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Alabama Governor Robert Bentley announced Tuesday that the state will not set up a state insurance exchange under the Affordable Care Act, commonly referred to as Obamacare. The governor also decided that an expansion of the state's Medicaid program will not happen because "the state simply can't afford it."
"I am not going to set up a state-based exchange that will create a tax burden of up to $50 million on the people of Alabama. As governor, I cannot support adding such a tax burden onto our citizens," Governor Bentley said. "The Affordable Care Act is neither affordable nor does it actually improve health care. Congress and the President have said they want to work together to solve the fiscal crisis facing this country, and I suggest they start with this health care bill."
"I have been speaking individually and in group settings with governors from all over the country, and I feel that a significant number of these governors will take a similar stand," Governor Bentley added. "That will send a clear signal to all of our elected leaders in Washington that the health care bill should be changed."
One group that is not supporting Governor Bentley's decision, Alabama Arise, called it a "major blow to the state's health care system and overall economy." Arise says it's a statewide coalition of 150 congregations and organizations that promote policies to improve the lives of low-income Alabamians.
"Health care reform offers Alabama a way up from the bottom," Arise executive director Kimble Forrister said. "Coverage for the most vulnerable would mean more stable, timely care that lowers our reliance on emergency rooms. Better primary and preventive care would finally start to bring down the chronic disease rates that have held us back for so long. Leaving billions of federal dollars on the table in Washington is a shortsighted move for our economy."
Gov. Bentley has sent mixed signals on the Affordable Care Act since Congress passed the law in 2010. Then gubernatorial candidate Robert Bentley had campaigned on a platform of setting up a healthcare exchange in Alabama.
The governor has been an outspoken supporter of what he calls, "free-market" models of exchanges. The governor said that he would have rather had the state of Alabama take the same course as Utah in setting up a state-specific exchange outside of the jurisdiction of the federal government. Utah's model is currently on track to maintain a state-level exchange in compliance with the Affordable Care Act.
As governor, Bentley created the Alabama Health Insurance Exchange Study Commission to explore the pros and cons of setting up an exchange. The committee returned in November 2011 with recommendations to set up an exchange.
Alabama's Attorney General Strange also included the state in the lawsuit that challenged the constitutionality of the Affordable Care Act. The United States Supreme Court upheld almost the entire law. The only section that was blocked was that which required states to expand their Medicaid programs.
Under the Affordable Care Act, states have until November 16 to determine if they'll set up their own exchange, work with the federal government to create an exchange, or work with the federal government to create a hybrid model that is designed with input from both the state and the Federal Department of Health and Human Services.
Rep. Greg Wren, (R - Montgomery) who chairs the Permanent Joint Legislative Committee on Medicaid Policy proposed a model for a statewide exchange during the legislative session last Spring. The proposal passed the House but failed in the Senate.
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