Repeat problems to come up in first legislative session of 2017, delegation says

The Alabama State Legislature is likely to see some old problems return in its upcoming legislative session, according to members of the Shelby County Legislative Delegation.

Members of the delegation spoke at the 2017 Alabama State Legislative Preview luncheon on Jan. 4. During the luncheon, hosted by the Greater Shelby Chamber of Commerce Governmental Affairs Work Group and the Montevallo and South Shelby chambers, legislators discussed what they expected to see in 2017. The legislative session starts Feb. 7.

“I would say the theme will be second verse, same as the first,” said Sen. Cam Ward, “in that we’re gonna have some of the same problems we’ve had over the last few years again this time.”

Some of those problems include the general fund budget — which Ward said “continues to be a nightmare” — as well as Medicaid funding and Alabama’s prison system.

A federal lawsuit regarding mental health care in Alabama prisons could present funding issues for the state, Ward said, if U.S. District Judge Myron Thompson rules that the state isn’t offering adequate services in its prisons.

“It’s a federal lawsuit that the state of Alabama will lose, I can tell you,” Ward said. “And when we do lose, what Judge Thompson is liable to say is that we’re running an unconstitutional system of mental health and healthcare in our prison system, and he’s probably going to force us to hire a lot of new people and engage in construction projects.”

If more services are required, the state might be forced to mandate an ad valorem tax to fund those changes, McClendon said. Other states have mandated the tax in the past, he added, and while most legislators do not want to mandate the tax, it might be unavoidable.

In regard to funding, many legislators were in agreement that the state’s budget would continue to be an issue. One reason, Rep. Matt Fridy said, is that the budget heavily relies on negotiation.

“Agencies don’t come in and tell us, ‘Hey for this year for us to operate, here’s how much money we need,’” Fridy said. “They say, ‘We need this much,’ but it’s inflated.”

It’s hard to know how much money agencies actually need, said Rep. Dickie Drake, because so many inflate the amount for which they ask. They might ask for an amount and then drop it by $50 million without issue, Drake said, which he feels shows there’s waste occurring in the government.

The state government also faces a problem of being too big, which leads to the funding issues it is consistently facing, said Rep. Arnold Mooney.

“There’s a real concern from some of us, and I don’t mind voicing it, that government is too large in this state,” Mooney said. “If we don’t begin to deal with the size of government, we will never solve the problem facing our state.”

Budget issues also stem from discussions around Medicaid, which Rep. April Weaver said will likely take a lot of her time during this legislative session.

“As you know, it took us to a special session in the fall, where we finally found $785 million to meet the request last year,” said Weaver, chairman of the house health committee. “Since 2006, it has grown 59 percent. Everyone knows we can’t keep on trying to fund that kind of increases.”

In 2016, Weaver discussed the creation of Regional Care Organizations to shift the Medicaid service to need for care, but that project has since been derailed. Now providers who see the problems occurring with Medicaid funding have decided to not participate “at the level they originally thought they were going to,” Weaver said.

There are also questions about how the incoming Trump administration will handle Medicaid, Weaver said, and what will replace it.

“We don’t know what the Trump administration is going to do with the ACA [Affordable Care Act] and the Medicaid program,” Weaver said. “So that’s a wait and see game because with it being at the federal level, we have to deal with whatever they hand down to us.”

If President-elect Donald Trump chooses to implement block grants, Weaver said those could benefit the state by allowing more input on how Medicaid should work.

“Right now the federal government tells the state of Alabama, ‘Here’s a list of patients,’” said Sen. Jim McClendon. “We don’t get to pick eligibility. They tell us, ‘Here’s the procedures you’re going to pay for.’ We don’t get to pick the procedures.”

Block grants, McClendon said, would allow the state to adjust eligibility and procedures. Some beneficiaries of Medicaid are opposed to block grants, he said, because they like the federal government’s current system.

“We have a very interesting session coming up, there’s no question about it,” McClendon said. “So much is contingent on what happens in Washington, D.C.”