Alabama House committee OKs bill allowing Medicaid to sue parents over health insurance
Rep. Ben Robbins, R-Sylacauga, speaks to a colleague on the floor of the Alabama House of Representatives on Feb. 12, 2025 at the Alabama Statehouse in Montgomery, Alabama. HB 177, sponsored by Robbins, would allow Medicaid to sue some parents who fail to enroll their children in available employer-sponsored health insurance.(Brian Lyman/Alabama Reflector)
An Alabama House committee Wednesday approved a bill that would allow Medicaid to sue some parents who don't enroll their children in employer-provided health insurance when available.
HB 177, sponsored by Rep. Ben Robbins, R-Sylacauga, would require some parents to place their children on employer-provided health insurance and would mandate that custodial parents with access to employer-sponsored health insurance enroll their Medicaid-eligible children in those plans. It would also give judges discretion to order noncustodial parents paying child support to do the same. If a parent fails to comply, Medicaid would have the authority to seek reimbursement through a civil lawsuit.
'If you are a parent that has employer provided insurance, you need to put your child on your insurance and not have more Medicaid,' Robbins said to committee members.
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The bill passed with an amendment by Rep. Kerry Underwood, R-Tuscumbia, requiring attempts by Medicaid to seek reimbursement to comply with state and federal law. The amendment also removed a provision that the Centers for Medicare & Medicaid Services (CMS) would have a lien on any amount recovered through a court order.
Robyn Hyden, executive director of Alabama Arise, a policy advocacy group focused on poverty issues, raised concerns about affordability, arguing that low-income parents may struggle to pay for employer-sponsored coverage. Hyden said that insurance costs can consume a significant portion of a low-wage worker's income.
'One example I would use is a friend I know who works at Advance Auto Parts. Her take-home pay is $600 a week, or $32,000 a year, so she could opt in to pay for health insurance through her employer, [but] it would take more than one-third of her paycheck,' Hyden said.
But Robbins said the bill is a cost-saving measure, saying it ensures parents who have the means to provide health insurance for their children do so.
'That's the ultimate goal of the bill, to incentivize noncustodial parents that can afford it, to take the responsibility they should take, and have the state have the mechanism to get their money back,' Robbins said.
Other opponents worried about unintended consequences, particularly the financial burden on parents who already struggle to make ends meet. Apreill Hartsfield, policy and data analyst with VOICES for Alabama Children, said that there are about 200,000 adults in Alabama who can't afford health insurance through their employer but don't make enough to qualify for Medicaid.
'If they can't afford the insurance anyway, we just want that recognized by the legislation and to make sure that those aren't some of those unintended consequences,' Hartsfield said.
Dr. Marsha Raulerson, a pediatrician representing the Medical Association of the State of Alabama on Medicaid Agency's Medical Care Advisory Committee, questioned after the committee meeting whether judges always act in the best interest of children or the mother, saying that she lost count on how many mothers have legal issues with fathers and 'they never get anything right from the court.'
'Why should anything that has to do with the child's health care be something that's at the discretion of a judge?' Raulerson asked.
Committee members questioned how the bill would be enforced and who would oversee compliance.
Robbins responded that while Medicaid would monitor cases, enforcement would largely happen in court.
'If you go in front of a judge, and the judge enters an order, and you don't follow it, then you're in contempt of court,' Robbins said. 'That could mean you go to jail.'
The bill now moves to the House.
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