By Marissa Evans, CQ Roll Call
July 28, 2016 -- Alabama Gov. Robert Bentley is betting on a state lottery as a solution for fixing budget woes and preventing problems for people enrolled in the state's health insurance program for low-income residents.
Yellowhammer State lawmakers will soon be called back to Montgomery for a special session on allowing residents to vote in November on a state lottery. Bentley, a Republican, said in a video statement on Wednesday that the lottery could start generating an estimated $225 million a year by fiscal year 2018. No start date has been announced for the special session.
"Montgomery doesn't have all of the answers," Bentley said. "Let's hear from the people of this great state on whether the time has come to approve a statewide lottery to help fund essential state services for our children, our elderly, those with mental illness and those who are in most need."
It would be the second time that Alabamians would vote on whether or not to have a state lottery. In 1999, 54 percent of voters rejected it.
Alabama adjourned its legislative session on May 4 in the aftermath of bitter budget talks. Bentley vetoed the Republican-controlled legislature's budget, which the governor criticized for shortchanging Medicaid, the joint federal-state health insurance program for the poor and disabled. But lawmakers overrode his veto on April 5, putting into effect a $1.8 billion budget for the state's general fund. The budget left Medicaid with an $85 million shortfall, putting the program's main services and regional care organization initiative in jeopardy.
Yasamie August, press secretary for Bentley's office, said in an interview that the idea of the special session is to find solutions for funding looming service gaps and the state's general fund for fiscal year 2017. While the governor is working to find funding that would keep Medicaid's essential services afloat, the regional care organization program is still a priority.
"Right now the talk is about finding a way to make sure RCOs [regional care organizations] are adequately funded," August said. "It's a program the governor is passionate about and as we look for ways to fund Medicaid that's a part of the puzzle that we need to keep intact."
On Feb. 9, the federal Centers for Medicare and Medicaid Services (CMS) approved a waiver allowing Alabama to create 11 regional care organizations to help the state's 1 million Medicaid beneficiaries with primary care, behavioral health and specialty care. The RCOs will run the state's managed care program and be paid a fixed monthly fee per patient. The state could receive as much as $748 million in federal Medicaid matching payments to pay for start-up costs and payments to doctors and other providers, according to the state.
The agency was slated to have the program in place by Oct. 1 but without the necessary funding to keep up existing operations, that date is in limbo. However, the state legislation provides flexibility for the agency to come up with an alternative implementation plan.
Robin Rawls, director of communications for Alabama Medicaid, said in an email statement that the state is working with Bentley and CMS on "continuing to move forward with our implementation work."
