Special to the
Gov. Kay Ivey and her cabinet members deserve applause for taking swift and decisive action to protect Alabamians during the COVID-19 pandemic. The steps they have taken to increase social distancing, remove administrative barriers to seeking assistance and get resources to where they are most critically needed will save lives and reduce the strain on Alabama’s hospitals.
We urge Ivey to continue to use every tool available to address this crisis. The stakes are high: An estimated 46% of Alabama adults are at higher risk of developing serious health complications from the coronavirus. Seniors, people with disabilities, and people with underlying health conditions appear to be at most serious and immediate risk from the virus. Alabamians with low incomes and those who lack health insurance are also high-risk groups, because their options for responding to the health threat and related challenges are limited.
In a recent letter to Ivey and Medicaid Commissioner Stephanie Azar, Alabama Arise and 36 partner organizations endorsed several tools available to the state to increase access to health care. Federal law gives states wide flexibility to use their Medicaid and Children’s Health Insurance Programs (ALL Kids in Alabama) to respond to health emergencies and other disasters.
The options below include some that Alabama Medicaid has adopted already. Many others could be implemented in short order, and some could be requested now for future use. They are in keeping with the important recognition by Ivey and federal officials that COVID-19 requires a bold, timely and comprehensive response. Here are some of our key recommendations:
-Expand health coverage for the uninsured. Medicaid expansion is a must to ensure coverage for more than 340,000 Alabama adults with low incomes. Our state also should ensure that women with pregnancy-related Medicaid coverage can remain enrolled for at least 12 months after childbirth. And Alabama should eliminate asset tests for seniors and people with disabilities.
-Make enrollment more accessible. Alabama should remove administrative barriers to enrollment by maximizing the use of presumptive eligibility and self-attestation of income and citizenship. Officials also should use information from the school lunch program as part of the express lane process to determine Medicaid eligibility.
-Keep people covered. Alabama should temporarily delay the annual renewal process under its authority to exceed time limits in emergency situations. The state also should maintain coverage for Alabamians who temporarily reside out of state because of the coronavirus. And it’s essential to prevent disruption of services for people with special health care needs and disabilities.
-Expand benefits that are covered. Alabama should take up the option in the Affordable Care Act (ACA) to ensure that all necessary treatment and preventive services, including vaccines, are covered for all adult Medicaid participants without cost-sharing. We should cover 90-day supplies of maintenance medications, allow advance refills and cover home delivery of prescription drugs. Alabama also should expand covered home- and community-based services. And the state should maximize the use of telehealth to extend provider access and reduce direct personal contact during the pandemic.
-Ensure continuity of care. Thousands of Alabama Medicaid participants depend on health services and daily living supports provided in home- and community-based settings and long-term care facilities. For these individuals, disruptions in care and assistance can be life-threatening.
-Medicaid and other services that provide health care for struggling and marginalized Alabamians form the backbone of the health care system that protects us all. A health emergency only heightens the need for that system to be as strong as we can make it. We urge Ivey and state Medicaid officials to use every tool available to protect Alabamians in the short, medium and long terms.
For more information, visit www.alarise.org. The organization’s headquarters are located in Montgomery.
Jim Carnes is policy director of Alabama Arise, a nonprofit, nonpartisan coalition of congregations, organizations and individuals promoting public policies to improve the lives of Alabamians with low incomes.