With a heavy assist from Republican lawmakers, the Alabama Farmers Federation (ALFA) is doing an incredible thing. Through bills like Senate Bill 84 (SB84) and House Bill 477 (HB477) the organization has mounted a direct challenge to the dominance of Blue Cross Blue Shield Alabama (BCBS) to dictate who receives health insurance and controls the health care of Alabamians.
BCBS controls over 90 percent of the insurance market in the state, but that could change if one of these bills becomes law. On Thursday, HB477 cleared the House, moving on to the Senate, WSFA Montgomery reported.
Lawmakers spent hours at the State House Thursday debating a bill that would allow ALFA to provide health plans to its members.
Supporters say it will help the state’s farmers struggling with rising health care costs. Some farmers say they are having to take a second job off the farm to get health insurance.
The Bill’s sponsor David Faulkner says it’s modeled after similar plans in 10 other states that have brought farmers a 30-60% savings on health care.
What’s the issue causing such debate? Certain lawmakers did not like that the Department of Insurance couldn’t have oversight.
“Lawmakers did remove an amendment that would have given the Department of Insurance oversight to enforce the act,” WFSA continued.
Ahh, the gatekeepers. BCBS would be undercut by the state, opening up to a more competitive insurance market, while the Department of Insurance would also lose its relevance. Lord only knows what might happen to the CON Board (Certificate of Needs). Therein lies the fear: the gatekeepers are worried and the lawmakers funded by the gatekeepers are also worried.
There was one “No” vote on the bill, 1819 News reported. Rep. Marilyn Lands (D-Huntsville) chose to abstain.
After nearly two hours of loosely defined debate on Faulkner’s amendment, it passed 74-15. Immediately afterward, the body voted to approve the bill 99-1, with one abstention. The lone ‘no’ vote came from State Rep. Marilyn Lands (D-Huntsville), arguably the most liberal member of the legislature.
This is rather surprising, but… not. I attended a listening session last October hosted by Lands and Rep. Terri Collins (R-Decatur), supposedly to help Lands and Collins understand the issues surrounding women's health care from the mouth of their constituents and thus better serve families. Perhaps there are no farming families in Lands’ district, because her “No” vote clearly telegraphs that she is not listening – especially to women who admittedly take up the lion’s share of health care and who are the household managers, especially in farming families.
Lands’ vote against HB477 reflects that she is more interested in central planning than she is about real health care solutions, despite the fact she uses this topic as her calling card.
Before the legislative session began, Lands appeared on "Inside Huntsville," claiming that she wanted to be known for “working across the aisle,” and being a champion for mental health. Lands made a big to-do about the mental health crisis in Alabama, as well as her other hobby horse of maternal health.
But would not better health care and insurance options improve this? If Alabama health outcomes statistics, ranking just above Mississippi and Louisiana, are any indication, Medicaid hasn’t done much to improve this, so how would expansion make it any better? Why the insistence on making central planning stronger, while limiting the ability of other companies to compete against it?
Lands successfully championed her own bill, House Bill 89, the “Presumptive Medicaid Eligibility for Pregnant Women” through the House and the Senate. The key word here is “Medicaid,” the ultimate in central planning and government control. Lands is a staunch advocate for Medicaid expansion, and should Gov. Kay Ivey sign this bill into law, this will be one more step in that direction.
In terms of Medicaid in Alabama, the Alabama Policy Institute (API) recently published “Medicaid Expansion in Alabama: Responsibilities, Costs & Consequences,” reporting on the consequences of Medicaid expansion. Medicaid’s current annual cost to the state is $863 million, “approximately 28.6% of the total General Fund budget for fiscal year 2024,” the report says. “The state share of the Alabama Medicaid Agency’s budget is set to increase by more than $91.7 million under the fiscal year 2025 enacted General Fund budget.” This is without any so-called expansion, and the report asserts that if enacted, the budget would balloon even more.
This barnacle on the taxpayer appears to be what Lands prefers. What she doesn’t seem to want is allowing a private-sector organization to shepherd its own health insurance plan, or for them to create an additional model that other private business concerns in the state could follow. Far be it that anyone gets out from under the thumb of BCBS.
In reading the coverage of this debate, it seems that ALFA is about giving citizens, particularly our hardworking farmers, not only a choice in health care, but other options that give them a greater capacity to obtain quality health care.
“This crisis has left many farm families uninsured or compelled to seek non-farm employment to afford coverage,” the Alliance for Affordable Healthcare says, explaining why this bill is necessary.
The financial burden jeopardizes their livelihoods and casts a shadow over Alabama’s agricultural economy.
Farmers often fall into a health care ‘donut hole,’ earning too much to qualify for ACA subsidies but unable to afford full insurance premiums.
Small businesses, including solopreneurs, experience the same dilemma with stretches of delayed income, unpredictable outcomes, and tight budgetary margins. We make too little to afford high-cost premiums, but too much to qualify for Affordable Care Act low-income subsidies.
In every interview, Lands makes a big deal about the mental health crisis in our state. Does she not care how our mental health is affected when trying to provide health care for our families while being priced out of the market or being forced to take work outside of farming businesses? It’s a real slap against independence and freedom. Perhaps that is the point.
Lands seems like a hypocrite. She is less interested in solutions for mental health and women’s health and more interested in maintaining the power of central planning that keeps both these out of reach.
Jennifer Oliver O'Connell, As the Girl Turns, is an investigative journalist, author, opinion analyst, and contributor to 1819 News, Redstate, and other publications. Jennifer writes on Politics and Pop Culture, with occasional detours into Reinvention, Yoga, and Food. You can read more about Jennifer's world at her As the Girl Turns website. You can also follow her on Facebook, Twitter, and Telegram.
The views and opinions expressed here are those of the author and do not necessarily reflect the policy or position of 1819 News. To comment, please send an email with your name and contact information to [email protected].
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