Governor Bentley has said he would not expand Medicaid as it currently exists. The commission he appointed has suggested what an “improved” Medicaid might look like:

A state commission recommended an overhaul of Alabama’s Medicaid program that would divide the state into community-based managed care networks. “For the patient it could well mean they are going to have more encompassing care. For the agency, this will be the biggest fundamental change in Medicaid since its construction,” said State Health Officer Don Williamson.

The biggest change?

The Alabama Medicaid Advisory Commission approved the report which recommends shifting Medicaid from a fee for service model.

So, how is that going to work out? Will Alabama opt for expansion? As I have pointed out, Medicaid in Alabama pays for a lot of stuff (using much more federal money than state):

Rep. Greg Wren, R-Montgomery, is working on legislation for the session that begins Feb. 5. Wren said Medicaid now consumes so much of the state General Fund that it dictates what the state can do with other agencies.

“We have to resolve it first,” Wren said.

I guess we’ll know soon enough.