issues and how Arise supports their actions. And we asked them to indicate their priority issues. Here’s what our organizers heard from participants:

Pres Harris:

  • Participants shared consensus about the need to expand Medicaid to address several health care concerns. These included rural hospital closures, maternal mortality rates in Alabama and support for mental health care needs.
  • Concern for the survival of our democracy with attacks on voting rights was expressed. Public education, affordable housing and public transportation also were highlighted. Several said it is hard to prioritize the current Arise issues, as they are all critical.
  • Participants shared what motivates them to action: hearing the stories of those directly impacted, knowing they are coming together with others to advocate, and the feeling of confidence they get because Arise has helped equip them with information and tools to act.

Stan Johnson:

  • We heard consensus that all the issues are important, and it is difficult to pinpoint which is a priority over another.
  • Jobs to Move America supports everything Arise does and wants to see a clawback of incentives to companies that violate child labor laws (e.g., Hyundai’s supply chain). We want to raise that up for consideration. These kids come from impoverished backgrounds in Mexico/Central America, and they send money back to their families. Sen. Merika Coleman and Rep. Neil Rafferty had a bill last year, and it passed in the Senate and House committee unanimously; we just ran out of time. We need to send these car manufacturers a message. They are working on a strategic direction proposal to submit.
  • We need to continue to grow the communication network throughout the state.
  • Alabama Arise is the most respected organization in the State House.
  • We need to make serious reforms to the state budgets and appropriations so we can take care of the people of Alabama, instead of Mercedes, etc. We do not have money to fund social programs, but corporations are receiving gigantic tax breaks. These are billions of dollars that could have helped the citizens of Alabama.
  • One organization is working on criminal legal reform in Alabama, especially looking at the death penalty.
  • A participant was very upset that Alabama does not participate in programs, and then the same government comes and says we do not have any money.
  • Several participants said transportation needs to improve in Alabama, which also helps people have access to jobs. Transportation is a big topic for people with disabilities. One participant said some of her clients are not able to get to appointments at UAB because of a lack of public transportation. Some transportation directors, on the other hand, do not see the need and want to make further cuts because of low ridership on the buses. Her clients are losing their jobs because of unreliable transportation. Decatur has Ride on Demand, where you must call in to request a ride. It can be a two-hour wait time. There are bus stops on busy roads, so it is dangerous for individuals in wheelchairs as well as able-bodied individuals. These are some of the reasons people do not use Decatur’s transportation system.
  • Another participant from Mobile said she has been working on Medicaid expansion and is glad we were able to get an extension on the coverage for postpartum maternity care. She is pushing health care as the main issue, along with the social determinants associated with health.

Adam Keller:

  • We need more mental health services, which will help reduce prison overcrowding and crime.
  • Alabama needs prison reform, including addressing the prison labor situation.
  • We heard affirmation of our current agenda, including specifically voting rights and Medicaid expansion.
  • We heard discussion of burnout and the importance of persistence (with the grocery tax as an example).
  • Some members shared that they wouldn’t be involved if it wasn’t for our help and said Arise gives them more hope for the state.

Additional listening sessions

This section highlights participants’ input from the 19 additional sessions recorded by the Arise organizing team. In general, all participants strongly affirmed Arise’s work on current legislative priorities. Many thought that Arise should continue to build on momentum it has around some of the current issues. Many also said we need to see more change in the existing priorities. Members seemed to affirm these sentiments, as no new issues were proposed for 2025. These notes lift up the other issues of concern that participants highlighted as we listened.

Pres Harris – Baldwin, Elmore and Mobile counties

Participants in these meetings affirmed the current Arise priorities, acknowledging that our issues are long-haul issues.

Other issues raised:

  • The need to address gun violence.
  • The need for parole reform was proposed by a group of women from the Julia Tutwiler Prison for Women who are sponsored by Arise member group Greater Birmingham Ministries. GBM submitted the issue as a strategic approach under the existing criminal justice reform issue.

Stan Johnson – Birmingham/Jefferson County and Tuscaloosa/West Alabama

Most of the participants in these meetings focused on the existing legislative priorities and discussed ways to continue the work toward progress.

A member group planned to submit a proposal for a strategic approach to getting more funding for the 988 mental health crisis hotline that connects folks to needed resources. This is not a new issue, but it would be part of Arise’s permanent priority of adequate state budgets.

Other issues raised: More needs to be done about payday loans, energy/solar power incentives and veterans in crisis.

Whit Sides, Arise’s Cover Alabama storyteller, participated in a session with disability advocates that involved listening to and sharing stories related to intellectual disabilities and neurodivergence/autism. Participants were interested in developing their stories for advocacy with policy and lawmakers.

Adam Keller – Northeast/Madison and Morgan counties

Most of the participants in these meetings strongly affirmed the current Arise priorities.

During further discussion, participants highlighted issues related to public education, child nutrition, paid parental leave and parole/probation reform.

Several conversations centered on how the work of Arise connected with labor and worker power.

Formeeca Tripp – Houston, Lee, Montgomery and Tallapoosa counties

Many participants in these meetings expressed appreciation for Arise’s work around our current issues, especially voting rights, health care and other safety net issues.

Other issues raised:

  • The lack of affordable housing that contributes to issues of homelessness.
  • Legislation that impacted the Black population historically and current laws and policies that lawmakers have passed.
  • Issues that negatively impact racial equity and inclusion.
  • The need to address gun violence and have programs for youth.

What are the benefits of a universal school breakfast program in Alabama?

By LaTrell Clifford Wood

Alabama should do more to equip schoolchildren and teachers for success. Our state consistently ranks among the bottom five states for educational outcomes. And one essential school supply missing from several Alabama schools would immensely improve said outcomes: universal school breakfast. Below are a few of the positive effects that universal school breakfast would have for children across Alabama.

Reduce child hunger across our state. In Alabama, 23% of school-age children are food insecure, with a disparate impact among children of color. Universal school breakfast could guarantee a morning meal for all Alabama children during their required school day.

Address chronic absenteeism. In recent years, nearly 1 in 5 Alabama children have been chronically absent, with 53% of Alabama schools experiencing some form of high to chronic absenteeism. Decades of research has shown that students who participate in school breakfast see improved attendance and decreased tardiness, according to the Food Research and Action Center. 

Improve adolescent mental health. Young adults who reported experiencing food insecurity during childhood also reported greater psychological distress in adulthood, according to National Health and Nutrition Examination Survey data.

Improve standardized testing and math scores. Alabama ranks 46th in average math ACT scores. Student academic achievement increases, especially for math, when accessible breakfasts are made available to school-age children.

Reduce the long-term cost of closing the health coverage gap. Given the chronic health conditions associated with hunger, like diabetes and heart disease to name a few, a state subsidy for universal school breakfast is a form of preventative care that could have a long-term impact on the projected cost of closing the coverage gap in Alabama.

Alleviate behavioral problems. The behavioral effects of hunger include impulsivity, hyperactivity, irritability, aggression, anxiety and a greater propensity to using rewarding narcotics, according to a study by the National Institutes of Health. Reducing hunger would reduce these behaviors.

Aid Alabama’s teachers in regulating their classrooms. Attrition rates among teachers have surged nationwide and statewide in recent years. Teachers spend roughly $300 per year of their own money to feed hungry students in their classrooms.

Address educator attrition rates. Nearly 40% of teachers who left the profession said they had better material support in their current roles when compared to teaching, according to a survey conducted by the Institute of Education Sciences. Universal school breakfast is a simple but powerful way to provide material support for Alabama’s teachers and students.

For questions regarding the implementation, impact and general importance of universal school breakfast, please contact Alabama Arise’s LaTrell Clifford Wood at latrell@alarise.org or Carol Gundlach at carol@alarise.org.

Universal school breakfast helps Alabama children learn and thrive

By Carol Gundlach

School breakfast helps kids learn: Children who start the day with breakfast learn better. They have better classroom participation and are less likely to skip school than kids who don’t get breakfast. But tight family budgets and stressful mornings mean many children arrive at school hungry. School breakfast can help fill this gap.

School, bus and family schedules make it difficult to serve breakfast before the school day begins: School breakfast participation declined nearly 8% nationally after pandemic-era free breakfast ended. Only half of the children who get lunch at school also get breakfast.

The solution – universal free breakfast: School districts across the country have found that breakfast served after the first bell increases participation and helps kids learn.

Paperwork is a barrier for hungry children: Federal funding for traditional school breakfast relies on school’s assessing students’ eligibility for meal subsidies and reporting on how many free, reduced and paid meals are served. The Community Eligibility Provision (CEP) can reduce the paperwork for schools that serve a high share of children with low incomes. But many schools either can’t make CEP work financially or worry about its impact on other federal grants.

What the Legislature can do: The Legislature can help feed Alabama’s schoolchildren by appropriating Education Trust Fund (ETF) money to match federal reduced and paid breakfast funds. Schools that want to offer free breakfast can use these matching funds to provide breakfast for all of their students at the start of the school day.

How this would work: The Legislature would appropriate money to match federal school breakfast grants. The Alabama State Department of Education would allow local schools to apply and would distribute these matching dollars. Schools that receive funding would report to, and be monitored by, the Department of Education.

The decision to offer free breakfast is optional: Whether to apply for matching funds would be totally voluntary for schools or systems. Those that want to participate can apply for the matching funds. Those that don’t think it will work for them can choose not to apply.

How this would interact with CEP: The Community Eligibility Provision allows eligible schools to provide free meals for all their students. But some Alabama schools that are technically eligible for CEP can’t make the federal reimbursement rate work for them. And other Alabama schools would like to offer free breakfast but don’t want to adopt CEP fully. This proposal would allow schools to be made whole if they do adopt CEP or would allow schools to offer universal breakfast without having to adopt CEP fully.

Bottom line

An ETF appropriation of approximately $14 million in 2023 dollars would allow every school in Alabama to offer breakfast to all of their students.

 

Expand Medicaid to save moms and babies in Alabama

By Debbie Smith

Where you live shouldn’t impact whether you get health care. But many women face preventable barriers to obtaining maternal health care in Alabama. Closing Alabama’s health coverage gap through Medicaid expansion is an essential part of the solution.

Alabama has experienced a steady rate of labor and delivery department closures in recent years, creating several maternity care deserts in Alabama.

  • A maternity care desert is defined as a county or area with a lack of access to maternity care resources. These areas often have no obstetric providers and no birth centers or hospitals offering obstetric care.
  • More than one-third of Alabama counties are maternity care deserts, with some people having to drive up to 100 miles to reach the nearest labor and delivery department. The lack of essential delivery and prenatal care in the Black Belt and other areas worsens the state’s maternal and infant health disparities, especially for women with low incomes.
  • Since October 2023, at least four hospitals have closed their labor and delivery departments.

The closure of accessible labor and delivery departments is dangerous for mothers and babies.

Expanding Medicaid would help strengthen access to maternity care providers by improving rural hospitals’ overall finances, which could reduce the number of labor and delivery department closures in the state.

Alabama has the highest maternal mortality rate in the nation. Similarly, Alabama’s infant death rates are higher than those in most other states. Alabama has the nation’s third highest infant death rate.

Medicaid expansion can help address the high maternal mortality rate and health disparities in Alabama by ensuring continuous coverage before, during and after pregnancy.

  • Medicaid expansion would provide more women with access to regular prenatal checkups, leading to early detection and management of potential health issues for both the mother and the baby.
  • Research shows that adoption of Medicaid expansion is associated with lower rates of maternal mortality, and reduction in infant mortality as well.
  • Medicaid expansion also has been found to increase preconception health counseling, folic acid intake and postpartum contraception.

Summer EBT for 2025

By LaTrell Clifford Wood

A state appropriation for Summer EBT will ensure $40 in food benefits per summer month for more than 500,000 eligible Alabama children ages 5-17.

 

An Alabama Arise flyer explaining the need for and benefits of Summer EBT starting in 2025.

1 in 4 Alabama children are food insecure.

Too many of our children don’t know where their next meal will come from. Because of systemic barriers to food access, a disproportionate amount of food-insecure children come from communities of color. The Summer EBT program has been shown to help alleviate this problem by both reducing hunger and supporting healthier diets among children.

500,000+ Alabama children will benefit starting in 2025.

In recent years, 94% of Alabama’s children who relied on free and reduced-price meals during the school year have not had access to these meals over the summer. The Summer EBT appropriation in the 2025 Education Trust Fund budget will help reduce hunger for hundreds of thousands of Alabama children in summer 2025.

Summer EBT could spur $100M each year in economic activity.

This federal nutrition program required a $10 million state match for administrative and setup costs. This funding will generate substantial economic benefits, both for families and for local retailers that accept EBT benefits. Also worth noting: The costs of operating this program likely will decrease in future years.

Preparing for Summer 2025

  • Summer EBT cards will be addressed to and in the eligible child’s name.
  • Children will be automatically eligible to receive Summer EBT benefits if at least one of these is true:
    • The child’s household receives assistance under Medicaid, the Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance for Needy Families (TANF) and/or the Food Distribution Program on Indian Reservations (FDPIR).
    • The child is in foster care or experiencing homelessness.
  • Applications will be required for all other eligible children.

 

Alabama enrollment navigators provide help, but options are limited without Medicaid expansion

By Whit Sides
A woman sits at a booth at an event.
Enroll Alabama navigator Rebecca Sylvester staffs a table at a community event in Huntsville. (Photo courtesy of Enroll Alabama)

Rebecca Sylvester spends her days answering phone calls from desperate Alabamians.

As an enrollment navigator for Enroll Alabama, a grant-funded organization dedicated to helping people find health coverage, she faces a daily battle with the harsh realities of Alabama’s health care system.

But despite her dedication to finding resources for everyone who calls, she is forced to deliver heartbreaking news to most of her callers: There might not be any options for them. Especially for people caught in Alabama’s health coverage gap, who earn too much to qualify for Medicaid but too little to qualify for insurance subsidies under the Affordable Care Act (ACA).

“I think that I can count one mom who was able to get back on Medicaid out of hundreds of people I spoke to,” Rebecca said.

Even then, this mother was a special exception. She was part of a brief window that allowed those who were enrolled in Medicaid during the COVID-19 pandemic to maintain coverage during the federal public health emergency (PHE). But because the PHE declaration ended in 2023, navigators are now hearing from people who are losing their Medicaid coverage during a process known as “unwinding,” or a return to pre-pandemic eligibility requirements.

Adults between ages 18 and 64 in Alabama have to meet some of the strictest income eligibility requirements in the country to have Medicaid coverage. Parents in a two-person household, for example, do not qualify for Alabama Medicaid if they make more than just $3,684 a year.

The wide range of people in Alabama’s coverage gap

The frustration in Rebecca’s voice is palpable. The coverage gap is a consequence of Alabama’s decision not to expand Medicaid to cover adults with low incomes under the ACA. That policy failure has left nearly 300,000 residents without affordable access to health care.

This means Rebecca talks to a very diverse group of people every day. They include young adults aging out of ALL Kids (Alabama’s Children’s Health Insurance Program). Many are working adults who don’t get insurance through their employer. Some are older adults who are approaching age 65 but are not yet eligible for Medicare.

Rebecca’s work is more than just finding coverage solutions. It involves discussing complicated and systemic failures with confused and often desperate callers who are learning about it for the first time.

“I don’t think I’ve had a single client where I’ve been like, ‘You’re in the Medicaid coverage gap,’ and they knew what that was,” she said.

The stories never stop coming

Two people at a booth speak with a person visiting that booth.
Enroll Alabama navigators answer questions at a community event in Montgomery. (Photo courtesy of Enroll Alabama)

Many people are shocked to learn how few resources exist for all the Alabamians living in the gap.

Rebecca discussed one conversation that was particularly hard. The caller not only had lost health coverage but also had become homeless and reached out for help.

“This person genuinely believed that there was some sort of help out there for people who really needed it,” Rebecca said.

She said the harsh truth is that, without Medicaid expansion, such public resources are virtually non-existent in our state. And while she tries to find free or sliding scale clinics to help, they can’t be the fix for everything.

Enroll Alabama helps people navigate the often confusing landscape when trying to find health coverage, but the resources they can offer are limited. Our state’s failure to expand Medicaid leaves hundreds of thousands of people scrambling to find a patchwork of temporary solutions to their health issues.

By not accepting federal funds that would ensure health coverage for those in the coverage gap, our state continues to deny Alabamians the peace of mind that folks in 40 other states have.

‘It’s heartbreaking’

One young woman Rebecca helped was attending community college and needed ongoing mental health support. She lost coverage when she turned 19, aging out of ALL Kids, and her small campus didn’t offer student health resources that larger universities do. Her mother received disability payments, and her family couldn’t afford private insurance premiums of more than $400 a month.

“She apologized to me for needing Medicaid,” Rebecca said. “I couldn’t believe it!”

Rebecca says navigators come face to face every day with stories like these every day. These situations highlight how stigma and misunderstanding surrounding public assistance programs hurt so many people across Alabama. Rebecca’s frustration is evident when she talks about not being able to assist everyone who reaches out for help.

“It’s heartbreaking to tell someone there’s nothing I can do for them,” she said. “They fall in the gap, and there are just no options available.” She said this sense of helplessness is shared among other navigators who see firsthand the gaps in the system.

A growing network of navigators

Mark Linn, assistant project director for Enroll Alabama, also does navigator work. He said that though navigators often hit roadblocks when working with folks in the coverage gap, they still keep their phones and schedules open for anyone who needs them.

A crowd of people pose for a photo.
The Enroll Alabama navigator team gathered at their 2023 annual meeting at the Tutwiler Hotel in Birmingham. (Photo courtesy of Enroll Alabama)

“Everyone is different, and no situation is permanent,” Mark said. “If we can, we’re going to find something for you.”

There are enrollment navigators all across Alabama, including nine navigators within United Way. Two other navigators work within hospitals (DCH in Tuscaloosa and East Alabama Medical Center in Opelika). Another navigator based at The Right Place serves individuals and families who have low incomes or face homelessness in Anniston.

And this year, resources are becoming available in areas where they weren’t before. New navigators are serving Black Belt communities, as well as areas in northeast Alabama like Fort Payne, Rainsville and Scottsboro.

Enroll Alabama’s partnership with 211 also makes it accessible for anyone in the state to reach out and get connected with clinics, programs or resources close to home.

“Our navigators are familiar with all the resources in their area and have a list right beside them,” Mark said. “So if someone calls from Chilton County, but I’m not there, I can plug them in with our navigator from that area… on top of them just calling 211. It’s really a great resource.”

Navigating unfamiliar territory together

Mark agreed with Rebecca that a lot of folks reaching out to navigators for help are in unfamiliar territory, facing not having coverage for the first time. Through a partnership with social workers at UAB, Mark said, he often helps patients in heart failure navigate their new situation. He also meets them where they are.

“I do make house calls and go out to hospitals. A lot of times, I’m meeting in the library or at McDonald’s,” he said.

Mark said a lot of Enroll Alabama’s work focuses on helping people submit Medicaid applications, or checking to see if they are eligible for tax credits through the ACA. But in Alabama, the income eligibility restrictions can make the path forward very narrow.

“Beyond that, when they’re in the coverage gap, sometimes the best we can do is give them a phone number and pass them along to charity care, which doesn’t feel great.” Mark said.

It’s also important for people to know that even if they don’t qualify for a special enrollment period, ACA tax credits or Medicaid, other community resources like low-cost clinics may be available. Mark still encourages everyone to call 211 or set up an appointment with a navigator directly if they are uncertain about finding care or resources.

“You are never bothering us. ‘Navigator’ is right there in the name,” he said. “We are always here to help.”

It’s time for Alabama to join our neighbors

The benefits of Medicaid expansion are clear. States like Arkansas and North Carolina that have expanded Medicaid report lower uninsured rates, improved access to care, and better health outcomes. Rural hospitals, which have been closing at alarming rates in non-expansion states like Alabama, have access to life-saving funds that allow them to stay open and serve their communities.

Recently, Alabama’s Joint Health Committee held a hearing where legislators spoke with lawmakers from Arkansas and North Carolina about their experiences with Medicaid expansion. The testimonies highlighted the positive impact, emphasizing how expansion has bolstered rural hospitals and provided vital health coverage to those who needed it.

Arkansas lawmakers shared that expansion has decreased their uninsured rate and improved overall health outcomes. And North Carolina officials pointed to the financial stability it has brought to rural health care facilities.

Expanding Medicaid in Alabama could have similar positive health and economic outcomes, a recent study by the Public Affairs Research Council of Alabama (PARCA) found. Medicaid expansion would create more than 20,000 local jobs and bring significant federal funding into Alabama’s economy, PARCA projected. Most importantly, it would ensure health coverage for nearly 300,000 Alabamians and save hundreds of lives every year.

Remaining hopeful for change

Rebecca said she still listens to everyone who calls asking for help, even when there aren’t many resources available. However, there is an important way that folks in the coverage gap can get involved. 

“We encourage anyone who is struggling to access health care to call their legislators and let them know the issues they’re having,” said Debbie Smith, Alabama Arise’s Cover Alabama campaign director.

“Legislators need to hear from real people that this is a real issue. It can be easy for legislators to overlook a statistic,” Debbie said. “It’s much more difficult to ignore when someone is suffering because they can’t access the medical care they need.”

Navigators play a vital role in the coalition of private partners, providers and nonprofits working every day to address the issues facing Alabamians in the coverage gap.

“We’re thrilled to partner with Enroll Alabama,” Debbie said. “We’re so thankful that there is an organization that can help people find the resources that are available to them even though our state has shamefully created gaps in coverage.”

If you or someone you love would like help navigating the health care marketplace, applying for Medicaid or finding a federally qualified health care clinic in your area, please visit Enroll Alabama’s website to set up an appointment with a navigator. You also can call them directly at 844-248-7698.

If you don’t always have access to a computer, you can download an application to print and share later here.

About Alabama Arise and Cover Alabama

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

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

U.S. Labor Secretary calls Alabama Arise ‘truly incredible’ during visit to Birmingham

By Chris Sanders
Nine people stand for a posed photo.
Alabama Arise staff and members participated in a listening session with the U.S. Department of Labor and the City of Birmingham on June 11, 2024. From left: Arise board member Kenneth Tyrone King, Arise’s Cover Alabama storyteller Whit Sides, former Arise board member Helen Rivas, health coverage gap storyteller Diana Isom, acting U.S. Labor Secretary Julie Su, Arise worker policy advocate Dev Wakeley, Arise communications director Chris Sanders, Arise member Marva Douglas and Birmingham Mayor Randall Woodfin. (Photo courtesy of Chris Sanders)

Alabamians need quality jobs that provide economic security and an opportunity to get ahead. That was the message Alabama Arise staff and members were excited to share with acting U.S. Secretary of Labor Julie Su during her visit to Birmingham last week.

Numerous Arise supporters participated in a worker listening session with the Department of Labor (DOL) on June 11. And worker policy advocate Dev Wakeley represented Arise at a June 12 roundtable meeting on good jobs.

Nine people stand for a posed photo.
Alabama Arise worker policy advocate Dev Wakeley (third from right) participated in a June 12, 2024, roundtable on job quality with acting U.S. Labor Secretary Julie Su (center) and local business and civic leaders. (Photo by Shawn T. Moore, Department of Labor)

The DOL’s initiative to enhance job quality aligns well with Arise’s advocacy to improve life for Alabamians who are marginalized by poverty, Wakeley said. He also praised Su’s willingness to visit Alabama to hear workers’ concerns personally.

“We saw the closest thing you could imagine to unity of purpose,” Wakeley told AL.com after the visit. “When the Department of Labor comes in and talks about wanting to build good jobs that really allow for human beings to thrive and advance and to provide for their families, we are grateful for their presence, and we love to hear that.”

‘Alabama’s workers should not have to settle’

Su expressed her appreciation for Arise’s work as well. She praised both Arise and Jobs to Move America (an Arise member group and partner in the Alabama Coalition for Community Benefits) during a June 12 news conference at the North Birmingham Library.

“I did want to thank the union leaders for showing up here and every single day, to Jobs to Move America and Alabama Arise, who have helped make this trip so rich and meaningful for me,” Su said. “You are all truly incredible.”

Su came to Alabama on the second stop of the DOL’s Good Jobs Summer Tour. The tour aims to promote and build support for the department’s Good Jobs Principles, a shared framework for job quality for workers, businesses, unions, advocates and other interested parties. The principles include equitable pay and benefits, safe and healthy workplaces, and an organizational culture that values every worker’s contributions. Birmingham Mayor Randall Woodfin announced Birmingham’s commitment to the principles during the news conference.

Arise proudly supports and endorses the Good Jobs Principles. Learn more about them here.

Watch the video above to hear acting U.S. Labor Secretary Julie Su’s full remarks about good jobs during her June 12, 2024, news conference in Birmingham.
 

“We are being intentional about connecting all of Alabama’s residents and all of Birmingham’s workers to good jobs,” Su said. “Because Alabama’s workers should not have to settle. Because no one should have to work full time year-round and still live in poverty. No one should have to work two or three jobs and still barely be able to put together a life. That is not the American promise. That is not the American dream.”

Workers’ rights, public transportation uplifted during listening session

Su’s remarks reflected many of the concerns that Birmingham-area workers shared during a listening session with Su and Woodfin. More than 70 people attended the June 11 session, and many discussed their personal experiences with workplace challenges or lack of essential work supports.

Four people stand for a posed photo.
Alabama Arise organizer Adam Keller (right) attended a June 11, 2024, listening session with the U.S. Department of Labor and the City of Birmingham. Attending alongside him were (from left) Matt Holmes, Seth Cain and Wesley Verzwyvelt. All four men are members of the International Alliance of Theatrical Stage Employees (IATSE). (Photo by Whit Sides)

Several workers underscored the necessity of protecting employees’ right to form and join unions if they choose. Others highlighted the need for higher pay and more robust benefits like child care and health insurance. The final attendee to speak was longtime Arise member Marva Douglas, who emphasized the importance of securing state funding for public transportation so every Alabamian can get to work, school or anywhere else they need to go.

Two women are pictured speaking to each other.
Midfield resident Marva Douglas (left), a longtime Alabama Arise member, speaks with acting U.S. Labor Secretary Julie Su after a June 11, 2024, listening session in Birmingham. (Photo by Whit Sides)

An opportunity infrastructure

Su said the DOL stands with workers in advancing racial justice and breaking down other systemic barriers to job quality. Good jobs, she said, are about more than just making ends meet today. They are about the promise of a better tomorrow.

“A good job … means a job with security,” Su said. “A job where you know that you can not just get by, but get ahead. Where you have leave and benefits, so if you or your children need to go to a doctor, you can. Where you have a retirement plan so that you know that at the end of a career, you can retire with dignity.”

Making this vision of job quality a reality will require the creation of “opportunity infrastructure” in communities across the country, Su said. That means bringing workers, businesses, policymakers, advocates and educational institutions together to build an inclusive economy for everyone, she said.

“We have more bridges to build,” Su said. “The bridge from poverty to prosperity. The bridge from racial exclusion to real equity. So let’s roll up our sleeves, and let’s build together.”

LaTrell Clifford Wood: Arise’s new star at the State House

By Whitney Washington

The halls of the Alabama State House had a new face this legislative session.

LaTrell Clifford Wood started as Alabama Arise’s hunger policy advocate in November. Since then, the Stillman College graduate has worked tirelessly to ensure Alabama’s most marginalized residents have access to food. In her role, she advocates directly with lawmakers for legislation that supports getting food to the Alabamians who need it most. She also convenes the Hunger Free Alabama coalition of 88 organizations.

As the youngest member of the Arise staff, LaTrell offered up insights after her first legislative session.

“I think this session has really taught me to hold space for the world to grow, change and evolve, and find new room for hope,” she said. “You can have a resume that is really heavy with blue collar and service experience, and those experiences are meaningful. Those are ‘real jobs.’”

A photo headshot The intergenerational relationships with other Arise staff members proved to be helpful as she navigated an especially challenging session.

“I picked up gems of wisdom from people who have been doing this work a lot longer than me, and actualized the value that young people can bring to a space when they are treated as meaningful contributors,” LaTrell said.

Making use of opportunities

LaTrell grew up in Irondale, a city of about 13,000 near Birmingham, and is a proud HBCU grad. Her time at Stillman brought her into hunger advocacy work and a systemic framework for change.

“There are systems in place by which we lose wisdom with the people we love. So I said to myself, ‘Whatever I do, I have to take care of myself, and it has to be sustainable,’” LaTrell said. “Since I was a pandemic grad, I decided to take a break and explore more options, and that led me to Congressional Black Caucus Foundation [CBCF].”

Through the CBCF, LaTrell interned in U.S. Rep. Terri Sewell’s office in Washington, D.C. That is where she first learned of Alabama Arise.

“My team in Rep. Sewell’s office really advocated for me, and Akiesha [Anderson, Arise’s former policy and advocacy director] really opened the doors for me to Alabama politics, and made a safe space for me to come back home and grow and learn at Arise, and I am so grateful for her and the rest of Arise’s staff for welcoming me,” LaTrell said.

Telling her story

LaTrell’s advocacy this year helped secure $10 million in Summer EBT administrative funding for 2025. (See page 2.) She finds that telling her personal stories to lawmakers has helped her in this work.

“It was really healing and energizing to talk to Sen. [Rodger] Smitherman, whose district I grew up in, about my experiences with hunger and its impact, and see him really stand 10 toes down for children across the state,” she said. “Countless children will have some measure of relief from hunger over the summer months, for generations to come. It’s hard to wrap my head around in more ways than one.”

After an impactful first legislative session, LaTrell has even bigger goals for Arise’s hunger advocacy work. Universal school breakfast is her next advocacy priority.

“I think the first step in that is leaning into securing a state appropriation to subsidize universal school breakfast in the next year,” she said.

LaTrell also said she hopes to help bring even more young people like her into the Alabama Arise fold.

“I look forward to building more avenues to meet young Alabamians where they are,” she said.

An optimistic look at Alabama

As a young Alabamian who returned to the state after working elsewhere, LaTrell said she wants the rest of the world to see what Alabama is really like.

“When I go out of state, a lot of people say, ‘You’re from Alabama?’ And there’s always a tone,” she said. “So my favorite experience is being able to school people on all the misconceptions they have, and all the contributions Alabamians and Alabama have made to the U.S. and the world.”

LaTrell is incredibly proud of her Alabama roots and how they’ve shaped her family.

“My family has been domestic refugees of the state, run out by racial violence during the first wave of the Great Migration. But somehow, we find our way back, and every generation, we have been able to make a meaningful difference. And that is worth being proud of,” she said.

How to get involved

For those looking to get involved with the critical work of feeding Alabamians, LaTrell has some suggestions.

Arise supporters who live in or have connections in Limestone and Morgan counties, as well as Opelika, can support hunger advocacy by talking with parents, educators and superintendents in their communities about the Community Eligibility Provision (CEP). More than 50% of the schools in these areas could serve universal school meals through CEP but are not. The deadline for schools to opt in for the upcoming school year is June 30.

“I encourage members to keep an eye out for hunger-related action alerts, and follow us on Facebook at Hunger Free Alabama!” LaTrell said.

Summer EBT, Legislative Day energy highlight busy, tough 2024 session in Alabama

By Chris Sanders

You made a difference! Alabama Arise members played a decisive role this year in securing summer food assistance for more than 500,000 children starting in summer 2025. Summer EBT funding brought an uplifting conclusion to the Alabama Legislature’s 2024 regular session, which ended May 9.

The Summer EBT victory showed the power of Arise’s policy analysis, organizing and advocacy. After the House passed an education budget without Summer EBT funding, Arise ramped up pressure on the Senate. Our policy team and lobbyists educated lawmakers about the program’s benefits. Our communications team generated dozens of media stories to build public support. And our organizers rallied Alabamians to speak out.

Ultimately, folks like you got Summer EBT funding across the finish line. Arise advocates flooded lawmakers with more than 2,700 emails, calls and personal visits urging support. And it worked: Senators added Summer EBT to the budget, and Gov. Kay Ivey signed it into law.

Our members also displayed their passion for change during Arise’s annual Legislative Day on April 2. More than 230 people packed the State House in support of our Cover Alabama campaign to close Alabama’s health coverage gap.

Lawmakers dealt setbacks to several Arise legislative priorities this year but made important progress on others. Through it all, our members kept speaking out for policies to improve the lives of Alabamians marginalized by poverty.

An infographic showing more than 8,900 Arise members took action this legislative session. 2,713 contacts on Summer EBT; 1,633 contacts on closing the health coverage gap; 1,555 contacts on workers' rights; 930 contacts on the CHOOSE Act; 688 contacts on protecting voting rights; and 1,417 contacts on other legislation.

Setbacks on school funding, voting rights, racial equity

Early in the session, legislators enacted three harmful new laws, all of which Arise opposed. One was the CHOOSE Act (HB 129 by Rep. Danny Garrett, R-Trussville). Over time, this law could divert hundreds of millions of dollars annually from public schools to private schools and homeschooling.

Another bad bill rushed into law was SB 1 by Sen. Garlan Gudger, R-Cullman, which criminalizes several forms of assistance with absentee ballot applications. Arise and other advocates fear this law could have a chilling effect on good-faith efforts to assist people who need help exercising their voting rights.

A third shortsighted new law is SB 129 by Sen. Will Barfoot, R-Pike Road. The act forbids state agencies and public schools and universities from sponsoring numerous diversity, equity and inclusion (DEI) programs. It also authorizes firings of employees found to violate the act knowingly. In late May, Jacksonville State University became the first university to close its DEI office in response to this law.

Later, legislators passed two new laws that undermine worker protections. SB 53 by Sen. Arthur Orr, R-Decatur, removes the requirement for an eligibility to work form for 14- and 15-year-olds. And Orr’s SB 231 makes companies ineligible for state or local tax incentives if they voluntarily recognize a union.

Good new laws on child care, housing, criminal justice reform

One positive workers’ rights law this year was SB 119 by Sen. Robert Stewart, D-Selma, which increases penalties for child labor violations. The Legislature also created tax credits designed to increase access to child care (HB 358 by Rep. Anthony Daniels, D-Huntsville) and workforce housing (HB 346 by Rep. Cynthia Almond, R-Tuscaloosa). And Orr’s SB 270 improved access to public records.

Lawmakers also enacted two good criminal justice and due process reforms. Almond’s HB 275 will increase pay for many lawyers representing indigent defendants. And HB 188 by Rep. Terri Collins, R-Decatur, requires a uniform hearing process and hearing rights for students suspended or expelled from public K-12 schools.

The work continues

Several other Arise-backed bills made major progress but came up just short of passage. HB 29 by Rep. Chris England, D-Tuscaloosa (allowing resentencing hearings for some defendants convicted under the Habitual Felony Offender Act) won House committee approval. Orr’s SB 62 (removing state sales tax from many infant and maternity products) passed the Senate but never reached the House floor. And HB 309 by Rep. Ginny Shaver, R-Leesburg (providing paid parental leave for state employees) passed the House but died on the Senate calendar.

With your support, Arise will keep advocating for important policy changes like these in 2025 and beyond. We will keep working to expand Medicaid and eliminate the state grocery tax. And we will keep strengthening our movement for a better, more inclusive Alabama.

Summer EBT passage a hard-fought win for Alabama children

By LaTrell Clifford Wood

Alabama Arise members helped secure a policy change this year to reduce hunger for more than 500,000 children across the state. Beginning in summer 2025, eligible children ages 5-17 will receive $120 in Summer EBT benefits to continue to have school meals through the summer. The state must cover half of the administrative costs, but the benefits are 100% federally funded.

Children will be automatically eligible to receive Summer EBT benefits if their household receives assistance under Medicaid, the Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance for Needy Families (TANF) and/or the Food Distribution Program on Indian Reservations (FDPIR). Foster children and children experiencing homelessness also will qualify automatically. Applications will be required for all other eligible children.

Arise advocacy builds momentum

Rep. Laura Hall, D-Huntsville, was the first legislator to inquire about Summer EBT this session during February’s budget hearings. Hall offered an amendment to the Education Trust Fund (ETF) budget to add Summer EBT administrative funding. But the House approved the budget without it.

Arise then kicked advocacy efforts into high gear. Hundreds of our supporters demanded that their senators support Summer EBT funding, and Arise generated dozens of media stories to increase public awareness and pressure. Reports from Senate secretaries and members foreshadowed Summer EBT’s success. Several said they were overwhelmed by the number of emails and calls they were receiving.

Legislative supporters kept up the push, too. Hall joined Rep. Barbara Drummond, D-Mobile, in efforts to build momentum for Summer EBT in the Senate. Sens. Vivian Figures, D-Mobile; Garlan Gudger, R-Cullman; and Rodger Smitherman, D-Birmingham, submitted requests to add an ETF line item for Summer EBT.

A victory to reduce hunger in Alabama

Arise and other Hunger Free Alabama coalition members made their case directly to the Senate’s ETF budget committee April 25, testifying in support of Summer EBT. Our advocacy worked. The following week, the committee added $10 million for the Department of Human Resources to administer Summer EBT in partnership with the state Department of Education.

The full Senate approved the budget 30-0 in early May. And after a brief jump-scare moment when lawmakers delayed the bill in a conference committee, the House and Senate both voted unanimously for the final budget – including the Summer EBT funding – on May 9, the session’s final day. Gov. Kay Ivey signed the budget into law on May 15.

Arise is relieved by the great news that Alabama children and families will be able to participate in this essential program in summer 2025. And we are inundated with gratitude for our members and partners who responded to our action alerts. Your advocacy made the difference!