Governor Kay Ivey has requested federal approval to implement work requirements for Alabama Medicaid recipients, despite opposition from 90% of respondents during the public comment period. On the same day she submitted her proposal, a federal judge blocked Kentucky's attempt to add work requirements to its Medicaid program. 

Establishing work requirements for Medicaid recipients will create a catch-22 in which the poorest Alabamians will lose access to healthcare if they don't get a job or even if they do! By working just 10 hours for minimum wage, a mother of two will become ineligible for Alabama Medicaid while still being unable to afford private insurance. 

Access to healthcare is among the top concerns for rural and small town families who must often travel longer distances to see a doctor. The lack of jobs, limited access to affordable and quality childcare, and higher transportation costs mean work requirements will hurt small town communities the most.

While work requirements will add new administrative costs for the state to track who is or isn't working, Governor Ivey has the authority to improve healthcare access and defer any new costs to the federal government by expanding Medicaid. New research from around the country since Medicaid expansion began shows clear benefits, especially in rural areas including:

• Keeping hospitals open and improving access to treatments for asthma, hypertension, and addiction

• Nearly half a million new visits for depression--a leading cause of suicide--in rural areas alone

• Improved quality of care offered by community health centers serving rural areas

With a majority of Alabamians (62%) living in communities of 15,000 or less, it is clear Medicaid expansion would have a huge impact on our state by improving overall health and creating new good-paying jobs without increasing costs. Alabama should join the 32 other states that have expanded Medicaid to ensure access to quality healthcare for all residents.