- Associated Press - Wednesday, August 5, 2015

MONTGOMERY, Ala (AP) - The Alabama House of Representatives on Wednesday narrowly approved a deep cut to the state’s Medicaid program as lawmakers continue to deadlock on a solution to the budget shortfall.

The budget cut came out of frustration over the stalemate and is largely seen as a way to build pressure on lawmakers to find some sort of compromise. But opponents called it a dangerous gamble with the health care of the state’s most vulnerable people.

House Ways and Means General Fund Committee Chairman Steve Clouse said it will put the focus of the budget debate on Medicaid, which consumes more than one-third of the general fund and is the largest funding challenge for lawmakers. Clouse said the health care program for the poor and disabled is also the “foundation for our health care system in the state of Alabama” - but he said many voters don’t understand the importance of funding it the way they do schools, roads or even prisons.

“I think people need to realize the importance of Medicaid to our communities, to hospitals, to nursing homes, rural health clinics, doctors and nurses,” Clouse said.

House members voted 46-44 for the budget amendment that would give Medicaid a $156 million reduction. The budget now goes to the Alabama Senate, where lawmakers have been even less supportive of tax increases.

The proposed cut drew harsh criticism, and no praise, during three hours of debate on the House floor.

“The services we are going to eliminate in this process are going to be life-threatening to many people,” said Rep. Pebblin Warren, D-Tuskegee.

State Health Officer Don Williamson said he was uncertain the program could function under such cuts. The cut drew immediate pushback from hospitals, nursing homes, the AARP and other groups.

“This isn’t a game. People’s health and livelihoods are at stake,” said Jim Carnes, policy director at Arise Citizens’ Policy Project, and advocacy group for the state’s poor.

Clouse proposed the funding cut Tuesday after the House budget committee rejected a 25-cent per pack tax increase on cigarettes.

Republicans proposed the tax increase but did not have enough votes in their own party to move it out of committee. Democrats voted against the tax, and House Black Caucus members said they will not vote for the taxes unless other ideas, such as Medicaid expansion under the Affordable Care Act or more comprehensive tax reform, are on the table for discussion.

House members Wednesday at first voted down the budget cut by one vote. Lawmakers came back and narrowly approved it.

Gov. Robert Bentley called lawmakers into special session to address a projected shortfall in the state’s general fund. Lawmakers have so far rejected Bentley’s call for $302 million in new taxes but have yet to get a solution of their own through either chamber.

“It’s chaos. The tension here is so thick, and there are so many factions,” said Rep. Patricia Todd, D-Birmingham.

Clouse said his preference is to have a second special session just on Medicaid funding. Regardless, he thought a second special session would be required as lawmakers continue to deadlock.

Senate Finance and Taxation General Fund Chairman Arthur Orr said he thought the chance of getting an answer in a single special session was, “less than 50 percent.”

“And declining,” Orr said.

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