The loss of Medicaid coverage has significantly affected access to essential healthcare services, particularly for Black Alabamians who face existing healthcare disparities and economic challenges. Pictured above is Alabama Arise board member Kenneth King speaks at Cover Alabama’s advocacy event outside the State House in Montgomery on March 21, 2023. King shared his story of living in Alabama’s health coverage gap and urged lawmakers to support Medicaid expansion. ( file photos)

MONTGOMERY, Ala. — As the Alabama Medicaid Agency proceeds with its process of reassessing the eligibility of over 1.1 million Medicaid recipients in the state, the impact on Black Alabamians has become increasingly concerning. Nearly 186,000 Alabamians have been removed from the low-income health insurance program since last summer, with Black residents disproportionately affected.

The latest figures from a new agency report on February enrollment show a loss of 17,887 Alabamians from the program compared to January. On average, more than 20,000 Alabamians have lost Medicaid coverage each month since last June, due to the state’s review of eligibility following the expiration of COVID- related federal protections.

Black Alabamians have been hit particularly hard by the Medicaid cuts, as they account for nearly 38% of those who lost coverage between January and February, despite making up only 27% of the state’s population. This highlights the significant vulnerability of Black communities in Alabama, who already face healthcare disparities and economic challenges.

The reasons for losing coverage vary and can include procedural issues like failing to file the proper paperwork, as well as exceeding the state’s strict income eligibility caps. These caps restrict Medicaid eligibility to those with certain qualifiers such as being pregnant, blind, or having a disability, and set income limits at $964 a month for individuals or $1,436 for couples.

In counties with large Black populations, the loss of coverage is pronounced. In Jefferson County, the state’s most populated county, 2,154 residents lost Medicaid coverage between January and February, totaling 23,973 since last June. Mobile County saw a loss of 1,610 residents in the same period, while 980 lost coverage in Montgomery County.

The loss of Medicaid coverage for Black Alabamians has serious consequences for their health and well-being, reducing access to essential healthcare services. This could further exacerbate existing disparities and contribute to poorer health outcomes within the Black community.

Calls for Medicaid expansion have been growing, as it could extend coverage to an additional 300,000 Alabamians, including many Black residents. Such expansion would raise the income eligibility thresh- old to $20,783 for individuals and eliminate the state’s current strict eligibility requirements.

Lawmakers were briefed earlier this year on a proposal to expand Medicaid through a private-public partnership model, which would not require state spending for a minimum of five years, and potentially up to ten, due to significant federal financial assistance. Nevertheless, Alabama remains one of the few states that has yet to expand Medicaid under the Affordable Care Act, leaving many Black Alabamians vulnerable to the ongoing Medicaid cuts.