Alabama Arise is proud to have joined with groups across the state as partners in the Hunger Free Alabama coalition. Our goal is bold and essential: to prevent and eliminate hunger and malnutrition in Alabama through advocacy for better public policies.
In our new video, coalition members Drew Glover and Celsa Allende Stallworth discuss Hunger Free Alabama’s work and the vision that drives it. Visit hungerfreealabama.org to learn how you can join in advocating for change!
Expanding Medicaid and ending the state sales tax on groceries will remain top goals on Alabama Arise’s 2023 legislative agenda. More than 400 members voted on Arise’s issue priorities in recent days after the organization’s annual meeting Saturday. The seven issues chosen were:
Tax reform, including untaxing groceries and capping the state’s upside-down deduction for federal income taxes, which overwhelmingly benefits rich households.
Voting rights, including automatic universal voter registration, removal of barriers to voting rights restoration for disenfranchised Alabamians, and other policies to expand and protect multiracial democracy in the state.
Criminal justice reform, including retroactive application of state sentencing guidelines and repeal of the Habitual Felony Offender Act.
Death penalty reform, including a law to require juries to be unanimous in any decision to impose a death sentence.
Public transportation to empower Alabamians with low incomes to stay connected to work, school, health care and their communities.
“Arise believes in dignity, equity and justice for everyone,” Alabama Arise executive director Robyn Hyden said. “Our 2023 issue priorities reflect the need to work together to break down policy barriers that keep people in poverty, and that disproportionately harm Black and Hispanic Alabamians. We must build a healthier, more just and more inclusive future for our state.”
The time is right to expand Medicaid in Alabama
One essential step toward a healthier future for Alabama is to ensure everyone can afford the health care they need. Arise members believe Medicaid expansion is a policy path to that destination, and research provides strong support for that position.
Medicaid expansion would ensure health coverage for more than 220,000 Alabamians caught in the coverage gap. These residents earn too much to qualify for the state’s bare-bones Medicaid program but too little to afford private plans. Expansion also would benefit another 120,000 Alabamians who are stretching to pay for coverage they cannot readily afford.
“Medicaid expansion would boost our economy and improve the lives of hundreds of thousands of Alabamians,” Hyden said. “It’s time for Gov. Kay Ivey and lawmakers to say yes to the generous federal incentives for Medicaid expansion. Making this crucial investment in Alabamians’ well-being now will make our state better for decades to come.”
Why and how Alabama should untax groceries
Alabama’s state grocery tax makes it harder for people with low incomes to make ends meet. The tax adds hundreds of dollars a year to the cost of a basic necessity for families. And most states have abandoned it: Alabama is one of only three states with no sales tax break on groceries.
The state sales tax on groceries brings in roughly 6% of the Education Trust Fund’s annual revenue. But lawmakers have a path available to end the state grocery tax while protecting funding for public schools. Arise will continue to support legislation to untax groceries and replace the revenue by capping the state income tax deduction for federal income taxes (FIT).
The FIT deduction is a skewed tax break that overwhelmingly benefits the richest households. It is also exceedingly rare: Alabama is one of only two states to allow this deduction in full. The FIT deduction and grocery tax are two policies that contribute heavily to Alabama’s upside-down tax system. On average, Alabamians with low and moderate incomes must pay twice as much of what they make in state and local taxes as the richest households do.
“By untaxing groceries and capping the FIT deduction, lawmakers can make Alabama’s tax system more just and equitable,” Hyden said. “This plan would empower more families to keep food on the table while also protecting funding for our public schools. The Legislature should seize this opportunity to make life better for every Alabamian.”
We deeply value the input we get from Alabama Arise members, our allies and most importantly, those directly affected by the work we do together. We depend on what we hear to help guide our issue work and our strategies.
Despite the ongoing challenges of connecting in person, we kept working at finding ways to listen. We did another series of three statewide online Town Hall Tuesdays. And we held seven additional listening sessions around the state, engaging about 200 people.
The town halls happened every two weeks, starting July 12 and ending Aug. 9. Other meetings took place throughout the summer. Below are summaries of what we heard in those meetings.
Town Hall Tuesdays
Food and health
Most participants deeply cared about Medicaid expansion. They discussed how it would help many people, including rural communities struggling with access to care. Many were frustrated that Gov. Kay Ivey has not yet expanded Medicaid in Alabama. Others discussed the connection between health and access to healthy food and nutrition. Some participants noted that other barriers like transportation also directly impact health, nutrition and employment.
Related issues raised were the needs to address the racial wealth gap and increase wages for front-line workers. Many people expressed appreciation for food banks and pantries but acknowledged that they cannot meet all food security needs. Participants encouraged Arise to remain vigilant about the threat to impose stringent work requirements for Medicaid and SNAP food assistance. Many participants also mentioned untaxing groceries as a way to improve food security.
Democracy and justice
Many participants expressed concerns about legislative attempts to suppress voting rights and said Election Day should be a state holiday. Others also expressed concerns about ballot access for people with disabilities, limited numbers of voting precincts and gerrymandering. Bottom line: We should make it easier to vote, as ballot access is key to a strong democracy.
Several participants expressed concerns about the need for more services for people leaving incarceration. We need to expand community corrections programs, enact real prison reform and get rid of unjust fines and fees.
Some participants identified language accessibility as a potential barrier to receiving many services and participating fully in our democracy. Others were concerned about allocation of American Rescue Plan Act funds and wanted more funding for the Housing Trust Fund.
The path forward
This town hall was an opportunity to talk about any issues of concern people wanted to highlight. Participants raised the following needs and concerns:
Expand Medicaid in Alabama now and address health disparities, including women’s health issues.
Untax groceries and improve our regressive tax system.
Improve voting access, including restoration of voting rights for people who were formerly incarcerated.
Address environmental issues, including working to improve air quality in schools.
Improve affordable housing access and language access, fully fund the child home visitation program and address gun violence.
Group and regional listening sessions
Session participants around the state strongly affirmed Arise’s work on the current 2022 issue priorities. They also emphasized the ongoing work to be done in those areas. Current issues highlighted were Medicaid expansion, criminal justice reform (particularly in the area of unjust fines and fees), more funding for child care and first class pre-K, public transportation and death penalty reform.
Session participants also discussed issues that aren’t on the Arise agenda but are of concern to them and their communities. Some of those issues include:
Affordable housing, with a focus on increased funding and availability. One example was discussion of whether to limit the number of vacation rental properties one person could own in an area, as this can contribute to the shortage of affordable housing. Many renters also discussed the soaring prices of rent.
Automatic organ donor registration linked to getting and renewing driver’s licenses.
Broadband internet extension to reach more rural households and Alabamians with low incomes.
Government intrusion on private medical decisions. One example shared was concern over lawmakers interfering with rights of transgender teens to seek medical care. Another concern raised was doctors being able to provide medical care during pregnancy and decide the right time to intervene on a pregnancy that threatens the life of the mother.
People-friendly federal policies reduced poverty and made it easier for people to get health care in 2021, U.S. Census figures released this week show. Perhaps the most eye-opening improvement was a dramatic reduction in child poverty nationwide.
The recent Child Tax Credit (CTC) expansion alone kept 5.3 million Americans above the poverty line. The one-year expansion under the American Rescue Plan Act (ARPA) made the full CTC available to children living in families with low or no earnings. It increased the maximum credit to $3,000 per child and $3,600 per child under age 6. And it extended the credit to 17-year-olds. The expansion expired in 2022 after Congress failed to renew it, but lawmakers could revisit that decision later this year.
Child Tax Credit improvements fuel record drop in U.S. child poverty
CTC expansion helped reduce disparities for Black and Hispanic children. It also drove the U.S. child poverty rate to a record low of 5.2% under the Supplemental Poverty Measure (SPM). Unlike the traditional poverty measure, the SPM reflects the poverty-reducing effects of tax credits and non-cash benefits like food assistance.
Alabama’s official child poverty rate was 22% last year under the American Community Survey (ACS), a more traditional measure that accounts for fewer factors than the SPM. That was an apparent increase from the pre-pandemic level of 21.1% in 2019, though within the margin of error. (ACS data for 2020 is unavailable due to pandemic-related data collection disruptions.)
SPM data paints a fuller picture of the poverty-reducing power of supports like the expanded CTC. Alabama’s three-year average overall poverty rate under the SPM was 10.3% in 2019-21. By contrast, the state’s overall ACS poverty rate moved from 15.5% in 2019 to 16.1% in 2021. That change was not statistically significant.
“The success of the Child Tax Credit expansion was undeniable,” Alabama Arise executive director Robyn Hyden said. “This policy slashed child poverty and helped families make ends meet across our state and our country. Congress needs to renew the Child Tax Credit expansion and make it permanent. And our state lawmakers should do their part to help Alabama families keep food on the table by ending the state grocery tax and replacing the revenue in a responsible way.”
Uninsured rates fall nationally despite tumult of COVID-19 pandemic
Federal policy choices also fueled a slight reduction in the number of uninsured Americans last year. The U.S. uninsured rate dropped to 8.6% last year, down from 9.2% in 2019. Alabama’s uninsured rate stayed relatively flat, moving from 9.7% in 2019 to 9.9% in 2021. That change was within the margin of error.
Alabama continued a years-long pattern of outperforming the national average in insuring children in 2021. The state’s rate of uninsured children (4%) remained the best in the Deep South last year. Much of that sustained success is attributable to ALL Kids, the state’s Children’s Health Insurance Program (CHIP) created in 1998. ALL Kids has played a crucial role in reducing Alabama’s rate of uninsured children from 20% in the late 1990s.
A key factor in the overall health coverage improvements was the federal requirement for state Medicaid programs to keep participants covered throughout the ongoing COVID-19 public health emergency declaration. That declaration may end later this year, underscoring the importance of helping many enrollees transition to new coverage.
Enhanced subsidies under ARPA also helped make health coverage more affordable for millions of Americans with private plans. This includes many of the 219,000 Alabamians with marketplace plans through the Affordable Care Act. Congress renewed subsidy enhancements through 2025 in the Inflation Reduction Act, which President Joe Biden signed into law last month.
“Medicaid, ALL Kids and ACA marketplace coverage have saved and improved the lives of millions of Alabamians,” Hyden said. “Alabama should build on these successes by expanding Medicaid to help more than 340,000 people who are uninsured or struggling to afford health insurance.
Six Black women from Alabama’s Black Belt region assembled In a meeting room at downtown Birmingham’s Westin Hotel on Aug. 26-28 for a weekend of intense and insightful advocacy training. The weekend served as this cohort’s introduction to both each other and the material they’ll be learning. And Alabama Arise had the privilege of being part of the event.
Black women die of cervical cancer at 1.5 times the rate of white women in the United States.
In Alabama, Black women die of cervical cancer at nearly twice the rate of white women.
With the HPV vaccine, cervical cancer is nearly entirely preventable.
The Black Belt region is especially hard hit due to lack of access to health care.
“Research is clear on the best possible outcomes in ideal situations. But the reality is far from ideal for many women in rural Alabama,” Jennifer said. “Less access to health care, the need for more preventive education, and barriers such as a lack of transportation increase these health disparities for too many families.
“Working with the advocates, I see women who are passionate about their communities. They are ready to use the best tools available to change this bleak narrative. I was fortunate to facilitate this training and help them identify their personal and collective voices, share their knowledge of resources, and envision better health outcomes in their community through their personal advocate lens.”
Crash courses and lessons from history
I was lucky to meet these women, learn a little about Alabama’s history and work with my colleagues in creating a helpful curriculum for the weekend. Arise executive director Robyn Hyden charged right into advocacy training on that Friday morning. Her sessions described the role of advocates, how to talk to legislators and how to get bills passed into law. Jennifer took over in the afternoon, giving a crash course on Medicaid, Medicare and the U.S. health care system.
The cohort joined the rest of SRBWI’s conference attendees for dinner that evening. Over a warm meal, I was able to chat with current coworkers, former board members and longtime Alabama activists.
Then the audience was honored to hear from Rev. Carolyn McKinstry. McKinstry, an original SRBWI member, was working as a secretary at Birmingham’s 16th Street Baptist Church when it was bombed on Sept. 15, 1963, killing four young Black girls. She’s spent much of her life as an advocate and historian to ensure the world doesn’t forget the abominations that Alabama faced during that time.
McKinstry kindly shared her story with us. She told us about that fateful day, but also the days beyond it. She described a Birmingham terrorized by racial violence and how that trauma continues to affect her and other survivors to this day. But she also described the resilience, intelligence and power that arose from communities into a movement for justice and equity.
McKinstry is only a few years older than my mother. That’s a harsh reminder of just how recent these atrocities are. And it’s a reminder of how much work remains to reform institutions and policies that continue to fuel racial disparities.
Shifting power and lifting barriers
The cohort reconvened on Saturday morning, when Arise organizing director Presdelane Harris (no relation to Jennifer) started off the morning with a session on communication styles and building relationships. I followed up with a session on coalition building. During lunch, researchers from both SRBWI and HRW gave a presentation on the heart of this cohort’s formation: cervical cancer in Black women in the South.
This group of women will act as community researchers and liaisons. They will promote the HPV vaccine, advocate for patients trying to access health care and dispel myths around cervical cancer. It’s a daunting task for sure, but throughout the training, it became clear they were up to it.
After lunch, I led a session on engaging with the media for advocacy work. Then Arise story collection coordinator Whit Sides gave a heartfelt presentation on sharing your own story and collecting stories from others.
The SRBWI conference and the Black Belt cohort training were an incredible opportunity to see some of the often invisible organizing and community-building work that is happening across Alabama. People long neglected by institutions and lawmakers are finding creative ways to take care of themselves and their communities. And Arise is committed to working alongside them to amplify their voices and lift policy barriers standing in their way.
“The Inflation Reduction Act will help build a healthier future for people across Alabama. This plan will make health coverage more affordable for hundreds of thousands of Alabamians and millions of Americans. It will improve air quality by investing in clean energy and reducing emissions that fuel climate change. And it will pay for these investments by closing tax loopholes that subsidize profitable corporations and wealthy households.
“This plan will save money for patients and the federal government by allowing Medicare to negotiate certain prescription drug prices. It will cap the cost of insulin and other out-of-pocket drug expenses for Medicare enrollees. And it will extend enhanced subsidies that make health coverage more affordable for many of the 219,000 Alabamians with marketplace plans through the Affordable Care Act.
“We’re happy that the U.S. Senate passed this important legislation. And we look forward to the House approving it and sending it to President Joe Biden to sign into law.
“We also will continue advocating for state lawmakers to make other needed investments in families and communities. We’ll keep working for additional funding to make child care, housing and public transportation more affordable and available across Alabama. And we’ll continue pushing for Medicaid expansion to help more than 340,000 Alabamians who are uninsured or struggling to afford health insurance.
“These policy choices are essential to improve Alabamians’ quality of life and to boost our state’s economic prosperity. We’re determined to see each and every one of them across the finish line.”
The COVID-19 pandemic has stretched families, hospitals, schools, businesses and food banks across Alabama to their limits. Like tens of millions of other Americans, local and state officials have had to adapt to new challenges and respond to existing health and economic challenges exacerbated by the pandemic over the last two years.
Congress reacted to these challenges by passing several major recovery packages to provide relief to individuals, states and local governments. The most recent package was the American Rescue Plan Act (ARPA), a $1.9 trillion measure enacted in March 2021. One key provision of ARPA is known as State and Local Fiscal Recovery Funds (SLFRF). Congress allocated this money to help states and localities address the impact of the pandemic and promote equitable recovery.
How Alabama has used ARPA funding so far – and the opportunities that remain
Of the $195 billion of SLFRF money appropriated to states, Alabama will receive more than $2.1 billion. State and local governments can spend these dollars in four ways, according to the U.S. Department of Treasury’s Final Rule released in January 2022:
Replace lost public sector revenue.
Support the COVID-19 public health and economic response.
Provide premium pay for eligible workers performing essential work.
Invest in water, sewer and broadband infrastructure.
To date, Alabama has allocated more than $1.1 billion to various programs and projects through three special sessions. Lawmakers allocated $480 million for prison construction and health care during the first two sessions in September and November 2021. The Legislature appropriated another $772 million during the third special session in January 2022. Legislators devoted that money to a range of projects, including broadband, water and wastewater infrastructure and rural hospitals.
The Legislature has yet to appropriate the remaining $1 billion in state ARPA recovery funds. But legislators may return this summer or fall for a special session focused on the use of those funds. Alabama Arise is encouraging lawmakers to invest some of that money in affordable housing, public transportation and food security infrastructure. Each of those investments would provide long-term improvements in economic opportunity and quality of life for people across Alabama.
Top priorities: Affordable housing, public transportation and food security
The COVID-19 recession caused a wave of evictions and foreclosures across Alabama. The state could help address its housing shortage and resulting homelessness by providing $25 million for the state Housing Trust Fund. This investment would create and support jobs across the state. It also would reduce Alabama’s shortfall of more than 76,000 affordable homes for people with low incomes.
Essential work supports can help more Alabamians reenter and stay in the job market during and after the pandemic. One critical support is reliable transportation to and from work, school, child care or medical care. Legislators can help strengthen communities and expand economic opportunity by investing $20 million in the state Public Transportation Trust Fund. Arise partnered with 81 other organizations in June 2022 to urge lawmakers to take that important step forward.
Hunger was already a large and perpetual problem across Alabama even before the pandemic. Sudden income loss, rising prices and occasional shortages have made it much more difficult for many people to feed their children and families. Alabama’s food banks remain essential to feeding those in need, even as many have faced staff and volunteer shortages. Lawmakers can help ease this strain by distributing $5 million to the state’s food banks. This funding would empower food banks to maintain services by replacing and improving critical infrastructure like equipment, fleets and warehouses.
ARPA funding for affordable housing, public transportation and food security infrastructure will make life better for the Alabamians hit hardest by COVID-19 and the economic downturn it caused. And these investments will go a long way toward helping create a more equitable and prosperous future for every Alabamian.
Imagine a world where the people most harmed by hunger and food insecurity exercise their power to propose their own solutions to address this social determinant of health.
What might happen if health care systems were responsive to those solutions? And what if a group of dedicated community leaders, organizations and civic groups rallied together to implement those solutions? That’s what Alabama Arise and our partners resolved to find out near the Gulf Coast.
In Mobile and Baldwin counties, 55% of people live in food deserts. These are Census tracts with low or no access to healthy foods. So after convening more than 100 community members and their families for a series of listening sessions, our grassroots partners from Mobile’s Trinity Gardens neighborhood proposed launching a “produce prescription” project to benefit regional Medicaid participants. Thanks to community organizing, mobilization and partnership, their dream is becoming a reality.
Once a month, participants receive a box of fresh produce as part of a Produce Prescription Program developed by our partners at the American Heart Association and staffed by community partners and volunteers. The Heart Association’s data has shown that where this program has been implemented, participants experience measurable health improvements. Organizing and advocacy for community-based solutions improves health outcomes.
Arise continues to work with community leaders and partners to urge Medicaid to fund more community-led projects. When we facilitate getting resources to communities, they become hubs for equity and innovation. Community-driven ideas can help shape programs that improve overall health outcomes.
To learn more about this program and how you can help, email me at firstname.lastname@example.org.
The COVID-19 pandemic added to the hunger challenges already facing many Alabamians. In response came a wave of federal flexibilities and waivers for the nation’s programs that feed children. As a result, many Alabama students have received nutritious, often free meals with fewer administrative barriers.
However, many of these child nutrition waivers could be coming to an end soon ‒ unless state officials and concerned Alabamians act quickly.
For the past two summers, the Summer Food Service Program’s flexibilities have included permitting non-congregate meal service. This allows parents, guardians or children to take meals from the pickup site. It also allows meal provision for multiple days at once.
But unless the Alabama State Department of Education requests an extension, these flexibilities will end June 30. That would be in the middle of summer food service, causing undue stress and confusion to students, educators and families. Alabama Arise and other partners in the Hunger-Free Alabama coalition sent a letter to state school Superintendent Eric Mackey urging him to ask the U.S. Department of Agriculture for an extension for the rest of summer.
Above: Arise’s Celida Soto Garcia explains how community eligibility helps keep Alabama children fed.
The continued push for community eligibility
As we continue pushing for extended flexibility, it is important to keep building support for the Community Eligibility Provision (CEP). This option allows more than 450 high-poverty schools across Alabama to offer breakfast and lunch at no charge to all students. Arise members should contact their local school superintendents and urge them to opt into CEP if they haven’t already. Parents and guardians can take an extra step by submitting their school meal application to the appropriate school district.
Food insecurity is a challenge for 16.1% of Alabamians, including 20.4% of Alabama’s children, according to 2021 projections from Feeding America. These numbers are unacceptable and should not increase further because of preventable deadlines. Arise will continue to work proactively with local, state and national partners to expand food access across the state.
Alabama is on its way to reducing maternal mortality and improving health for families across the state ‒ but we can’t stop here.
Lawmakers and Gov. Kay Ivey last month enacted a budget that extends postpartum Medicaid coverage to a full year after childbirth. That is up from the previous cutoff of only 60 days after birth. Alabama Arise and other members of the Cover Alabama Coalition will continue to work with the governor’s administration and legislators to ensure this program is sustainable and permanent.
Alabama has the nation’s third-worst maternal death rate. Each year, nearly 40 new mothers in the state die within one year after delivery. The toll on Black mothers is nearly three times that of white moms.
Research shows that outcomes improve when moms have access to high-quality, equitable and uninterrupted care. Extending the Medicaid postpartum coverage period is a big step to save lives and improve the health and well-being of families, communities and the entire state.
The work that remains
This is an exciting win, but we know that one year of coverage is, ultimately, not enough. And we know the solution: The most effective way to reduce maternal deaths is to make sure people giving birth have access to care before, during and after pregnancy. We need full Medicaid expansion, and we won’t stop until we get it.
Medicaid restrictions are not affecting only new parents. More than 220,000 Alabamians are caught in our health coverage gap, earning too much to qualify for Medicaid and too little to afford private insurance. And another 120,000 are stretching to pay for coverage they cannot afford. Expanding Medicaid would give these Alabamians the health care that they need to survive and deserve to thrive.
Postpartum Medicaid extension will be only the first of many wins toward creating a more equitable state health care system. It’s been a long fight, but I know we can do this.