The local newsblog posted two marginally related stories together in the printed version of their online material today. The first was a story out of Birmingham. The story was at its most basic level a press release and a response. The release offers information on:

research by University of Alabama at Birmingham School of Public Health economists David Becker and Michael Morrisey, who say expansion in Alabama would provide Medicaid coverage to an additional 300,000 people and generate $20 billion in economic activity. That,they say, would add $1.7 billion in tax revenue to Alabama coffers from 2014 to 2020.

Take away $770 million in estimated Alabama costs, and the net gain in tax revenue is about $930 million, Becker said.

The response is a predictable one from our Republican Governor:

Gov. Robert Bentley on Tuesday reiterated his stance against Medicaid expansion under the federal Affordable Care Act following the release of a UAB study estimating $1 billion in new tax revenue under such an expansion.

“Gov. Bentley will not expand Medicaid under its current structure,” said governor’s spokesman Jeremy King. “Our priority right now is fixing the system we have, not expanding a broken system.”

The article next to it is a report on the United Foundation’s health ranking for Alabama. The headline reads “Getting healthier (Just Barely). The statistics are fairly bleak:

  • High prevalence of smoking
  • High prevalence of obesity, sedentary lifestyle & diabetes
  • High prevalences of low birthweight & high infant mortality rate

So, how are we healthier? Turns out we were ranked number 48th last year and are number 45th this year. Why? Our children are better off than Mississippi and other neighboring states. In part this is because two thirds of Alabama’s children, as a consequence of the economy, are eligible for the supplemental nutritional assistance program (food stamps). It is also because of Medicaid with only 15% of these children having no insurance.

Perhaps when the governor finds out that the “new” Medicaid, hugely changed by virtue of the fact that enrollment is exclusively income based, has a different structure he will relent. After all, he is a physician and in the words of one of the investigators:

“If chronic conditions are better managed; if mental health is better managed, we have people who are more productive,” Becker said. “That’s certainly good for the state.”