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$85 Million Medicaid Cut Hits Small Towns Worst

Alabama’s pediatricians seemed to expect a Medicaid funding crisis this year, and the Legislature didn’t disappoint.

Alabama’s pediatricians seemed to expect a Medicaid funding crisis this year, and the Legislature didn’t disappoint.

Almost as if they expected to be let down by state lawmakers, a group of doctors from the Alabama Chapter of the American Academy of Pediatrics held a conference call with reporters in mid-April, technically before the state’s Medicaid spending gap was even official, to focus on the problem.

Lawmakers had already shown little interest in finding new revenue, and within a few weeks it became clear there was an $85 million hole between what the state Medicaid program said it needed and what it would be getting. A bill to plug that hole died in the last hours of the regular session in the state Senate. Part of the $85 million was to install regional care organizations aimed at reining in Medicaid costs.

The physicians, meanwhile, told reporters that funding cuts would jeopardize an already thinly stretched and fragile network of health care outside urban areas. Doctors who had hoped to expand clinics in Birmingham and south Alabama, thus boosting local economies, said they might instead have to lay off health providers.

“I’ve practiced 30 years. I grew up in this state,” said Dr. Cathy Wood, a Montgomery pediatrician. “There are many of us who have quite an interest in trying to establish better medical access for kids, but you exist from year to year on a slippery slope with a banana peel under your foot, and it’s really hard to plan and create something that does make it easier for kids to get what they need.” 

The state’s annual wrestling match over Medicaid funding isn’t doing a thing to improve Alabama’s image when it comes to young doctors who are deciding where to practice, according to Dr. Eric Tyler of Alexander City-based Pediatric Associates.

“You crush a network, and how are you going to get young people who are first starting their medical career interested in investing their life, living in a small town and providing care in a small town, when they’re not going to know from year to year if they’ll be able to fulfill the mission,” Tyler said.  

At press time, Gov. Robert Bentley had given no indication he would call a special session to address the cuts. “Unless the governor calls us back for a special session, they’ll have to live within their means like the rest of us,” Senate President Pro Tem Del Marsh, R-Anniston, told the Montgomery Advertiser.

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