MONTGOMERY — Gov. Robert Bentley’s office said this week that talks about a possible Medicaid expansion in Alabama have been ongoing.

This wouldn't be the typical expansion under the Affordable Care Act that some other states have done and Bentley and other Republicans have opposed for more than two years.

Bentley in recent months has said he would be open to expanding Medicaid only if it was an Alabama-specific plan in which the federal government let the state control the money and could put its own requirements on it.

"My stipulation is that if they are able-bodied, they have to work or they have to be in a workforce training program,” Bentley said in February.

Bentley spokeswoman Jennifer Ardis said this week that talks have continued with the federal Centers of Medicare and Medicaid Services about expanding the program to more working poor.

About one in five Alabamians receives some sort of health service through Medicaid.

About 300,000 more people would receive health care under this expansion, the same number of Alabamians who would have under the Affordable Care Act expansion.

In April, Republicans passed a resolution urging Bentley not to expand Medicaid above its current levels.

The resolution states Medicaid is the state’s largest line item in the General Fund budget and that officials should be looking for ways to reduce enrollment, not expand it.

Senate Democrats later countered with their own resolution urging Bentley to expand Medicaid. That resolution passed because most Republicans didn’t vote.

The Republicans’ resolution opposes expansion under waivers, but Sen. Greg Reed, R-Jasper, said Thursday he doesn’t think its opposition extends to Bentley’s current proposal.

Reed has served on various Medicaid-related committees in the past four years. He supported the resolution but is open to looking at the block grant idea.

Reed also said that he soon will bring legislation to reform Medicaid spending on long-term care. Next to hospitals, nursing homes are Medicaid’s largest expense, about $2 billion a year.

Reed said he’ll propose something similar to the regional care organizations created for medical care, in which care providers are paid a set amount per patient — not per service.

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


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