MONTGOMERY — The Alabama Health Care Improvement Task Force today recommended that Gov. Robert Bentley and the Legislature “move forward at the earliest opportunity to close Alabama’s health coverage gap with an Alabama-driven solution.”

That coverage gap exists for Alabamians who are too poor for mandated insurance coverage under the Affordable Care Act, but make too much to qualify for Medicaid under the state’s income qualifications.

“Alabama ranks at or near the bottom in the nation in health outcomes for premature births, infant mortality, diabetes, obesity, smoking, cancer, heart disease and stroke,” the task force said in a letter to Bentley, dated today. “All these dismal measures can be improved through better access to primary care.”

Medicaid expansion under the Affordable Care Act, which Bentley has rejected since 2012, would cover people at up to 138 percent of the federal poverty level, which is about $33,000 in annual income for a family of four. About 290,000 people would be covered under the expansion.

About 185,000 working Alabamians would get low-cost insurance, according to the task force.

The recommendation from the task force, which Bentley created in the spring, is just that. Medicaid expansion still needs approval from Bentley and funding from the Legislature.

A University of Alabama at Birmingham School of Public Health report in July estimated if the state were to pick up 10 percent of expansion costs, the obligation will be about $222 million a year. If the current approach to funding the state’s match is maintained, the General Fund would be responsible for about 33 percent of that amount, or about $73 million a year.

Task force member Sen. Gerald Dial said that funding will be an issue.

“The bottom line is … it’s going to be a tax increase on all the people of this state,” Dial, R-Lineville, said. “You’ve got some senators who wouldn’t vote for any tax for any issue because they made a pledge.”

At next month’s meeting, the task force is expected to discuss a tobacco tax increase of 75 cents per pack to pay help pay for expansion. This year, lawmakers approved a 25-cent-per pack increase that now goes to fund Medicaid.

The governor’s office didn’t have an immediate comment about today’s recommendation.

Mary Sell covers state government for The TimesDaily. She can be reached at Follow on Twitter @DD_MarySell.

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