House Speaker Nathaniel Ledbetter, R-Rainsville, watches the floor of the Alabama House of Representatives on May 9, 2024 at the Alabama Statehouse in Montgomery, Alabama. Ledbetter said Thurdsay that the chamber could consider changes to the state’s school funding formula in the coming session, but that Medicaid expansion was not a priority. (Brian Lyman/Alabama Reflector)
The leader of the Alabama House of Representatives said Thursday that Medicaid expansion will not be one of the chamber’s priorities for the 2025 legislative session, but that changes to the state’s school funding formula remain a possibility.
Speaking Alabama House Speaker Nathaniel Ledbetter, R-Rainsville, speaking after addressing a meeting of the Montgomery Chamber of Commerce on Thursday, said he “did not see anything coming down the pike” with respect to Medicaid expansion after President-elect Donald Trump’s election victory.
“I think the thing now, because of where we are at in the change of administration, that is probably going to change,” he said of how the federal government plans to handle the federal entitlement program, including how the government plans to allow states to expand it. “I think we are better off seeing what they are going to do.”
The comments came as Blue Cross Blue Shield of Alabama (BCBS of Alabama), the state’s largest insurer, has been advocating a plan to use Medicaid expansion dollars to pay for private insurance plans for people in the insurance coverage gap.
The health insurance company presented the proposal, known as ALLHealth, during an Association of County Commissions of Alabama (ACCA) last month. The company estimated it would provide health insurance to up to 330,000 eligible residents living in the state, either through the plan itself or by helping people pay their premiums with health insurance provided by their employers.
Ted Hosp, vice president of governmental affairs for BCBS of Alabama, said the proposal would assist with hospitals struggling to remain viable, especially in the more rural parts of the state by reducing the rate of uninsured individuals and families. It could also assist with providing access to mental health services for counties by paying for all the health care costs for people who are incarcerated if they receive care outside of the jail setting.
The ACCA’s 2025 legislative agenda calls on lawmakers “to establish for Alabamians an insurance program that will take advantage of available federal funding without exposing the state of Alabama to undue budgetary requirements.” ACCA declined comment on the matter Thursday. A message seeking comment was left on Thursday with BCBS of Alabama.
Ledbetter did not comment on specific Medicaid expansion proposals on Thursday. He said last year that legislators had to have a “conversation” about “public-private partnerships” on health insurance.
Alabama is one of 10 states that has not expanded Medicaid, which would allow anyone making up to 138% of the poverty level – $20,782 a year for an individual and $35,632 for a family of three – to get coverage under the program. Medicaid in Alabama almost exclusively covers children, the elderly and those with disabilities. Able-bodied childless adults almost never qualify, and adults with qualifying children can only receive Medicaid if they make 18% of the poverty level: $4,648 a year for a family of three.
School funding
Ledbetter said there would be a “good possibility” of making changes to the way the state funds schools.
“I think it is something that we will be working on,” he said. “I think the direction in which we are going is going to be positive. We just got to work it out. Anything that drastic, that stuff is going to have lots of conversation, and a lot of numbers to be looked at.”
Alabama currently funds schools based on attendance figures, with the number of students in a school getting translated into teacher units.
Lawmakers, including House Ways and Means Education Committee Chair Danny Garrett, R-Trussville, have been exploring the possibility of weighting funding to students with particular needs, such as English language learners; students in poverty and students in charter schools.
Lawmakers reviewed three models at a commission meeting in December that was formed to evaluate possible changes to the funding formula the state used to fund schools, with different priorities that included low-income students, those with disabilities and others living in rural areas.
The first model will total $713 million, the second will be $786 million and the third amounts to $825 million.
State education officials decline to weigh in further on the funding formula after Thursday’s Montgomery Chamber of Commerce meeting.
“We haven’t seen a bill,” said Alabama State Schools Superintendent Eric Mackey. “We are just kind of waiting. Obviously I have sent people to the committee meetings, so we have seen what the public has seen, but we have not seen anything other than what has been presented in those public sessions.”
The 2025 legislative session begins Feb. 4.
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