ADPH seeking budget increase to cover Children’s Health Insurance Program

State Health Officer Dr. Scott Harris speaks at an Alabama Department of Public Health meeting on Jan. 18, 2024 in Montgomery. (Alander Rocha/Alabama Reflector)

The head of the Alabama Department of Public Health said Tuesday that an increase in their department’s budget was due to increases in enrollment and state costs for the Children’s Health Insurance Program (CHIP).

Dr. Scott Harris, Alabama’s State Health Officer, made the remarks amid questions from Sen. Greg Albritton, R-Atmore, the chair of the Senate Finance and Taxation General Fund committee, who asked for clear explanations on how federal and state funds are being used, especially given a estimated budget increase of about $42 million (32%) for the 2026 fiscal year.

“You’re heading in the direction that we thought we might be headed, and that is the crashing and burn scenario where money is in demand,” Albritton said.

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Of the $42 million increase, $34.6 million is due to the increased Children’s Health Insurance Program (CHIP) state match.

Harris said that CHIP, which provides low-cost health coverage to children in families that earn too much money to qualify for Medicaid, has seen an increase in enrollment and costs. A pandemic-era federal restriction prohibited states from terminating Medicaid coverage in exchange for more federal funds. As a result, Harris said, children who lost CHIP coverage were enrolled in Medicaid and stayed there until terminations started in June 2023.

Harris also said that the federal government changes the CHIP match rate each year, and it’s higher this year after being cut and frozen for three years during the pandemic.

“More money is almost completely explained by the CHIP match,” Harris said to Albritton.

“I’m not denigrating the plan at all. I’m just trying to figure out where we’re going to get that money yesterday,” Albritton responded, adding that in past years, it has been 100% funded by the federal government.

The State Health Officer also discussed ADPH’s various services, including disease control, emergency response, and health facility inspections. Harris said ADPH is responding to a syphilis outbreak among newborns , or congenital syphilis, a severe and potentially life-threatening infection seen in newborns whose mothers were infected and did not receive complete treatment. ADPH estimates that cases of congenital syphillis rose from four in 2012 to 42 in 2022, a tenfold increase.

Harris also said they are leading a pilot program for perinatal care in underserved counties set to launch in October, a pilot program Gov. Kay Ivey proposed in the Feb. 6 State of the State address .

Harris also mentioned the department’s efforts in curbing substance use disorder by providing county health departments naxalone, an opioid-overdose antidote, and said the department is closely monitoring the bird flu outbreak affecting dairy farms in some states.

The hearing also featured presentations from the Alabama Department of Veterans Affairs (ADVA) and the Legislative Services Agency (LSA). ADVA provided an overview of its operations, describing its role in supporting veterans through educational programs, long-term care homes, and veteran service offices. The agency operates with a budget of approximately $230 million, with 46% coming from state funding and 54% from federal funding.

Kirk Fulford, deputy director of the LSA, discussed the state’s financial outlook. He warned that future revenue from interest on state deposits is unpredictable but said the outlook for next year’s General Fund budget is promising. Fulford said the state has already raised enough in the General Fund to meet its obligation next fiscal year.

“The projection looks like the number is leveling out in terms of growth to be seen. We were exponentially high over the past couple three years, and so the number of the growth rate will come down,” Fulford said.

Budget hearings for state agencies will likely continue through August, Albritton said.

“We’re trying to plan out how best to look at what we can get done as soon as we can and prepare thoroughly — with seat belts tight so we don’t get jolted too much,” Albritton said in between hearings.

The Alabama Law Enforcement Agency and the Alabama Department of Mental Health are scheduled to present their budget outlook on Wednesday.

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