WASHINGTON, D.C. — Defend Forgotten America (DFA) today announced a new research initiative from Stefan Grow, former Chief of Staff for Florida’s Medicaid agency, offering policy solutions to keep Alabama rural and small urban hospitals open without raising taxes. President Donald J. Trump’s Big Beautiful Bill (BBB) restores conservative accountability to Medicaid while giving strong, well-run states the flexibility they need to serve their citizens better. However, outdated federal Medicaid reimbursement rules are punishing fiscally responsible states like Alabama and putting rural and small hospitals at risk.
That’s why DFA has launched a research report to help Alabama to do more with less. Under Governor Kay Ivey (R-AL), Alabama runs one of the most disciplined Medicaid programs in the country. It balanced its budget, rejected Medicaid expansion, and protected taxpayers. Yet, due to federal wage index formulas, Alabama hospitals receive the lowest reimbursement rates in the continental United States, threatening closures and service cuts in rural and small-urban communities.
“Alabama has spent responsibly and protected taxpayers—and now its rural and small urban hospitals are facing challenges due to outdated bureaucratic rules. Conservative states shouldn’t be punished for doing things right,” said DFA Executive Director Jenn Pellegrino. “It’s time to empower Alabama’s conservative leaders with practical, lawful tools to strengthen Medicaid, protect taxpayers, and ensure that federal dollars work for the people of Alabama—not the Washington swamp.
DFA’s research supports the efforts of Alabama’s congressional delegation, including Senators Katie Britt and Tommy Tuberville, to push federal regulators to correct regional reimbursement disparities using existing authority.
View the full report here.
