Issue: Health

Get covered: Open enrollment ends Dec. 15, 2019

By Jim Carnes

The deadline to #GetCovered is one month away! Open enrollment for 2020 Marketplace health coverage under the Affordable Care Act ends Sunday, Dec. 15, 2019. Don’t miss your chance to make sure you’re covered in case of accident or illness.

Visit healthcare.gov or call 800-318-2596 to explore your coverage options. And be sure to spread the word about this opportunity to your friends and family, too.

Our friends at the Center on Budget and Policy Priorities put together five good reasons to visit healthcare.gov during open enrollment. This resource discusses how to compare plans, seek financial help and ensure your insurance meets your needs.

Even if you already have Marketplace coverage, we still recommend that you log in and double-check your options. Another plan may better meet your needs in the coming year.

Expand Medicaid to shore up children’s health coverage in Alabama

By Jim Carnes

Children’s health coverage has long been a point of pride for Alabama, and we can’t afford to backslide. But Alabama’s rate of uninsured children has moved in the wrong direction since 2016, according to a recent report from Georgetown University’s Center for Children and Families (CCF).

Our state’s uninsured rate for children (3.5%) remained one of the best in the South in 2018. After years of improvement, though, Alabama’s number of uninsured children ticked up from 32,000 in 2016 to 41,000 in 2018.

That’s a warning sign that our policymakers should heed. Alabama must protect the coverage gains we’ve made through ALL Kids. And we should build on those gains by expanding Medicaid to cover adults with low incomes.

When parents have health insurance, their children are more likely to have coverage as well. Medicaid expansion would boost health security for struggling families across Alabama. That would be good for children, good for communities and good for our entire state.

Check out our news release for more on the Georgetown CCF report. Then urge Gov. Kay Ivey to expand Medicaid so all Alabamians can get the care they need to survive and thrive.

Medicaid expansion would help Alabama veterans meet their health care needs

By Jim Carnes

Veterans Day gives Alabama a chance to shine. Our cities and towns hold parades and ceremonies each Nov. 11 to honor service members and to burnish the state’s reputation as a great place for veterans to retire.

This year, as we celebrate those who have risked and sacrificed to defend our country, let’s remember a group too often overlooked: veterans who have low incomes and no health insurance. And let’s commit to expanding Medicaid to help them meet their health needs.

Medicaid expansion would help Alabama veterans. Thousands of Alabama veterans are living without health coverage for themselves or their family members. They don't qualify for Medicaid or VA care, and they can't afford employer-based coverage or private insurance. 5,062 Alabama veterans with low incomes have no health insurance. (1,812 women and 3,250 men.) 7,934 low-income adults who live with Alabama veterans have no health insurance. (4,703 women and 3,231 men.) Medicaid expansion would give Alabama veterans and their families the health security they need.

It’s a common misconception that people who serve in the U.S. military automatically receive lifetime eligibility for health coverage and other benefits. In reality, though, veterans’ health benefits depend on their length of service, military classification, type of discharge and other factors. Treatment for service-connected conditions has no time-of-service requirement, but other health benefits do.

Active-duty service members and their families receive health coverage through the Department of Veterans Affairs (VA). Most also receive “bridge” health insurance coverage in the 180 days before and after their active-duty service.

But many veterans — including many National Guard and Reserve members — return home without military health care for the long term. For the 13,000 Alabama veterans and adult family members who have no military health insurance and can’t afford private plans, the consequences can be dire.

A lasting commitment to Alabama’s uninsured veterans

Returning to civilian life can be challenging enough without the added burden of being uninsured. Injuries sustained from combat, environmental hazards or physical stress can cause chronic disability or loss of function. And the mental stress of combat and separation from family also puts some veterans at risk for mental health problems and substance use disorders. The rising rate of veteran suicides is stark evidence of this troubling toll.

There’s something Alabama can do to help. If we expanded Medicaid to adults earning up to 138% of the federal poverty level ($29,435 a year for a family of three), nearly 13,000 uninsured veterans and family members could get the health coverage they need. Medicaid expansion would be a meaningful and lasting commitment to make life better for veterans across Alabama.

More Alabama children were uninsured in 2018 than in 2016, new report shows

By Chris Sanders

Alabama’s rate of uninsured children has moved in the wrong direction since 2016, according to a report released Wednesday by Georgetown University’s Center for Children and Families.

The state’s uninsured rate for children (3.5%) remained one of the best in the South and was far below the national average (5.2%) in 2018. But after years of improvement, Alabama’s number of uninsured children ticked up from 32,000 in 2016 to 41,000 in 2018. (More Alabama-specific data is available at this link.)

The increase is a warning sign that Alabama could slip backward in children’s health care if policymakers do not protect and expand coverage, Alabama Arise policy director Jim Carnes said.

“Children’s health coverage has long been a point of pride for Alabama, and we can’t afford to backslide,” Carnes said. “ALL Kids and Medicaid have played huge roles in that success. And our state should build on those gains by expanding Medicaid to cover adults with low incomes as well. Medicaid expansion would boost financial security for struggling parents and increase the odds that their children get and stay insured. It would be good for children, good for families and good for Alabama.”

White House efforts to undermine the Affordable Care Act (ACA) also likely contributed to the coverage erosion, the report finds. Federal officials have shortened the open enrollment period for ACA Marketplace plans and have slashed outreach and advertising funding. Open enrollment for 2020 Marketplace coverage begins Nov. 1, 2019, and will continue until Dec. 15, 2019.

ACHN launch begins a new era for Alabama Medicaid

By Jim Carnes

Alabama Medicaid reforms first envisioned six years ago are finally going into effect today. And Alabama Arise will work hard to ensure Medicaid’s new structure keeps patient needs and consumer voices at the forefront.

The new plan brings regional control and care coordination of primary care services through seven Alabama Coordinated Health Networks (ACHNs) serving more than 700,000 Alabama Medicaid enrollees, mostly children. The ACHNs also will serve pregnant women and family planning patients. The networks, which officially launched today, will begin providing care coordination services Nov. 1.

A map of the seven Alabama Coordinated Health Networks that will serve more than 700,000 Alabamians enrolled in Medicaid.

The goals: Healthier patients and a strong consumer voice

For the first time, Alabama Medicaid governance will include consumer voices at the policy table. Each ACHN will have a Consumer Advisory Committee as well. Arise and our advocacy partners are pleased with this accountability provision and are working to strengthen consumer oversight.

Arise has partnered with the Alabama Disabilities Advocacy Program and the Disabilities Leadership Coalition of Alabama to recruit consumer representatives for the new roles. Together, we held a training for the group on Sept. 20. A major goal of Arise’s Medicaid consumer advocacy is to help the regional representatives work together as a statewide team.

Alabama Arise organizing director Presdelane Harris speaks at a training session for Medicaid regional consumer representatives Sept. 20 in Montgomery.
Alabama Arise policy director Jim Carnes presents at a training session for Medicaid regional consumer representatives Sept. 20 in Montgomery.

In addition to the new consumer voices, we’re hopeful about the plan’s emphasis on improving health outcomes. Each ACHN will receive funding to develop and implement Quality Improvement Projects (QIPs) targeting three initial quality measures: (1) childhood obesity, (2) infant mortality and birth outcomes and (3) substance use disorders. Doctors will be eligible for bonus payments for meeting or exceeding goals on numerous care coordination and quality measures.

Arise will seek to ensure the QIPs reflect and respond to community needs. We’re working particularly closely with local partners in Mobile to bring community input into the QIP design process there. Stay tuned for more information about our food security work in the Trinity Gardens neighborhood!

Compare and contrast with past reforms

The Legislature voted overwhelmingly in 2013 to create Medicaid regional care organizations (RCOs) to cut costs and promote preventive care. But Gov. Kay Ivey, citing delays and budget problems, used an escape clause in the law to abandon RCOs in 2017.

The new ACHNs resemble the former RCOs, with a few key differences. Under the RCO plan, Medicaid would have given private, nonprofit managed care organizations a set monthly payment for each Medicaid enrollee (or member) in their region. The organizations, in turn, would have assumed full financial risk if overall costs exceeded those payments.

ACHNs also involve private nonprofit contractors, but payments will be based on medical services and care coordination services provided. The organizations also will assume only partial financial risk.

How the new ACHNs will work

The ACHNs will coordinate primary care for people with Medicaid coverage. Your ACHN will have a phone line to call when a Medicaid member has a health problem.

New services will help patients get the health care that’s right for their needs. To get these services, people who have Medicaid coverage (children, pregnant women, and people getting family planning services) will need to have a primary care doctor of their choice.

Their doctor will become their “medical home” – the first place to contact for ordinary health needs. And new services will be offered to improve patient health.

Medicaid members who already have a primary doctor can continue under their care. Coordinating patient care through a primary doctor helps avoid expensive emergency room visits for routine health care needs.

Other Medicaid reform efforts underway

ACHNs are the next step down the reform path for Alabama Medicaid. In October 2018, the agency launched a new statewide Integrated Care Network (ICN) to serve Medicaid long-term care patients. About 16,000 of the ICN members live in nursing care facilities. Another 9,000 receive long-term care services at home or in their communities through Medicaid waivers.

The state’s 13 regional Area Agencies on Aging provide the care coordination services for the statewide ICN. And as with ACHNs, Arise is working to ensure a strong consumer voice in the ICN. Arise has a seat on the ICN Consumer Advisory Committee, as well as an appointee on the ICN board.

Alabama’s Medicaid reforms are an encouraging move toward more patient-centered care. The inclusion of consumer voices and the emphasis on care coordination for quality improvement have the potential to move the needle on some of Alabama’s most persistent health challenges.

That would be a win for hundreds of thousands of Alabama Medicaid members – and for the whole state.

Criminal justice study group offers Alabama a chance to set the right course toward reform

By Dev Wakeley

Alabama needs a criminal justice system that values the lives and well-being of everyone involved. Our state should treat people fairly, apply punishment humanely and focus on restoring offenders to productive roles in society.

Alabama Arise is closely monitoring the Study Group on Criminal Justice Policy that Gov. Kay Ivey appointed in July. Former Alabama Supreme Court Justice Champ Lyons chairs the panel, which also includes six legislators, the attorney general, the finance director and the commissioner of the Department of Corrections (DOC). The group has held two meetings so far and will report its findings in January 2020.

Arise hopes the study group can identify and endorse reforms needed to modernize Alabama’s criminal justice system. Improvements are possible in every aspect of the state’s incarceration and supervision systems. Sentencing reform and recidivism reduction through improved services and re-entry programs will be two vital steps. And it will be crucial to ensure that people who were incarcerated have voices in identifying needs and developing policy.

Expanding Medicaid, mental health services would reduce prison populations

Medicaid expansion is an essential part of Alabama’s prison reform solution. Expansion would reduce financial strain on prisons and strengthen safeguards against recidivism. On the first count, Medicaid would allow prisoners who are hospitalized to receive Medicaid coverage. This would drastically reduce state costs if an inmate develops a serious illness or becomes a victim of the shockingly high levels of violence in state prisons.

Further, Alabama could use Medicaid expansion to provide mental health and substance use disorder treatment in communities with a chronic lack of such resources. Many convictions result from underlying mental health or substance use problems that go untreated. Stronger investments in mental health and addiction treatment could prevent many people from entering the criminal justice system in the first place. And Medicaid expansion would allow Alabama to expand mental health services tenfold with little or no increase in state cost.

Sentencing reform would ease burdens on Alabama’s criminal justice system

Many Alabama courts have a sad legacy of imposing large fines and overly punitive sentences for relatively minor crimes. These measures, coupled with unreasonably high economic consequences for convictions, often ruin people’s ability to start over after a conviction.

The Legislature recently adopted some beneficial changes to modernize the state’s sentencing practices. But the state still needs many other significant improvements to ensure proportionality and justice.

For instance, Alabama’s habitual offender law can lead to manifestly unjust results. The law allows people with previous convictions to be sentenced to life in prison for theft of a credit card. And people too often receive a prison sentence even when the sentencing guidelines say community correction programs are more appropriate. Fixing these shortcomings would save money and help mitigate the overcrowding crisis in state prisons. It also would reduce the odds that a minor offense would destroy someone’s life.

Alternative courts have better outcomes

The study group also should consider the benefits that problem-solving courts provide to both offenders and the state. Both drug courts and mental health courts are proven ways to reduce recidivism significantly – and therefore reduce state costs.

These programs address underlying conditions that lead many Alabamians to end up in the criminal justice system. And they can keep life-altering convictions from limiting a person’s prospects by dismissing charges upon completion of the assigned program. But these programs are expensive, and no uniform statewide eligibility criteria exist for either drug or mental health courts.

The study group should recommend expanding and standardizing the use of these proven, efficient programs. As noted above, Medicaid expansion would strengthen the capacity of community-based services to fulfill the mandate of alternative sentencing.

Alabama can create a criminal justice system that works for everyone

One of Arise’s core beliefs is that policymakers always should seek input from people who would be affected by changes. The same principle holds true when it comes to reform of the state’s prisons and criminal justice system.

Thousands of people throughout Alabama could have better lives if our state updates and improves its criminal justice system. People who have been involved in the system have valuable insight into ways it can improve. In particular, people who were formerly incarcerated can help identify needed improvements and recommend ways to avoid some pitfalls of current operations.

The study group has a chance to make desperately needed strides toward criminal justice reform before the next legislative session. The solution to Alabama’s prison problem must be broader than just building new prisons while keeping outdated sentencing procedures and resource allocation.

Doing the bare minimum to avoid federal oversight would be a disservice to our state. The study group’s recommendations should offer a vision of a fully functional criminal justice system in Alabama. With full consideration of the available options and a willingness to recommend bold, far-reaching reforms, the study group can put Alabama on the right path toward dignity, equity and justice for all.

Alabama’s uninsured rate is growing because we haven’t expanded Medicaid

By Chris Sanders

U.S. Census findings released Tuesday show that about 32,000 more Alabamians were uninsured in 2018 than in 2017. They also found that the state’s uninsured rate remained higher than the national average. Alabama Arise policy director Jim Carnes issued the following statement in response:

“No one should have to go without the medical care they need simply because they can’t afford it. But that’s the reality for a growing number of Alabamians, because our state has refused to expand Medicaid. Gov. Kay Ivey and state lawmakers need to lift this policy barrier that separates hundreds of thousands of Alabamians from affordable health coverage.

“As Alabama’s inaction on Medicaid expansion continues, our state’s uninsured rate continues to climb. The share of Alabamians without health insurance coverage rose to 10% in 2018, up from 9.4% in 2017. This is a trend in the wrong direction, but we can reverse it with better policy choices.

“All Alabamians would benefit from Medicaid expansion. More than 340,000 adults across the state would gain health security. The new coverage would pump about $1.7 billion a year in direct federal spending into our economy. And over the next four years, economic activity related to expansion would generate $446 million in state tax revenues.

“Even more important than the economic gains would be the human gains. Medicaid expansion would give Alabama better tools to address mental illnesses, substance use disorders, infant mortality and other longstanding challenges. Closing our state’s coverage gap would mean healthier families, more vibrant communities and a more productive workforce.

“It’s time to make an investment in Alabama’s future. The governor should expand Medicaid to protect rural hospitals, create thousands of jobs and make Alabama healthier.”

Alabama Arise members vow to renew ‘untax groceries’ push in 2020

By Chris Sanders

Ending the state sales tax on groceries is one of the top goals on Alabama Arise’s 2020 legislative agenda. Nearly 200 Arise members picked the organization’s issue priorities at its annual meeting Saturday in Montgomery. The seven issues chosen were:

  • Tax reform, including untaxing groceries and ending the state’s upside-down deduction for federal income taxes, which overwhelmingly benefits rich households.
  • Adequate budgets for human services like education, health care and child care, including Medicaid expansion and investment in home visiting services for parents of young children.
  • Voting rights, including creation of automatic universal voter registration and removal of barriers to voting rights restoration for disenfranchised Alabamians.
  • Payday and title lending reform to protect consumers from getting trapped in deep debt.
  • Criminal justice debt reform, including changes related to cash bail and civil asset forfeiture.
  • Death penalty reform, including a moratorium on executions.
  • Public transportation, including state investment in the Public Transportation Trust Fund.

“We believe in dignity, equity and justice for all Alabamians,” Alabama Arise executive director Robyn Hyden said. “And we believe our 2020 issue priorities would break down policy barriers that keep people in poverty. We must build a more inclusive future where everyone can prosper.”

Why Alabama should untax groceries

The state grocery tax is particularly harmful for Alabamians who struggle to make ends meet. The tax adds hundreds of dollars a year to the cost of a basic necessity. And most states have abandoned it: Alabama is one of only three states with no sales tax break on groceries.

Alabama is also one of only three states with a full income tax deduction for federal income taxes (FIT). For those who earn $30,000 a year, the deduction saves them about $27 on average. But for the top 1% of taxpayers, the FIT break is worth an average of more than $11,000 a year. Ending the FIT deduction would allow Alabama to remove the sales tax on groceries and still have funding left over to address other critical needs.

The grocery tax and FIT deduction are two key factors behind 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 ending the FIT deduction, lawmakers can make Alabama’s tax system more equitable for everyone,” Hyden said. “They can strengthen state support for K-12 and higher education. And they can make it easier for struggling families to put food on the table. This is an opportunity to make life better for everyone in our state, and the Legislature should do it.”

Meet the working men and women caught in Alabama’s health coverage gap

By Jim Carnes

As we celebrate Alabama’s workforce on Labor Day, here’s a fact that deserves special attention: More than 100,000 Alabamians are working without health insurance. They work in child care, construction, food services and other vital jobs. They’re the folks who keep things going.

Yet they’re trapped in the health coverage gap. They can’t afford employer-based coverage or private insurance. And they earn too much to qualify for Medicaid. As a result, many struggle with health problems that sap productivity, add household stress and get worse without timely care.

Here are the jobs employing the most working women in Alabama’s coverage gap:

And here are the jobs employing the most working men in Alabama’s coverage gap:

Think about the importance of these lines of work. Then think about what access to regular health care would mean in the lives of these workers and their families.

Across the country, 36 states have closed their coverage gaps, but Alabama is lagging behind. What’s holding us back?

Lack of awareness plays a part. As folks go about their daily activities, they rarely stop to wonder who has health insurance and who doesn’t. It’s not something most people talk about – but it should be. Helping state leaders understand the real people who will benefit most from expanding coverage is an important step toward change.

Our entire state would benefit from Medicaid expansion. Broader access to regular care would improve the health of working families. Healthier families would mean higher productivity at work and better learning at school. And the additional federal funding would strengthen our health system and create jobs.

All these gains would spell a brighter future for Alabama. It’s time to expand Medicaid and make health coverage affordable for the workers we all depend on every day.

Learn more about Arise’s 2020 issue proposals

By Alabama Arise

Grassroots democracy will be on display when Alabama Arise members choose our 2020 issue priorities at our annual meeting Sept. 7 in Montgomery.

The following proposals will be up for a vote for our 2020 legislative agenda.

Below, you’ll find member groups’ summaries of their new and modified proposals. And you’ll find our policy staff’s overviews of the current issue priorities and our two permanent priorities: tax reform and adequate state budgets. We hope to see you in September as we gather to renew our shared commitment to building a better Alabama for all!

New issue proposal

Housing Trust Fund revenue

Submitted by Gordon Sullivan, Low Income Housing Coalition of Alabama (LIHCA)

LIHCA thanks Alabama Arise and its members for supporting the Housing Trust Fund in 2018 and previous years. Our combined efforts resulted in social and political momentum to secure dedicated revenue for the Alabama Housing Trust Fund (AHTF)! We are here to ask for your continued support of the AHTF and help in securing dedicated revenue for the fund in 2020.

We believe safe, decent and affordable housing is a basic human right. Hard-working Alabamians should be able to pay rent and still be able to put food on the table. Unfortunately for many Alabamians, finding a safe and affordable home is only a dream. Alabama is in a housing crisis, with a lack of nearly 70,000 rental homes for folks surviving on minimum wage and fixed incomes.

Folks making minimum wage have to work 82 hours a week to afford a market-rate two-bedroom apartment. By doing so, they miss out on family suppers and Little League, because there simply aren’t enough hours in the day. Every child deserves a safe place to call home and a chance to have those who love them help with homework and read bedtime stories.

The AHTF created a fund to construct, rehabilitate and maintain homes for low-income households. Though the AHTF was created in 2012, it was enabling legislation and did not come with funding. That means we can’t create any new or rehabilitate any existing homes or address housing problems related to natural disasters. That is why LIHCA will seek dedicated revenue for the AHTF in 2020.

Proposed legislation to fund the AHTF

The bill, sponsored by Rep. Neil Rafferty, D-Birmingham, would increase the mortgage record tax from 15 cents to 20 cents for every $100 of a mortgage. This would put approximately $15 million per year in the AHTF. This type of revenue is a common funding source for housing trust funds across the country. In Alabama, this tax has not been increased since it was enacted in 1935.

We know that two-thirds of Alabamians (67%) see the lack of affordability as a problem in our state and that a strong majority (63%) of Alabamians are ready for state action to increase housing opportunities for households priced out of the market. Building on the momentum of previous years, we believe attaining bipartisan co-sponsors and endorsements from influential groups throughout the state is possible in 2020.

With the creation of new affordable homes in Alabama, families will begin to achieve economic stability. Communities will reduce blight. And the state will see an economic impact of nearly $1 billion over 10 years.

The dedicated revenue bill supports Arise’s values and its membership’s vision for addressing poverty in Alabama by investing in communities and helping low-income households access safe and affordable homes. The dedicated revenue bill will provide $15 million per year to create and rehabilitate homes for those in need. We have been successful in building momentum with Arise’s support in past years. Let’s work together to finish what we started!

Modified issue proposal

Voting rights

Submitted by Scott Douglas and Tari Williams, Greater Birmingham Ministries, and Ned Freeman, Birmingham Friends Meeting (Quakers)

Let’s build on Arise’s commitment to voting rights, continuing to prioritize automatic voter registration (AVR) and focusing on restoration of voting rights for Alabamians affected by felony disenfranchisement. Under AVR, Alabamians would be registered to vote by default, without having to register themselves, because the state already has the necessary information. And restoring voting rights for everyone would affirm basic ideals of democracy.

Historically, Alabama has been a leader among states with the most severely punitive disenfranchisement laws. These laws, with their blatantly racist history, have kept African Americans from the polls in enormous – and enormously disproportionate – numbers. Of the more than 280,000 disenfranchised felons in Alabama, nearly 150,000 are black, according to the Sentencing Project. That means that disenfranchised felons make up more than 15% of the state’s voting-age African American population.

Alabama’s felony disenfranchisement policies have disparate impact on individuals convicted of felonies who are poor, black or both. Therefore, we propose the introduction of legislation that will (a) remove the financial barrier of requiring payment of all fines, fees and/or restitution and (b) restore voting rights to individuals while on probation and parole. This legislation is not cost-prohibitive, may take one to three years to pass because of upcoming elections and is not potentially divisive for Arise members.

Alabama’s disenfranchisement laws have fostered an underclass of tens of thousands of people who are unable to vote because they do not have enough money. In 1964, the 24th Amendment abolished the poll tax, but to this day in Alabama, money keeps a disproportionate number of people away from the ballot box. People should not be barred from voting solely because they are unable to pay back their fines, fees and restitution.

Restoring voting rights to rebuild community ties

If we truly want people convicted of felonies to re-engage with society, become rehabilitated and feel a part of a broader community (thus creating incentives not to recidivate), then our state should do everything possible to reincorporate these individuals into mainstream society. In terms of being a just and even-handed society, it is not fair if thousands of people are unable to regain their voting rights because they are poor. People who are wealthy or have access to money are able to repay their financial debts. But poor people (the vast majority of people who have felony convictions) are not. This is an unjust system.

Individuals on probation and/or parole are actively working on retaining and/or rebuilding their ties to their families, employers and communities. Allowing them to reestablish ties as stakeholders in political life provides an analogous and important reintegrative purpose and promotes public safety.

Felony disenfranchisement provisions, especially in the South and particularly in Alabama, date back to the post-Reconstruction era. Their intent was always clear and explicit: to disenfranchise African Americans and preserve white domination.

Restoring voting rights and automatically registering voters is good policy. Arise prioritizing these policies also has the immediate benefit of putting a positive voting rights agenda in the public debate during an era when voting has been under attack.

Current Arise issue priorities

Criminal justice debt reform

Court fees and fines impose heavy burdens on many struggling families. Driver’s license suspensions over unpaid fines can cause Alabamians with low incomes to lose their jobs. Cash bail for minor offenses can imperil families’ economic security. And multiple fees can stack up, making it impossible to move on from a conviction because consequences never end. In Alabama, people are subject to 63 separate fees in the criminal justice system – including even a $1 fee for paying fee installments.

This year, Arise emphasized reforming civil asset forfeiture within the umbrella of criminal justice debt. This practice allows police to seize cash or other assets if they find probable cause to link the property to a crime. But the process doesn’t require a criminal conviction, or even a charge.

Originally intended to fight drug kingpins, civil asset forfeiture today sees heavy use against people accused of minor crimes. Underfunded law enforcement agencies have incentives to use forfeiture because they are often able to keep much of the seized property.

A philosophically diverse coalition is seeking to end forfeiture abuses in Alabama, and reform efforts already have borne fruit. In 2019, comprehensive reform efforts moved quickly at first but then slowed amid law enforcement opposition. Eventually, the Legislature passed incremental reform, mandating public reporting of property seizures. Public opinion strongly favors further change, and momentum continues to build.

Death penalty reform

Alabama’s capital punishment system is unreliable and racist. Our state hands down nearly double the national average of death sentences. We are the only state with no state-funded program providing legal aid to death row prisoners. And state laws give insufficient protection against executing people who were mentally incapable of understanding their actions.

Arise has worked for increased transparency on the lethal injection procedures and a three-year moratorium on executions. Bills were introduced but did not move in recent years. In 2017, the Legislature voted overwhelmingly to bar judges from imposing death sentences when a jury recommends life without parole. But the judicial override ban is not retroactive. About a fifth of the 175 people on Alabama’s death row received death sentences against the jury’s recommendation. We would like to enforce the override ban retroactively.

Alabama’s death penalty practices reflect deep racial inequities. Before the 2017 ban, judges imposed death against a jury’s determination more often when victims were white. The state argued as recently as 2016 that it should be allowed to kill a prisoner even when a judge explicitly cited race at the sentencing hearing. Much work remains to modernize Alabama’s justice system and prevent erroneous executions.

Payday and title lending reform

Every year, high-interest loans trap thousands of struggling Alabamians in a cycle of deep debt. Payday loans are short-term (usually two-week) loans charging high annual percentage rates (APRs), up to 456%. Auto title loans charge up to 300% APR and also carry the risk of repossession of the family vehicle.

These high-cost loans strip wealth from borrowers and hurt communities across Alabama. Payday lenders are on track to pull more than $1 billion in fees out of Alabama communities over the next decade, with most of that money flowing to out-of-state companies. Predatory lending practices disproportionately target people of color and exacerbate the economic challenges in struggling rural and urban communities.

Arise is part of a statewide coalition promoting interest rate caps on payday and title loans. In 2019, we supported legislation to give payday borrowers a 30-day repayment period – the same as other monthly bills – up from as few as 10 days now. But the bill didn’t move, despite the Senate Banking Committee chairman’s assurances that he would allow a vote.

The 30 Days to Pay bill’s sponsor – Sen. Arthur Orr, R-Decatur – is working to ensure it will receive consideration early in the 2020 regular session. Heavy citizen engagement will be needed to overcome the lending lobby.

Public transportation

Our state’s jumble of local transportation systems fails to meet the needs of many people in rural, suburban and urban areas. Alabama is one of just five states with no state public transportation funding. For many low-income workers, seniors and people with disabilities, the transit gap is a barrier to daily living. Many folks can’t get to work, school, the doctor’s office or other places they need to go in a reasonable amount of time.

Alabama took a good first step in 2018 by creating a state Public Transportation Trust Fund. But the law did not allocate any state money, even though it would be a high-return investment in our future. Each $1 million invested in public transportation creates 41 full-time jobs, research shows. Those jobs would fuel economic growth and improve quality of life in our communities.

Appropriations for the state trust fund would be eligible for a 4-to-1 federal match. So by not funding public transit, Alabama leaves millions of federal dollars on the table each year.

The General Fund remains a key potential source for state public transit funding. Greater Birmingham Ministries’ Economic Justice/Systems Change group also has urged Arise to support legislation in 2020 to allow Alabamians to dedicate part of their state income tax refund to public transit. The state already allows voluntary contributions for mental health care, foster care and other public services.

Compiled by Dev Wakeley, policy analyst

Permanent Arise issue priorities

Adequate state budgets

Our state’s upside-down tax system starves state budgets of money needed to invest in our shared future. Alabama provides almost no state money for child care. In-home services for parents of at-risk children receive a paltry $3 million a year, far less than other states. And young adults struggle to afford rising tuition and fees at universities and two-year colleges.

Alabama must address comprehensive sentencing and prison reform in 2020. The General Fund budget will need more revenue to pay for stronger investments in mental health care, substance use treatment, drug courts, community corrections and more corrections officers.

Arise’s health care advocacy has three main goals: defend, reform and expand Medicaid. Our defense work this year focused on Alabama’s pending plan to impose a catch-22 work penalty, which would strip Medicaid from thousands of parents with extremely low incomes. Looking ahead, we expect a new push to cut Medicaid by block-granting federal Medicaid funds to states.

We’ve seen progress on Medicaid reform. The statewide Integrated Care Network (ICN) for long-term care launched last October. And the long-delayed regional primary care reform takes effect this October. Arise has recruited consumer representatives for the ICN governing board and all seven Alabama Coordinated Health Network (ACHN) boards. Next year, we’ll push for the next step: Medicaid expansion, which would benefit more than 340,000 Alabama adults.

Tax reform

Alabama’s tax system is upside down. The rich get huge tax breaks, while the heaviest tax burden falls on people with low and moderate incomes. High, regressive sales taxes on groceries and other necessities drive this imbalance. So does the state’s deduction for federal income taxes (FIT), a skewed break that overwhelmingly benefits wealthy people.

Arise has fought to end the grocery tax for more than a decade. The central challenge is how to replace the $480 million it raises for education. In 2020, we’ll intensify our efforts to show legislators the powerful link between untaxing groceries and ending the FIT deduction.

Alabama is one of only three states where filers can deduct all federal income tax payments from state income taxes. This tax break disproportionately benefits wealthy people, who pay more in federal income taxes and are more likely to itemize. Ending the FIT deduction would bring in enough revenue to untax groceries, fund Medicaid expansion and meet other critical needs.

Compiled by Jim Carnes, policy director, and Carol Gundlach, policy analyst