ASK THE CANDIDATES GUIDE:

MEDICAID EXPANSION IN ALABAMA

By Debbie Smith, Cover Alabama campaign director (debbie@alarise.org)

Purpose of this guide

Alabama is facing significant healthcare challenges. Here a few major ones:

  • Roughly 155,000 Alabamians are in the health coverage gap.

  • Rural hospitals continue to struggle financially and face closure.

  • Maternal mortality rates remain among the worst in the nation.

  • Thousands of uninsured veterans lack access to care.

Medicaid expansion is one policy option that could address many of these issues. Regardless of where candidates stand on Medicaid expansion and other healthcare-related issues, voters deserve clear information about their positions. This guide helps communities:

1. Understand where candidates stand before they enter the State House.

Once elected, lawmakers make decisions that shape healthcare access for years. Asking these questions early helps build relationships, open dialogue and ensure candidates understand that healthcare access is a priority for their constituents.

2. Keep Medicaid expansion in the public conversation.

When voters consistently ask about Medicaid expansion, it signals to campaigns, journalists and policymakers that this issue matters. Public conversation influences political priorities. Your questions help keep healthcare access visible and relevant throughout the election season.

3. Build a clear statewide picture of candidate positions.

By gathering and sharing responses, communities can better understand how candidates across districts are thinking about healthcare and where further engagement or education may be needed.

How to use this guide

  • Ask these questions at town halls, forums or campaign events.

  • If no public events are available, send questions via email or social media.

  • Share candidate responses with others in your community.

  • Report back to the coalition to help us assess candidates’ positions.

Questions to ask candidates

1. Rural hospitals

Rural hospitals across Alabama face ongoing financial strain.

  • Do you support Medicaid expansion as a strategy to help keep rural hospitals open in Alabama?

  • If not, what specific plan would you implement to stabilize rural hospitals and protect access to healthcare?

2. The coverage gap

About 155,000 Alabamians fall into the health coverage gap. For example, the income limit for a single mother with two children to qualify for Medicaid is just $410 per month, or less than $5,000 per year. This leaves many working families without affordable coverage.

  • Do you support Medicaid expansion to close Alabama’s health coverage gap?

  • If not, what specific plan do you have to ensure these Alabamians gain access to affordable healthcare?

3. Maternal health

Alabama has the second worst maternal mortality rate in the country.

  • Do you support Medicaid expansion as a way to improve maternal health coverage before, during and after pregnancy?

  • If not, what alternative steps would you take to improve maternal health outcomes in Alabama?

4. Veterans and uninsured adults

Approximately 10,000 veterans and more than 100,000 other adults remain uninsured across Alabama.

  • Do you support Medicaid expansion to reduce the number of uninsured adults in Alabama, including veterans?

  • If not, what is your plan to increase coverage for these groups?

5. Overall position on Medicaid expansion

Considering the challenges facing Alabama, including rural hospital closures, the coverage gap, maternal health concerns and uninsured veterans:

  • Do you support Medicaid expansion in Alabama? Why or why not?

  • If not, what specific alternative would you implement to address these challenges, and how would it compare in cost, coverage and impact?

2026 election information

Runoff election: Tuesday, June 16, 2026

  • May 29 is the deadline to hand-deliver a voter registration form for the runoff. June 1 is the deadline to register online or postmark registration forms delivered by mail.

  • The election manager must receive absentee ballot applications by June 9 (by mail) or June 11 (in person).

  • Completed absentee ballots must arrive at the election manager’s office by June 15 (if hand-delivered) or by noon on June 16 (if returned by mail).

General election: Tuesday, Nov. 3, 2026

  • Oct. 19 is the voter registration deadline for the general election.

  • The election manager must receive absentee ballot applications by Oct. 27 (by mail) or Oct. 29 (in person).

  • Completed absentee ballots must arrive at the election manager’s office by Nov. 2 (if hand-delivered) or by noon on Nov. 3 (if returned by mail).

Let us know what you hear!

After speaking with a candidate, please record:

  • Candidate name

  • Office sought

  • Date and method of contact

  • Summary of response

  • Direct quotes if available

  • Follow-up needed (if any)

This information helps us build a statewide understanding of where candidates stand on Medicaid expansion and other healthcare-related issues, as well as where further engagement may be needed. Please send this info to Cover Alabama at coveralabama@alarise.org. Thank you!