Healthcare (Medicaid)

SB 152 increases the administrative funding for Alabama's food stamp program from 5% to 7.5% of statewide benefits issued, directly affecting the Department of Human Resources (DHR). It also changes how the Children's Health Insurance Program (CHIP) is funded by removing its requirement to be prioritized against use tax revenue, instead allowing other state revenue sources to support CHIP. The bill amends specific sections of Alabama law to adjust the distribution of sales and use tax funds, ensuring DHR receives a fixed annual amount for food stamp administration while providing flexibility for CHIP funding. These changes are limited to administrative adjustments in tax fund allocation, with no new program benefits or eligibility changes.

HB 251 appropriates $36.6 million from Alabama's Children First Trust Fund and $43.8 million from other tobacco settlement funds for the 2027 fiscal year. These funds are allocated to specific state agencies - including the Alabama Medicaid Agency, Department of Early Childhood Education, and Youth Services - to support children's health, education, and social services programs. The bill requires tobacco settlement revenues to be deposited into the Children First Trust Fund within 30 days of receipt and mandates quarterly allocations to agencies based on available funds. It also transfers funds currently designated for the State Board of Education to the State General Fund during fiscal year 2027. All allocations are conditional on receiving tobacco revenues and must align with approved investment plans for each agency.

HB 232 permanently extends a 6% tax on net patient revenue from privately operated hospitals in Alabama, which currently funds Medicaid payments but was scheduled to expire on September 30, 2028. This tax, described as a "cost of doing business" for these hospitals, requires them to pay the assessment annually to support Medicaid hospital payments. Funds collected go into the Hospital Assessment Account, which must be used exclusively for hospital payments and cannot replace other state Medicaid funding. The bill removes the sunset clause, making the tax permanent for all privately operated hospitals in the state.

SB 61 requires Alabama's Medicaid Agency and the State Department of Human Resources to verify eligibility for Medicaid and food assistance (SNAP) through regular data matching with state agencies, instead of accepting self-attested information. It prohibits using categorical eligibility for SNAP benefits (where eligibility for one program automatically qualifies for another) and mandates that SNAP income/asset standards align strictly with federal limits. The bill also requires monthly checks of death records, incarceration, and residency data, and quarterly reviews of employment and tax records to confirm ongoing eligibility. Additionally, it mandates public reporting of aggregated fraud investigation data and sets certification periods for SNAP benefits based on household characteristics.

HB 258 requires timely repair of customized manual or motorized wheelchairs, directly affecting elderly and disabled users who rely on these devices. It mandates that repair providers complete repairs within 10 business days (with specific deadlines for assessment and part ordering), eliminates the need for new prescriptions or prior authorization for repairs from Medicaid or private insurance, and requires Medicaid to cover medically necessary repairs. The bill also forces wheelchair manufacturers to supply parts, tools, and documentation to independent repair shops on the same terms as their own authorized providers, and violations would be treated as deceptive trade practices. These changes aim to reduce repair delays and improve access to essential mobility equipment.

SB 153 appropriates $36.6 million from Alabama's Children First Trust Fund and $43.8 million from other tobacco settlement funds for the fiscal year ending September 30, 2027. The funds will be distributed quarterly to child and family services agencies, including the Alabama Department of Human Resources ($8.85M) and Alabama Medicaid Agency ($1.39M), based on tobacco settlement revenues received within 30 days. The bill requires written notifications of allocations by the State Director of Finance, conditions funding on actual tobacco revenue receipt, and transfers a portion of the fund to the State General Fund for the State Board of Education. Unused funds remain in the Children First Trust Fund rather than reverting to the general budget.