MONTGOMERY — On Tuesday, House Speaker Nathanial Ledbetter (R-Rainsville) poured cold water on the hopes of those wanting to see Medicaid expansion as the 2025 legislative session kicks off.
Every year ahead of the legislative session, advocates begin immediately pushing for the state to expand Medicaid under the provisions of the Affordable Healthcare Act. However, state officials often quash hopes of expansion, citing long-term cost and ideological reasons for further federal involvement.
SEE: Ivey ‘remains opposed’ to Medicaid expansion
However, for 2025, Ledbetter hit the brakes on Medicaid expansion talk on the first day of the session, saying the general consensus is to wait to see what actions the new President Donald Trump administration takes before pursuing further action.
“Doing anything with Medicaid right now would probably be cost-prohibited,” Ledbetter said. “I know that the government pays a certain amount of it. It’s always been the concern: what happens when the federal government pulls out?”
He continued, “[W]hat I'm hearing and everybody's wanting is to kind of wait and see what the federal government does.”
Alabama is one of 10 states that did not expand its Medicaid programs under the Affordable Care Act, which made adults under 65 with incomes less than 138% of the federal poverty level eligible for Medicaid.
Proponents of expansion frequently point to the so-called coverage gap for people of lower income who are not covered under the state’s existing Medicaid laws.
Since taking office last month, Trump has unleashed his Department of Government Efficiency (DOGE) under the leadership of Elon Musk to slash federal spending. Thus far, several federal programs have been put in the crosshairs for funding cuts or complete abolition.
The federal government provides some funds for Medicaid, while individual states make up the difference.
While Trump has pledged not to touch Medicaid funding unless some fraud or waste is detected, the shakeup at the federal level is certainly enough to give lawmakers across the nation pause before pursuing expansion.
To connect with the author of this story or to comment, email craig.monger@1819news.com.
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