Advocates revitalize push for Medicaid expansion in Alabama
Advocates revitalize push for Medicaid expansion in Alabama
Cover Alabama and Families USA release new data on potential savings
MONTGOMERY, Ala. – More than 50 advocates with the Cover Alabama coalition came to the Alabama State House on Tuesday to urge their lawmakers to expand Medicaid. The advocates highlighted a new analysis from Families USA, a nationwide nonprofit consumer health advocacy and policy organization.
Alabama is losing $181.6 million in 2026 by covering millions in state health care spending that otherwise could be paid for by the federal government under Medicaid expansion, according to the new Families USA report. Medicaid expansion would generate $71.8 million in net savings for Alabama this year, the report estimated. And that amount would not include additional revenue from economic activity resulting from expansion.
The report points to numerous potential funding sources that could help the state address our health care crisis. These include increasing the state cigarette tax and closing an income tax loophole that overwhelmingly benefits the wealthiest households.
“Alabama can't afford not to expand Medicaid,” said Debbie Smith, Alabama Arise’s Cover Alabama campaign director. “The most costly option is doing nothing.”
160,000+ Alabamians are in state’s health coverage gap
Tens of thousands of Alabamians have seen soaring costs this year for Marketplace health coverage under the Affordable Care Act (ACA). These price increases came after Congress failed to renew enhanced Premium Tax Credits (ePTCs) that make plans more affordable. The increases also came on the heels of other significant federal cuts to health care in HR 1, the so-called One Big Beautiful Bill Act.
Many Alabamians have elected to drop health insurance altogether after losing the ePTCs. An estimated 161,000 adults statewide fall into the “coverage gap,” meaning they earn too much to qualify for Alabama Medicaid but not enough to afford private insurance on their own. Expanding Medicaid could ensure coverage for more than 150,000 of these Alabamians. That is roughly equivalent to the combined capacities of Bryant-Denny Stadium in Tuscaloosa and Protective Stadium in Birmingham.
“In states that have expanded Medicaid, we’ve seen a 6% to 9% increase in the workforce. Just because people can make choices to support themselves and their families,” said Mary-Beth Malcarney, Families USA’s senior adviser on Medicaid policy.
Presenters at Tuesday’s event included Smith, Malcarney and Formeeca Tripp, Alabama Arise’s senior regional organizer. Many attendees also described their own health care experiences and explained why they support Medicaid expansion in Alabama.
“No one should have to decide between rent or medicine,” one advocate shared.
Additional resources
A video of Malcarney’s presentation is available here. Pictures from the event are available here. Interviews are available upon request.