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Alabama health insurance

Why Alabama is ranked 47th in 'healthiness,' – and how Obamacare might help

alabama guide to health insurance

By editor
July 31, 2014

If you live in Alabama – or you’re considering moving to the state – you should certainly be aware of the state’s perceived “healthiness.”

There are plenty of factors that might affect your own perception of the state’s attitudes toward providing health coverage and health care. We’ve put together a partial list for your consideration.

Alabama health ratings

The Commonwealth Fund’s Scorecard on State Health System Performance, 2014, rated Alabama 44th among the 50 states and District of Columbia. That means the state has dropped two spots since the 2009 rankings by The Commonwealth Fund.

Take a closer look at Alabama’s measurements.

The most recent edition of America’s Health Rankings (2013 edition) also measured the state’s “healthiness” and ranked Alabama #47 of the 50 states … down two spots from the 2012 assessment. The state’s ranking was hurt by factors that included the prevalence of obesity, low birthweight and high infant mortality.

For yet another look at health indicators that might explain Alabama’s health rating, check out the 2014 listing of Key Health Data About Alabama, compiled by Trust for America’s Health.

Alabama and Obamacare

In 2010, Alabama’s Congressional delegation opposed the health reform law. Senators Jeff Sessions and Richard Shelby both voted no on the law while six Alabama representatives voted no in the House.

At the state level, Gov. Robert Bentley indicated early on that he would support a state-run health insurance exchange, but ultimately sided with the state legislature, which decided to cede exchange control to federal government.

How the ACA could help Alabama

According to figures from The Henry J. Kaiser Family Foundation, an astounding 46 percent of Alabama’s 660,000 uninsured nonelderly residents were eligible for financial assistance under the ACA.
As of April 2014, 97,870 Alabama residents* were enrolled in qualified health plans (QHPs).

* This population includes legal U.S. residents who were uninsured, nongroup purchasers with incomes above Medicaid and CHIP eligibility levels.)

Alabama enrollment in QHPs

A quick look at the uninsured population in Alabama before and after implementation of Obamacare reveals that 15.97 percent of Alabamans were uninsured before implementation and 15.44 percent (projected) after implementation. That would suggest a .53 percent decrease in the uninsured population.

Medicaid expansion and Alabama

Alabama’s opposition to the Affordable Care Act also meant that the state opted to not accept Obamacare’s Medicaid expansion. As a result, 29 percent of Alabama’s uninsured nonelderly population fell into the coverage gap. Gov. Bentley has, however, proposed a Medicaid reform plan that could mean expansion by 2015.

See a full overview of Alabama’s Medicaid and CHIP programs.

Other reform provisions in Alabama

The Affordable Care Act established a federal loan program to encourage the creation of nonprofit, consumer-run health insurance issuers – called Consumer Operated and Oriented Plans (CO-OPs).  By January of 2013, 24 CO-OPs had received loans totaling $1.98 billion. Alabama is not one of the states. See a map of the states receiving CO-OP loans

Does Alabama have a high-risk pool?

Before the ACA reformed the individual health insurance market, coverage was underwritten in nearly every state, including Alabama.  Because pre-existing conditions were a factor in eligibility for coverage, some people were unable to purchase a private plan at all, or were only able to get one that excluded their pre-existing conditions.

The Alabama Health Insurance Plan (AHIP) was created in 1998 to give applicants an option for coverage if they were ineligible to purchase individual health insurance because of their medical history.  But unlike risk pools in many other states, AHIP was only available to applicants who were HIPAA eligible, coming off of a group plan with no more than a 63 day gap in coverage.

Under the ACA, all new health insurance policies became guaranteed issue starting on January 1, 2014. This change largely eliminated the need for high risk pools and MCHA stopped enrolling new members as of January 1, 2014.  In March, the Alabama Senate passed SB 123, allowing AHIP to “cease operations upon allowing current participants enough time to transition out of the plan.”  But the plan website has not yet announced a termination date for existing members.

State-based health reform legislation

Here’s a summary of recent Alabama bills related to healthcare reform:

More Alabama resources

Alabama state health insurance exchange

Alabama’s exchange

Find out what your state’s health insurance exchange will look like.


$4 million to 13,556 families

Insurance companies were forced to return an average of $518 per Alabama family in 2012.


Find out how your member of the Alabama Congressional delegation voted on health care.

AL state government resources

Alabama Department of Insurance, consumer page

Alabama Department of Insurance provides regulation of the insuance industry to provide consumer protection and help maintain market…

Alabama Department of Senior Services

Medicare resources (state health insurance assistance program) and more for Alabama’s older…

Alabama Medicaid Agency

The state/federal program that pays for medical and long-term care services for low-income pregnant women, children, certain people on Medicare, disabled individuals and nursing home residents – has income and other…

All Kids

All Kids is Alabama’s SCHIP program – providing low-cost, comprehensive health insurance for children 18 years and…

Alabama health insurance companies

Celtic Ins. Co.
Golden Rule

Health insurance for AL individuals

Resources for those individuals seeking health care insurance in Alabama. If you are looking for Alabama Medicare, visit our site for health insurance over 65.