Issue: Medicaid Expansion

Arise legislative update: Week of March 31, 2025

By Alabama Arise

With a little less than half of the Alabama Legislature’s 2025 regular session remaining, Arise’s David Stout breaks down what to expect in the weeks ahead. The General Fund and Education Trust Fund budgets both will begin moving soon. Arise is working to ensure the education budget includes funding to allow every public school to choose to provide no-cost school breakfast for every student.

Arise will keep advocating to reduce the state sales tax on groceries again this year. We’re also hopeful for continued progress on bills to improve maternal health and reform Alabama’s criminal justice system. And we are opposing bills that would authorize junk health plans and harm immigrant communities and their families.

Follow our updates by signing up for our email list at alarise.org and following us on all of our social media platforms!

Full transcript:

Hello, I’m David Stout, legislative director for Alabama Arise, with a look forward to the last 14 days of this legislative session.

Most importantly are the two budgets. The General Fund budget, which will allocate over $3 billion, and the Education Trust Fund budget, which will allocate over $9 billion, will be moving in the last days of the session. Arise has been working hard to include in the Education Trust Fund budget monies to incentivize all schools to provide breakfast for every student.

Very important in the Education Trust Fund budget is a bill that reduces the grocery tax by another cent. This has been a longtime objective of Arise. It is now in the Senate awaiting action.

There are several criminal justice and parole bills that have a chance of passing. A couple of the criminal justice bills deal with resentencing, which is progressive and will allow some inmates to be paroled early. Secondly, there are bills to provide oversight to the parole board, which is much needed. Also, for the first time, there is a bill moving that allows virtual hearings, meaning that a person or an inmate who is eligible for parole will be able to present directly, virtually, to the parole board.

There are a couple of Medicaid bills moving forward that are very important for maternal health. One will provide care early in pregnancy for a Medicaid-eligible mother, and another will provide drugs and care for mothers who suffer from postpartum depression.

And of course, there are always controversial bills that we will be monitoring and perhaps working against. One is the so-called Alfa insurance plan, which is not insurance at all. It does not provide oversight for the programs, nor does it cover preexisting conditions. Secondly, immigration bills continue to hang around, which can be punitive and certainly disruptive in Alabama.

Lastly, there are two Medicaid- and SNAP-related bills under consideration that would severely restrict the allocation of those benefits to the elderly, children, and those with disabilities.

It’s important to stay informed in the last 14 days of the session. It’s also important that you continue your membership or join. It is through contributions and membership that Arise is able to continue working on bills that will benefit all Alabamians.

Thank you.

Arise legislative update: Week of March 24, 2025

By Alabama Arise

Arise’s Dev Wakeley provides updates from the first half of the Alabama Legislature’s 2025 regular session as lawmakers are on spring break this week.

In good news, lawmakers passed a paid parental leave bill on Thursday! SB 199 will introduce paid leave for new parents who work as teachers or state employees. The bill now goes to the governor for her signature. We also saw important progress on untaxing groceries last week as the House voted 103-0 for HB 386. This bill would reduce the state sales tax on groceries from 3% to 2%, building on the momentum of the 1-cent reduction that Arise members’ advocacy helped secure in 2023.

Dev also warns that SB 84, which would authorize junk health plans, remains alive at the State House. We need to continue to oppose this bill and advocate instead for Medicaid expansion as a real solution to close Alabama’s coverage gap.

Full transcript:

Hi, I’m Dev Wakeley, Alabama Arise’s worker policy advocate, here with this week’s legislative update.

We got big news this week as more than 200 Arise members got together at the State House to advocate for positive policy change that benefits people who have the least resources in the state. We spoke with legislators all across the state about good bills that we want to see pass and bad bills that we want to stop. And we made some significant progress.

The biggest news from the past week was the passage of HB 327 and SB 199, which are the companion bills that will provide paid parental leave for state employees, for teachers in Alabama’s high schools, and for two-year college employees. These bills are sponsored by Rep. Ginny Shaver in the House and by Sen. Vivian Figures in the Senate, respectively.

This is a first-in-class bill throughout the South. It provides eight weeks of paid leave for mothers and two weeks of paid leave for fathers. It’s available for childbirth, for adoption of a child under the age of 3, and, unfortunately, in cases of miscarriage or stillbirth as well. This is the best in the South by far. It’s a great bill, and we’re really excited to see this pass.

We are going to see it signed by Gov. Kay Ivey. This is one of her legislative priorities, and this is a bill that Arise has been advocating for over a year now. Great to see that pass.

In other developments, we also saw a bill to knock another cent off the state portion of the grocery tax pass out of the House entirely. This bill is sponsored by Rep. Danny Garrett. It’s a great bill. Groceries shouldn’t be taxed, and we love to see this bill moving forward. We hope to see full passage of it.

In unfortunate developments, we’re seeing some movement by a junk health plan that will do nothing to benefit Alabamians and, in fact, will make real change via full comprehensive Medicaid expansion more difficult. That bill, SB 84, is something we’re hoping to stop. We had hundreds of our members speak with their legislators about the need to engage in real change and not allow corporations to paper over the health care problems that Alabamians are facing.

To know a little more about what we’re doing on a regular basis, please follow us on social media. Visit our website, and you too can become an Arise member and advocate for positive change in Alabama.

We’re going to keep working, and we’re going to see more wins just like the ones we saw this past week.

Thanks. I appreciate your time. See you soon.

Arise legislative update: Week of March 10, 2025

By Alabama Arise

Arise’s Jennifer Harris provides an update on bills to expand access to maternal health care, postpartum care and paid parental leave in Alabama. She celebrates the progress on HB 89 and SB 102, which would remove barriers to Medicaid enrollment for expectant mothers, as well as SB 191 and HB 322, which would improve access to care for mothers facing postpartum depression. Lawmakers also are advancing HB 327 and SB 199 to ensure paid parental leave for teachers and state employees.

Jennifer also shares the good news that both Republicans and Democrats are working to continue reducing Alabama’s state sales tax on groceries. HB 386, which would reduce the state grocery tax from 3% to 2%, could be up for a House vote when lawmakers return March 18.

Full transcript:

Hello. I am Jennifer Harris, senior health policy advocate at Alabama Arise, and I’m excited to share legislative updates from the State House this week on maternal health and family supports.

First up, HB 89 and companion bill SB 102, presumptive eligibility. Medicaid covers almost half of all births in Alabama, but unfortunately, for many of those moms, the paperwork process can take up to 60 days. This bill removes those barriers and allows moms to schedule their first prenatal appointments during the approval process. Prenatal health care for the entire pregnancy is a key factor in ensuring we have healthier moms and infants. These bills continue to move successfully through both chambers with bipartisan support.

Next up, SB 191 and HB 322. These bills seek to address postpartum depression in new mothers. They ask Medicaid to create a screening tool that helps physicians identify postpartum depression symptoms, provides for adequate treatment, and creates educational material to share with mothers, families, and providers.

In continued support for new and expanding families, SB 199 and HB 327 provide paid parental leave for new parents with eight weeks of paid leave. These bipartisan bills lead the Southeast in supporting working families.

And lastly, Alabama Arise worked to lift advocate voices and successfully champion a state grocery tax cut. This tax cut was implemented as a two-step process, with the first step beginning in 2023. HB 386 was introduced last week to continue our work to ease financial burdens for Alabama families. Look for updates to come on this exciting development.

The legislative session will be on break this week, but you can stay up to date by visiting our website, alarise.org, to sign up for our email list and action alerts. Be sure to follow us @AlabamaArise on all social media platforms and share with your friends and family.

Arise legislative update: Week of March 3, 2025

By Alabama Arise

Arise’s Debbie Smith highlights the wonderful turnout at Cover Alabama’s advocacy day on Medicaid expansion in Montgomery last week. She also discusses why Arise joined with more than 100 partner groups to oppose federal cuts to Medicaid and SNAP, and she explains how you can speak out against these harmful cuts as well. Finally, Debbie shares the good news that legislation to ensure paid parental leave for teachers and state employees is gaining momentum at the State House.

Full transcript:

Hi, everyone. This is Debbie Smith, Cover Alabama campaign director at Alabama Arise, sharing this week’s legislative update with news from both the state and federal levels.

Last week, Cover Alabama and the American Cancer Society Cancer Action Network partnered to bring together almost 100 people from across Alabama to push for Medicaid expansion and defend the program from harmful cuts. We heard powerful stories from people who lost their Medicaid coverage and fell into the coverage gap. Their experiences made it clear that expanding Medicaid isn’t just about covering more people—it’s about strengthening the program so no one is left without care.

At the federal level, there is a major threat. On Tuesday night, House Republicans passed a budget resolution that could lead to over a trillion dollars in cuts to Medicaid and SNAP benefits over the next decade, all while extending tax cuts passed during President Trump’s first term. Alabama Arise and over 100 partner organizations across the state sent a letter to lawmakers urging them to reject this budget resolution, warning that it would devastate health care and food assistance programs. Medicaid is the largest source of federal funding in Alabama’s budget, with more than 1 million Alabamians enrolled—over half of them children. Cutting Medicaid would put pregnant women, kids, and nursing home residents at risk while also threatening our rural hospitals.

And it’s not just health care at stake. SNAP, the program that helps people put food on the table, is also in danger. Nearly 400,000 households in Alabama rely on food assistance, including over 330,000 children. Alabama Arise and our partners have made it clear that slashing these programs will only increase hunger and hardship in a state where one in four children already experience food insecurity. But we’ve stopped harmful cuts to these life-saving programs before, and we can do it again. Let’s keep up the pressure—email Congress today and tell them no cuts to Medicaid by visiting coveralabama.org/savemedicaid.

There is some good news at the state level in Alabama. The Senate Finance and Taxation General Fund Committee just voted unanimously to advance SB 199, a bill that would provide paid parental leave to state employees, including K-12 public school teachers. This legislation, sponsored by state Sen. Vivian Davis Figures, ensures that state workers have the time they need to care for their families and children after childbirth, adoption, or miscarriage. Policies like this don’t just support workers—they strengthen families and communities.

Let’s continue advocating for policies that protect our health and our families. Together, we are making a difference.

Medicaid Expansion Advocacy Day – Feb. 25, 2025

By Alabama Arise

Alabama Arise and Cover Alabama joined with the American Cancer Society Cancer Action Network to host a Medicaid Expansion Advocacy Day on Feb. 25 in Montgomery. Nearly 100 passionate supporters came to the State House to speak out in defense of Medicaid and the urgent need to close Alabama’s health coverage gap.

As federal threats to Medicaid persist, advocates stressed that expansion is essential both to cover more people and to protect against harmful cuts. Many described the devastation of losing Medicaid coverage and falling into the gap – earning too much to qualify for traditional Medicaid but too little to receive tax credits for private coverage.

Camden resident Kiana George and Birmingham resident Angelica McCain told their personal stories of how the coverage gap has affected their lives. Their testimonies, as well as those from faith leaders, business owners and others, highlighted the urgent need for expansion to ensure everyone has access to care. Thank you to everyone who showed up, spoke out and made a difference. Your voices matter, and we are making progress together.

Transcript:

[Voiceover] Alabama Arise and Cover Alabama joined with the American Cancer Society Cancer Action Network to host a Medicaid expansion advocacy day on Tuesday, February 25, in Montgomery. Nearly 100 passionate supporters came to the State House to speak out in defense of Medicaid and the urgent need to close Alabama’s health coverage gap. Several people spoke about the devastating experience of losing Medicaid coverage and falling into the gap — earning too much to qualify for Medicaid but too little to receive federal tax credits to help pay for health coverage. Their testimonies underscored the urgent need for Alabama to expand Medicaid so everyone can get the health care they need to survive and thrive.

[Debbie Smith] I’m here with many advocates from across the state to ask the Legislature and Gov. Ivey to close the coverage gap and expand Medicaid. Right now, around 200,000 of our friends, neighbors and family members are caught in the Medicaid coverage gap. They work hard — taking care of our children, serving our food, stocking our grocery store shelves — but they can’t afford to see a doctor when they’re sick. And when they can’t get the care they need, it doesn’t just hurt them, it hurts all of us. When people don’t have health coverage, they aren’t able to see a doctor for regular checkups or early treatment. That means preventable conditions turn into expensive emergencies.

[Kiana George] Hello, I’m Kiana George from Camden, Alabama, or as they call it, Wilcox County. My story is pretty simple. I lost coverage back in September 2023 when they did the whole [unwinding], and then I’ve been basically fighting for my life ever since. I’ve always had blood pressure issues since around 2015-2016. I called Medicaid, and they told me because I made more than $295 a month, that I didn’t qualify. And then I called the Marketplace, and I don’t make enough money to get an insurance plan. So what am I supposed to do? I started getting bills in the mail, and that discouraged me from going to the doctor because if I’m already in debt, I can’t pay you. If I don’t have the money for insurance, I don’t have the money to pay you for not having insurance. I stopped taking my medicine last year because it was making me sick, but I was too scared to go back to the doctor to get it changed because I thought they were going to make me pay for it. And after that — not a good idea. Because guess who ended up a month after turning 30, in ICU in the hospital with stroke-level blood pressure. I did. As a matter of fact, while Jackson was boycotting outside, I was inside the hospital. In ICU.

And didn’t even know it. I would really, really appreciate all the lawmakers, all the legislators, the governor… anybody. I have a 9-year-old. I want to see my baby grow up. If I don’t have coverage, I’m not going to be able to live. Thank y’all.

[Angelica McCain] I’m Angelica. I came down here from Birmingham. My story starts at birth. I was on Medicaid as a baby. When my parents first moved here, my mom worked three jobs while my dad didn’t work at all. Medicaid was the only way we survived as children. Fast forward 18 years, 19, I get dropped. I start working in the service industry. If you’re familiar with the service industry, they are not legally required to offer health insurance to anyone, so if you make your career in the service industry, you’re not going to get health insurance unless you pay an arm and a leg for it. So, ultimately, I resulted in having to get Medicaid for my daughters as they were born. Medicaid would only cover me while I was pregnant, and that was it. They cover my children now. It’s confusing for me about why they will cover my children to be born but they will not cover me to continue to be healthy, to be alive for them. On top of that, my 9-year-old was diagnosed with a soccer-ball-sized tumor last summer in her right ovary. And thankfully for Medicaid, I didn’t have to pay $200,000 for her to have her surgery. That was a really difficult time, and then also having to fight for that coverage for my children to live… It just doesn’t seem humane in a lot of ways. And a lot of people are having to fight just to provide for their children. We shouldn’t have to fight this hard for it. We’re just hoping Alabama can cover the Medicaid gap and help everybody actually just be able to exist healthily.

[David Silverstein] I’m a businessman from Birmingham. Why am I here? For two reasons. One, because I believe we can do better as a state. I’d love for my children and my children’s children to stay in the state and make it a better place to live, and work, and raise a family. But think of this: If we expanded Medicaid, it would have close to a $2 billion positive economic impact on this state. Think about that. Our rural hospitals would have a chance to survive.

[Smith] Alabama is losing billions of dollars that could have been invested in our health care system. It’s time to stop pointing fingers and start leading. The time for excuses is over. The time for action is now. Let’s expand Medicaid. Let’s save lives. Let’s cover Alabama.

Vote ‘No’ on SB 84 and HB 477: Junk health plans are not the solution for Alabama’s health coverage gap

By Alabama Arise

Junk health plans lack basic consumer protections.

  • SB 84 and HB 477 would allow a “nonprofit agricultural organization” to offer unregulated health plans to its members in Alabama. The bill explicitly says these benefits would “not [be] provided through an insurance policy.”
  • Unlike health insurance sold by other carriers, plans like the ones offered under SB 84 and HB 477 could deny someone health coverage based on previous medical history. If people with preexisting conditions are accepted, they could be charged a higher premium and/or not have coverage for care related to their preexisting conditions.
  • These new plans could put caps on key benefits, and they would not have to limit annual and lifetime out-of-pocket costs for consumers. This could leave patients with massive medical bills or force them to forgo needed treatment.

Junk health plans lack financial oversight.

  • Plans under SB 84 and HB 477 would lack the financial requirements that Marketplace insurance has.
  • The plans could charge whatever prices they want without regulatory oversight, and they would not have to spend a minimum share of the money they collect on medical care.

Junk health plans are not a solution for closing Alabama’s health coverage gap.

  • Alabamians deserve health coverage that delivers stable, high-quality insurance they can afford to use when illness strikes. This coverage should include a full set of benefits to protect people when they become sick, and it should be available regardless of one’s medical history to prevent discrimination.
  • Good health coverage should be properly regulated to ensure that customers’ financial and medical interests are protected.
  • The plans offered under SB 84 and HB 477 would not ensure affordable or adequate health coverage for the nearly 200,000 Alabamians in our state’s coverage gap. Lawmakers should focus instead on boosting our state’s workforce by expanding Medicaid coverage to ensure every Alabamian can get the health care they need to survive and thrive.

Updated March 25, 2025, to add references to HB 477.

Arise legislative update: Week of Feb. 3, 2025

By Matt Okarmus

Arise’s David Stout welcomes everyone to the Alabama Legislature’s 2025 regular session. Watch to see what to expect and learn about parental leave, school breakfast and other key issues where we hope to make progress this year.

Remember to sign up for our action alerts. And you can read more about our 2025 legislative priorities.

Full transcript below:

Hello, I’m David Stout, the legislative director for Alabama Arise, and I’m here to give you a brief look at the upcoming 2025 legislative session. The session begins Tuesday, Feb. 4, and the Constitution prescribes that the Legislature must meet over 105 days. There are actually 30 so-called working days where they meet, debate, and vote on bills in a session.

There are many issues that are very important to Arise members, and we need to be aware of them and be able to give our input as this session proceeds. During the first week, the budget presentations before the Legislature will occur on Feb. 5 and Feb. 6. These budget hearings, for the first time, are wrapped into the session and will include presentations by financial directors, state departments, education— a whole variety of departments in state government.

Especially important this year, and critical to making Alabama a better state, are three key issues that Arise will be working on. One is parental leave, which we hope will give parental leave for the first time in Alabama to state employees and educators. Secondly, we will be offering a plan to incentivize schools to provide breakfast for all students in public schools in Alabama. Lastly, we will continue our efforts to see that Alabama joins the majority of other states and expands Medicaid to give health coverage to over 200,000 Alabamians who do not have it.

Arise will also be working on a broad agenda in the Legislature, including criminal justice reform, seeking funds for public transportation, maternal and infant health care, voting rights, death penalty reform, and pushing to take more taxes off groceries.

We will keep you posted as we move through this session. It’s extremely important that you stay engaged, and the way to stay engaged is to be conscious of the Arise action alerts. We hope you participate, we hope you contact your legislators, and we think it’s important that you meet with your legislators personally. It’s going to be a difficult session, but Arise is working, we think, for the betterment of the people of Alabama.

Arise 2025: How we’re working to build a better Alabama

By Alabama Arise

Alabama Arise believes in dignity, equity and justice for all. We believe in an Alabama where everyone’s voice is heard and everyone has the opportunity to reach their full potential. And we believe better public policies are the key to building a brighter future for our state.

Below, we’ll share some details of that vision with you before the Alabama Legislature’s regular session begins Feb. 4. We’ll focus on the crucial legislative priorities on our 2025 roadmap to change.

Graphic listing Alabama Arise's 2025 legislative priorities: Arise's roadmap to a better Alabama. The priorities are untaxing groceries, Medicaid expansion, voting rights, criminal justice reform, maternal and infant health, public transportation and death penalty reform.

It’s time to close Alabama’s health coverage gap

For more than a decade, Alabama has been outside looking in on a good deal. While hundreds of thousands of Alabamians continue to struggle without health insurance, state leaders have failed to expand Medicaid. A few loud voices have politicized an issue that never should have been political. And our state has paid the price in lost dollars, lost jobs and lost lives.

Alabama is one of 10 states that has yet to expand Medicaid. That inaction has left hundreds of thousands of Alabamians in a health coverage gap. We’re advocating to make this the year when our state closes that gap.

READ MORE – An Alabama solution: Closing the health coverage gap

Finish removing the state grocery tax

Alabama’s state sales tax on groceries is a cruel tax on survival, and Arise is committed to eliminating it. We were thrilled to see lawmakers pass legislation in 2023 to cut the state grocery tax in half after decades of persistent advocacy by our members. And we’ll continue advocating to remove the rest of the tax sustainably and responsibly. We’re grateful to serve on a state commission that is studying policy pathways to end the state grocery tax while protecting vital funding for public schools.

WATCH – The path forward in Alabama Arise’s work to untax groceries

Fund public transportation to improve life for all Alabamians

Alabama’s labor force participation rate is among the nation’s lowest. Only 58% of working-age adults reported they were actively working or looking for jobs as of November 2024. Our state also has nearly 100,000 more job openings than workers available to fill them. Yet 31% of Alabama job seekers cite transportation issues as the reason they are unemployed or underemployed, according to a study commissioned by the governor’s office.

Unfortunately, Alabama is one of only three states that has no state funding set aside to support public transportation. Alabama Arise will advocate for that to change during this legislative session.

READ MORE – Fund public transportation to improve life for all Alabamians

Expand voting rights to right past wrongs and safeguard democracy in Alabama

Voting rights are the foundation of our democracy, and we should do everything we can to protect them. However, since the U.S. Supreme Court stripped away federal preclearance of voting law changes in 2013, the Legislature has passed several harmful laws to create unnecessary barriers to voting rights in Alabama. This included 2024’s SB 1, which created a chilling effect for people trying in good faith to help Alabamians with absentee voting. Arise will advocate instead for positive steps to support voting rights, including passage of the Alabama Voting Rights Act, which would protect absentee voting and clarify voting procedures. Additionally, lawmakers will introduce bills to remove barriers to voting rights restoration for citizens released from incarceration.

READ MORE – Expand voting rights to right past wrongs and safeguard democracy in Alabama

It’s time for Alabama to prove we care about mothers and children

Healthy parents and healthy children mean a healthier future for Alabama. Comprehensive maternal and infant health care investments are crucial to ensure the health and safety of both infants and Alabamians of child-bearing age, especially postpartum mothers, pregnant women and future mothers. Lawmakers have numerous policy options to increase the number of health care providers and extend health coverage to more parents.

READ MORE – The Alabama Maternal Health Toolkit

School breakfast for all: What Alabama can do to help feed all of our kids

School breakfast for all would help reduce child hunger in Alabama, and it would go a long way toward the goal of guaranteeing a morning meal for every child in our state. School breakfast’s benefits are wide-ranging: It helps address chronic absenteeism, improves adolescent mental health, alleviates behavioral problems and improves test scores. Alabama Arise is pushing for a $16 million appropriation from the Education Trust Fund to ensure every district can pull down the maximum federal funding, and to give local schools the opportunity to offer no-cost breakfast for all Alabama children.

READ MORE – School breakfast for all: What Alabama can do to help feed all of our kids

Alabama’s death penalty practices remain unjust and unusually cruel

Americans increasingly oppose the death penalty. Gallup found that opposition to the death penalty more than doubled in the past 25 years. This may result from disturbingly high error rates in the system. For every 10 people executed since 1976, one innocent person on death row has been set free.

Alabama took an important step toward death penalty reform in 2017 by banning judicial overrides of juries’ sentencing decisions, and we will aim to work this session to make that ban retroactive. But the state’s death penalty scheme also remains broken in many other ways.

READ MORE – Alabama’s death penalty practices remain unjust and unusually cruel

Alabama’s parole system is still broken. How can we fix it?

The state’s parole system is a failure in both its design and in application of its own rules. We need to increase parole board oversight and eliminate racial disparities in parole. People also deserve to be able to attend their own parole hearings.

Arise’s suggested changes would be an important step in the direction of a more just Alabama, and they would mitigate some of the problems plaguing our state’s prison system overall.

READ MORE – Alabama’s parole system is still broken. How can we fix it?

Paid parental leave improves life for Alabama workers

Like any employer, our state should ensure its workers have jobs that support their ability to care for their families. The teachers, social workers and many other state employees who help look after our children and who build up Alabama for all the families in the state should be able to create and grow their own families without scrambling to pay the bills.

Paid parental leave is a common-sense policy that helps workers care for their families while maintaining their careers and financial well-being. State officials often have said Alabama is pro-family. Ensuring that teachers and state employees have paid parental leave is an important step to prove it.

READ MORE – Paid parental leave improves life for Alabama workers

‘It shouldn’t be like this’

By Whit Sides
Standing, posed photo of Florence Dutch
(Photo by Whit Sides)

Florence Dortch, 60, of Vredenburgh (Monroe County)

Florence has been uninsured for 22 years. Lately, she’s been receiving care from a rural health clinic in Monroeville, where she pays out of pocket for help with her arthritis, high blood pressure and monitoring her prediabetes. She has trouble affording her medications but is able to continue taking her prescriptions for now with help from her sister. 

“I make it work because I have to. I try not to think about how long I’ve been living like this, because it’s not great. It’ll get you down. I rely on a lot of help from the community, but it shouldn’t be like this, because I’m not the only one.”

Florence has a few more years until she’s eligible for Medicare. Because she works, she doesn’t meet Alabama’s stringent income eligibility requirements for Medicaid.

“If working people could get the coverage they deserve, we wouldn’t even be where we are now. Here in the Black Belt, or anywhere else.”

‘I just want to go to the doctor’

By Whit Sides

Standing, posed photo of Kiana George

Kiana George, 29, of Camden

“I felt like with Medicaid, I got the best care I’ve ever had, and I could afford the copays. I didn’t have to worry about racking up debt just for going to the doctor.”

Kiana is a child care provider working in Camden. She recently lost Medicaid coverage during the state’s “unwinding” period after learning she was “earning too much” at the day care center, leaving her in Alabama’s health coverage gap.

After she sought urgent care for polycystic ovarian syndrome, out-of-pocket bills for diagnostic labs and imaging left her with thousands of dollars in medical debt.

“I get these bills in the mail, and it’s so much stress. I don’t like owing people money. So I just don’t get help even when I’m in pain.”

Kiana visits free clinics offered at local health fairs but says the care is limited. She’s worried about needing care when she’s not close to home, or facing another medical emergency and collecting even more medical debt.

“I really wish Alabama would expand Medicaid. I just want to go to the doctor. I feel like without coverage, by the time I do get to the doctor, it is too late, and everything is way out of hand.”