"The Affordable Care Act brings an opportunity for all Alabamians to have health care," said Bernard Simelton, head of the Alabama NAACP. "We cannot allow one individual to make that decision for us."
Activists from NAACP chapters across the state gathered for a rally in downtown Montgomery to protest Bentley's decision not to expand the state's Medicaid program or set up a state health care exchange.
Both actions were originally requirements of the Patient Protection and Affordable Care Act, also known as Obamacare. When the U.S. Supreme Court upheld the act last year, it also gave governors the chance to opt out of both provisions.
Medicaid is a joint state-and-federal program that provides health insurance to many low-income people, including children and people with disabilities, but Alabama is one of the most restrictive states for Medicaid eligibility. Only people at or below the federal poverty level can qualify. The expansion would have made the program available to families at 133 percent of the poverty level — adding about 300,000 people to the 900,000 already on the Medicaid rolls.
Bentley rejected the expansion last year, saying in a press release that he couldn't expand the program "under its current structure." State officials are currently considering an overhaul of the program, which has taken up and increasingly large portion of the state General Fund, throwing the state a funding crisis last year.
Those who attended the Saturday rally said they were mystified by the governor's refusal to expand the program — given that the federal government will foot the bill for the first three years of Medicaid expansion and cover 90 percent of the cost after that.
"Gov. Bentley has said that the Medicaid system doesn't work," Simelton said. "I agree with part of that. But it's better than having nothing." He said the expansion would allow the state to instantly give medical coverage to hundreds of thousands of people at federal expense.
Others at the rally seemed just as concerned about protecting the people who now depend on the Medicaid system.
"There are so many people out there that couldn't survive without it," said Robert Floyd, president of the Conecuh County NAACP.
Floyd's 19-year-old grandson, William Anderson, said he's one of those people. Diagnosed with hemophilia shortly after his birth, Anderson said the program helped him get medical treatment.
"It's very important to have these features," he said. "To those who can't afford care, Medicaid is important."
While Obamacare has taken a beating in the political discourse of this majority-Republican state, many at the rally said they thought the tide was turning in the program's direction. Some said the re-election of Obama showed that the nation as a whole wants the program. Others said the public would soon begin to see the logic of providing care to everybody — and preventing bigger health care costs down the road.
"I'd like to know why we don't provide adult dental care already," said Jimmy Thomason, of Butler, in Choctaw County. Thomason noted that gum disease and other dental problems have been linked to heart disease and other expensive illnesses. Taking care of people's teeth, he said, could save costs later on.
Some of the rally's speakers urged rally-goers to return to their communities and talk up the issues in barber shops and churches. And some alluded to the relatively small size of the crowd.
Monroeville resident H.B. Williams, 82, can remember 1960s civil rights protests that would fill whole blocks of Dexter Avenue, the broad street that leads to the Capitol. Back then, he said, protesters would march on foot from west Montgomery to the city's downtown, picking up new marchers as they went.
"It's not done that way anymore," he said.
Still, Williams said, the results of the 2012 election showed that the nationwide public supports Obamacare.
"All you have to do is read the election results," he said.
The governor's Medicaid Advisory Commission is expected to return recommendations on reforming the program by the end of January. The Legislature is expected to take up those recommendations in its next session, which begins Feb. 5.
Capitol & Statewide Reporter: 256-294-4193. On Twitter @TLockette_Star.