Reforming Medicaid system
by Will Heath
ST. CLAIR COUNTY — For more than two years, Rep. Jim McClendon, R-Springville, says he and others in the Alabama Legislature have explored ways to reform the state’s Medicaid system.

“It’s like eating an elephant,” McClendon said. “Even one bite at a time, you never really get through it all.”

The proposal that McClendon and Sen. Greg Reed, R-Jasper — chairmen of the House and Senate committees on health, respectively — have devised, along with state health officer Don Williamson, will face its first official public hearing Tuesday. McClendon said the plan has been kept largely out of the public until this week.

“It is a $6 billion program,” he said. “Everyone involved with it — the providers, the hospitals, the nursing homes — each was concerned somebody was sitting at the table, cutting them out. Nobody was sitting at the table, except us and a representative from the governor’s office.”

The proposal — like much of the health care industry — is a complicated one. In essence, the new law would divide the state into “regions” — “No more than eight,” McClendon said — with Regional Care Operatives in each region devising their own plan to operate the federally funded Medicaid program.

“If their plan fits the requirements set by the statute, they can run their own Medicaid plan,” McClendon said. “Ultimately, the goal is for each of these regions to have a flat amount of money based on the people they cover — a per capita allowance — and then it will be up to them to administer the program, and pay the providers.”

McClendon said the need for reform exists because of a stagnant economy, which has resulted in increasing unemployment even as the cost of health care has continued to rise.

“Had we not had a cash problem, we probably would not have gotten around to this project,” he said. “We’re talking problems in the hundred-million dollar category. That’s really what stimulated us to get in here and come up with our own program, unique to Alabama, to try to put some controls on spending.”

The state Medicaid commission will oversee each regional operation.

“They (on the commission) will ultimately decide who they’re going to award it to, based on whether they meet all our requirements and who’s making the best deal for the state and the taxpayer,” said McClendon. “There’s a strong move here to get these expenses under control, and the taxpayer gives us the money for this. We get this spending under control, we’ve helped the taxpayer out, instead of just continuing to increase it year after year.”

The public hearing is Tuesday beginning at 10 a.m. in the Alabama House of Representatives’ chambers.

Elsewhere in the legislative week, Senate president pro tem Del Marsh, R-Anniston, hailed his body’s passage of a $1.7 billion General Fund Budget, providing level funding for most state agencies. The proposal also includes the first installment toward repaying money borrowed from the Alabama Trust Fund and provides the state court system with an additional $2.8 million over what was initially recommended by Gov. Robert Bentley.

“Alabama is fortunate that, unlike the federal government, our Constitution requires that we live within our means and not spend more than we take in,” Marsh said in a release. “Working with Gov. Bentley, the Legislature has made significant strides toward reducing the overall size and cost of state government.

“No stone has been left unturned as we’ve identified ways to cut spending and operate more efficiently and effectively. I applaud Sen. Orr and members of the General Fund Budget Committee for crafting a sound, fiscally responsible budget as we work to make out of limited taxpayer resources.”

Work in the House was limited this week, due to what Rep. Dickie Drake, R-Leeds, called “wasted time.”

“We’re wasting time, because the Democrats are filibustering everything we do,” Drake said. “I feel like we’re cheating the taxpayers by not getting work done. Hopefully they’ll get tired of it pretty soon and we’ll get back to business.”

Drake said he is personally working on an updated version of legislation that would raise punishments for anyone who fails to report child abuse. The legislation came up last year, but failed to pass before the legislative session ended.

“The statistics are unreal,” he said. “Something’s got to be done. Kids can’t speak up for themselves, so somebody’s got to do it.”

Rep. Randy Wood, R-Anniston, said he and others from the area have been in discussions with local officials regarding potential legislation that would OK Sunday alcohol sales in the area. Thus far, he said there is not enough public support.

“When you’re elected, you’re supposed to do what your constituents want to do, not what you want to do,” said Wood. “We did a little polling, and it showed the majority of the people did not want Sunday alcohol sales.

“It’s come over here to Anniston, and I told Anniston the same thing. How can I tell them yes when I’ve already told Pell City no? Over here, it shows the same thing — the polling says no.”

Rep. Mack Butler, R-Rainbow City, said legislation related to gun ownership is also likely to come up on the docket soon, and he said he is looking forward to those discussions.

“We want to have the strongest pro-gun legislation, but at the same time be respectful to the wishes of law enforcement,” Butler said. “I think we have it where everybody can live with it. I think you’ll see that move forward. Most of the gun owners in this state are good guys, so we don’t want that to be infringed upon.”

Sen. Scott Beason, R-Gardendale, is the sponsor of the bill in the Senate, and says he has spent many hours discussing it with law enforcement officials.

“My position is, I want law-abiding citizens to be able to protect themselves,” said Beason. “Law enforcement looks at it differently, because they’re more concerned about the criminal. But my position is, the criminal doesn’t care what the law is.

“We’ve had a lot of debate back and forth, and I think that’s where the division is. We’re working very hard to come up with something. My guess is, no one will be completely happy, but we need to have that debate.”

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© 2013