Figures cosponsors bill to expand health care coverage for Alabamians who lack coverage due to Alabama's refusal to expand Medicaid

February 4, 2025 – WASHINGTON, D.C. – Congressman Shomari C. Figures (D-AL02) announced that he is a lead co-sponsor for the Cover Outstanding Vulnerable Expansion-Eligible Residents Now (COVER Now) Act to expand health care coverage to millions of Americans who remain uninsured due to state-level refusals to accept federal Medicaid expansion funds.

"People across Alabama-both Democrat and Republican-have called for the state to expand Medicaid for over a decade," said Congressman Figures. "Because of the state's refusal to do so, more than 300,000 people are unable to receive quality health care that they would have access to if the state expanded Medicaid. This bill provides an option for the people of Alabama to bypass the state and receive health care coverage. Expanding Medicaid is a bipartisan issue given the fact that 40 states and the District of Columbia have already expanded coverage. I urge my colleagues to support this bill so that thousands of people in Alabama and millions of people nationwide can finally access the quality, affordable health care they deserve."

The COVER Now Act provides another option for states, like Alabama, that have refused Medicaid expansion. It establishes Medicaid pilot projects, allowing the Centers for Medicare & Medicaid Services (CMS) to work directly with counties and cities to provide coverage for individuals who would qualify for Medicaid if their states chose to expand.

The legislation launches a seven-year pilot projects: The bill proposes a structured approach, ensuring full cost coverage for the first three years and gradually declining to 90% by year seven.

The bill proposes a streamlined approach that automatically enrolls eligible individuals in the state plan if a statewide Medicaid expansion occurs during a pilot project.

The bill adopts successful county-based Medicaid expansion programs in states like California and Illinois, demonstrating the effectiveness of this collaborative approach.

The COVER Now Act is endorsed by a coalition of organizations, including UnidosUS, Southern Poverty Law Center Action Fund, National Partnership for Women & Families, American Diabetes Association, National Alliance on Mental Illness, National Multiple Sclerosis Society.

Medicaid – without any expansion – is the single costliest component of Alabama's state general fund budget. The State Finance Officer Bill Poole recently told the Legislature's budget committees that Medicaid will cost the state $1.18 billion in the 2026 budget. "That is a $238 million increase," from 2025. "There are no Medicaid expansion components to that. The reasons for this are complex and a lot of those are outside of (Alabama) Medicaid's control."

Medicaid cost the state $955,528,877 in 2025 (this is an estimate of what care will cost). Alabama Medicaid and the State Finance office estimates that the program will cost Alabama taxpayers $1,184,000,000 in the 2026 budget year that begins on October 1. That is a one-year increase of $228,471,123. The state's total SGF (non-education) budget in the Governor's recommendation is $3,702,690,829 – including conditional appropriations that won't happen if revenues decline - in the governor's SGF request which includes a $341,697,717 increase from 2025. 66.9% of that increase is Medicaid.

https://alison.legislature.state.al.us/files/pdf/lsa/Fiscal/FY2026/SGF/SGF_FY_2026_GOV_REC.pdf

In 2023 Medicaid expansion cost taxpayers in the states that did expand Medicaid $19.9 billion.

If Alabama had expanded Medicaid ten years ago it likely would have cost Alabama taxpayers in excess of $1.5 billion and been a continual drain on state resources moving forward likely necessitating a tax increase. Medicaid could save significant amounts of money simply by increasing its copays and deductibles however, the state is barred from doing this by the federal government.

The federal government has spent more money that it takes in for 25 years and has funded Medicaid expansion on their end almost entirely by adding more and more to the national debt. Medicaid expansion cost the federal government $158.3 billion in 2023 alone. The federal budget deficit in 2023 was $1.7 trillion with Medicaid expansion being 9 percent of that.

Figures was sworn into Congress last month. He is the new representative for Alabama's Second Congressional District.

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